Acidum Acelaicum – Indications, Contraindications

Acidum Acelaicum/Azelaic Acid is a naturally occurring dicarboxylic acid produced by Malassezia furfur and found in whole grain cereals, rye, barley, and animal products. Azelaic acid possesses antibacterial, keratolytic, comedolytic, and anti-oxidant activity. Azelaic acid is bactericidal against Propionibacterium acnes and Staphylococcus epidermidis due to its inhibitory effect on the synthesis of microbial cellular proteins. Azelaic acid exerts its keratolytic and comedolytic effects by reducing the thickness of the stratum corneum and decreasing the number of keratohyalin granules by reducing the amount and distribution of filaggrin in epidermal layers. Azelaic acid also possesses a direct anti-inflammatory effect due to its scavenger activity of free oxygen radicals. This drug is used topically to reduce inflammation associated with acne and rosacea.

Azelaic acid is a saturated dicarboxylic acid found naturally in wheat, rye, and barley. It is also produced by Malassezia furfur, also known as Pityrosporum ovale, which is a species of fungus that is normally found on human skin. Azelaic acid is effective against a number of skin conditions, such as mild to moderate acne when applied topically in a cream formulation of 20%. It works in part by stopping the growth of skin bacteria that cause acne, and by keeping skin pores clear. Azelaic acid’s antimicrobial action may be attributable to inhibition of microbial cellular protein synthesis.

Another Name of Azelaic Acid

• 1,9-nonanedioic acid
• Acide azélaïque
• Ácido azelaico
• Acidum acelaicum
• Acidum azelaicum
• Anchoic acid
• Azelaic acid
• Azelainsäure
• Lepargylic acid
• n-nonanedioic acid
• Nonandisäure
• Nonanedioic acid

Contraindications of Azelaic Acid

• Data or information not available

Dosage of Acidum Acelaicum

Strengths: 20%; 15%; 15% with emollients

Acne

• 20% Cream Formulations: Apply a thin layer to the affected area(s) 2 times a day

Acne Rosacea

• 15% Gel/Foam Formulations: Apply a thin layer to the affected area(s) 2 times a day

Pediatric Dose for Acne

12 years and older

• 20% Cream Formulations: Apply a thin layer to the affected area(s) 2 times a day

Side Effects Of Acidum Acelaicum

The Most Common

• Burning, stinging, or tingling of the skin
• dryness, itching, peeling, or redness of the skin
• ashen-grey discoloration of the skin
• blistering, peeling, or loosening of the skin
• bloody or cloudy urine
• chills or fever
• cough
• decreased amount of urine or less frequent urination
• increased sensitivity of the skin to sunlight, especially for patients with burns on large areas
• red skin lesions, often with a purple center
• sore throat
• sores, ulcers, or white spots on lips or in mouth
• swollen glands
• unusual bleeding or bruising
• unusual tiredness or weakness

Common

• signs of kidney problems (e.g., increased urination at night, decreased urine production, blood in the urine)
• signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
• any mouth sores
• cold or flu-like symptoms (such as fever or sore throat)
• confusion
• changes in mood or emotions
• difficulty sleeping or nightmares
• headache
• loss of appetite
• stomach pain
• tiredness or fatigue
• vomiting
• weakness

Rare

• signs of posterior encephalopathy syndrome (e.g., headache, seizures, visual disturbances, altered mental state)
• signs of reduced red blood cells (e.g., fatigue, a general feeling of being unwell, weakness, dizziness, fainting, pale skin, pale stool)
• swelling or tingling in your hands or feet
• blistering, peeling, or loosening of the skin
• blue-green to black skin discoloration
• dark urine
• fever with or without chills
• general body swelling
• increased sensitivity of the skin to sunlight, especially in patients with burns on large areas
• joint pain, stiffness, or swelling
• large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
• swelling of the eyes
• nausea or vomiting
• pinpoint red spots on the skin
• red skin lesions, often with a purple center
• red, swollen skin
• Blurred vision
• muscle cramps
• numbness or pain in the legs

Drug Interactions of Acidum Acelaicum

Since caffeine, alcohol, isotretinoin the nicotine from cigarettes or street drugs can affect the action of many medications, you should let your prescriber know if you use them. Depending on your specific circumstances, your doctor may want you to

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

Pregnancy Category of Acidum Acelaicum

Pregnancy

This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding

This medication may pass into breast milk. If you are a breast-feeding mother and are using azelaic acid, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding. The safety and effectiveness of using this medication have not been established for children.

References

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