Selected Systemic Medications Acne Treatment
| Medication | Dosage | Side Effects |
|---|---|---|
| Erythromycin | 250 mg bid-qid; with meals | N/V/D, abdominal pain and cramps, rash, stomatitis, elevated liver transaminase levels, jaundice |
| Doxycycline | 50-100 mg qd-bid (or 20 mg bid subantimicrobial dose); with meals | N/V/D, photosensitivity, stomatitis, discolored teeth (if <8 yr), esophagitis, lightheadedness, dizziness, vertigo, headache, pseudotumor cerebri |
| Tetracycline | 500 mg bid; take on empty stomach | Same as doxycycline |
| Minocycline | 50-100 mg qd-bid; with meals | Same as doxycycline (except less photosensitivity), plus rare lupus-like syndrome, or rare hypersensitivity reaction, and skin and mucous membrane hyperpigmentation |
| Isotretinoin | Start at 0.5-1 mg/kg/day. After 1 mo, full dose of 1 mg/kg/day to cumulative dose of 120-150 mg/kg (usually 15-20 wk) Lab tests: CBC, TG, ALT, B-hCG—baseline & monthly | Common: cheilitis, dry skin and mucous membranes, pruritus, epistaxis, conjunctivitis, photosensitivity, arthralgia, hypertriglyceridemia, elevated liver transaminase levels, decreased night vision Rare: pseudotumor cerebri, hepatotoxicity, major birth defects (Counsel regarding birth control/abstinence), cataracts, neutropenia thrombocytopenia, reported cases of depression |
N/V/D=5-nausea/vomiting/diarrhea.