Clindamycin, benzoyl peroxide (Duac once daily gel)

How does it work?

Duac once daily gel contains two active ingredients, clindamycin phosphate and benzoyl peroxide, both of which are medicines used to treat acne.

Clindamycin is an antibiotic that is used to treat infections with bacteria. It works by preventing bacteria from producing proteins that are essential to them. Without these proteins the bacteria cannot grow, replicate and increase in numbers. The remaining bacteria eventually die or are destroyed by the immune system. This treats the infection.

Clindamycin is active against a wide variety of bacteria, including the bacteria associated with acne, Propionebacterium acnes. This is a common type of bacteria that feeds on sebum produced by the sebaceous glands in the skin. It produces waste products and fatty acids that irritate the sebaceous glands, making them inflamed and causing spots. By controlling bacterial numbers, the inflammation of the sebaceous glands is brought under control, and the skin is allowed to heal.

Benzoyl peroxide is a type of medicine known as a keratolytic. This means that it works by breaking down keratin, a protein which forms part of the skin structure. When you apply benzoyl peroxide to the skin it causes the top layer of skin cells to break down and shed. This helps break down comedones (blackheads and whiteheads) and unblocks the sebaceous glands. It also helps to prevent the formation of new comedones.

Benzoyl peroxide also has an antibacterial action and directly kills the Propionebacterium acnes bacteria on the skin.

These two medicines are combined in this gel to have a complementary effect on acne. Benzoyl peroxide starts to reduce the oiliness of the skin immediately, but it may take two to six weeks of treatment before the full effect of both medicines on the acne is seen.

What is it used for?

• Mild to moderate acne.

How do I use it?

• Wash the skin with a mild cleanser and pat it dry before applying the gel.
• Duac once daily gel should be applied thinly to the whole affected areas of skin (not just the individual spots) once a day in the evening. If the gel doesn't rub in easily you are applying too much.
• Wash your hands after applying the gel.
• If you experience excessive redness, dryness or peeling of your skin after using this gel, decrease the amount of gel you use and use it less frequently (or stop temporarily). If any soreness persists consult your doctor.
• Do not use this product excessively - this won't make it any more effective but will increase the chance of it irritating your skin.
• This medicine should not be used for longer than 12 weeks at a time.

Warning!

• This gel is for external use on the skin only and must not be taken by mouth.
• Avoid getting the gel in contact with the eyes, mouth, lips and mucous membranes such as the lining of the nose. Rinse the gel off with warm water if you accidentally get it on these areas.
• Avoid applying the gel to broken, irritated or sunburnt skin.
• Avoid exposing the treated areas to prolonged sunlight or to sunbeds or sunlamps. If exposure is unavoidable, use a suitable sunscreen lotion because benzoyl peroxide increases the sensitivity of your skin to sunlight.
• This product may bleach hair and coloured fabrics including clothing, towels and bed linen. Be careful to avoid getting the gel on these materials.
• When clindamycin is taken by mouth it can sometimes cause inflammation of the bowel (colitis). Although this is very unlikely to occur when you use the antibiotic on the skin, if you get diarrhoea either during or after using this medicine, particularly if it becomes severe or persistent, or contains blood or mucus, you should stop using this medicine and consult your doctor immediately.

Use with caution in

• Sensitive skin.
• People with a history of inflammation of part of the intestines (enteritis).
• People with a history of inflammation of the bowel and back passage (ulcerative colitis).
• People with a history of inflammation of the large intestine due to antibiotic treatment (antibiotic-associated colitis).

Not to be used in

• People who are allergic to benzoyl peroxide, clindamycin or the related antibiotic lincomycin.
• This medicine is not recommended for children under the age of 12 years.

This medicine should not be used if you are allergic to any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

• The safety of this medicine in pregnancy has not been fully established, although it is not expected to be harmful. It should be used with caution during pregnancy, and only if the benefits to the mother outweigh any potential risks to the developing baby. Seek further medical advice from your doctor.
• It is not known if this medicine passes into breast milk after application to the skin. Clindamycin does pass into breast milk when taken by mouth. For this reason this medicine should be used with caution during breastfeeding and only if the benefits to the mother outweigh any possible risk to the nursing infant. If you do use this medicine while breastfeeding make sure you do not apply it to areas where it could be ingested by the baby or transferred to the baby's skin while you are feeding. Stop using the medicine and consult your doctor if the child develops diarrhoea while you are using this medicine.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start using this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while using this one, to make sure that the combination is safe.

This medicine should not be used in combination with products that contain the antibiotic erythromycin.

Skin preparations such as medicated cosmetics, soaps, cleansers, toiletries and other anti-acne preparations, particularly those containing high concentrations of alcohol or astringents, should be used with caution in combination with this medicine, as they are likely to have an additive drying or irritant effect on the skin.

Products containing tretinoin, isotretinoin or tazarotene should not be used at the same time as this medicine, since benzoyl peroxide may reduce their effectiveness and increase irritation. If combination treatment is required, the products should be applied at different times of the day (eg one in the morning and the other in the evening).

Other medicines containing the same active ingredients

There are currently no other medicines available in the UK that contain both clindamycin phosphate and benzoyl peroxide as the active ingredient.

Both medicines are available separately.