Azelaic Acid Topical (patient information)

# Why this medication is prescribed
Azelaic acid gel is used to clear the bumps, lesions, and swelling caused by rosacea (a skin disease that causes redness, flushing, and pimples on the face). Azelaic acid cream is used to treat acne. Azelaic acid is in a class of medications called dicarboxylic acids. It works to treat acne by killing the bacteria that infect pores and by decreasing production of keratin, a natural substance that can lead to the development of acne. The way azelaic acid works to treat rosacea is not known.

# How this medication should be used
Azelaic acid comes as a gel and a cream to apply to the skin. It is usually applied twice a day, in the morning and the evening. To help you remember to use azelaic acid, use it at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use azelaic acid exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.
Azelaic acid controls acne and rosacea but does not cure these conditions. It may take 4 weeks or longer before you feel the full benefit of azelaic acid. Continue to use azelaic acid exactly as directed even if you do not notice much improvement at first.
To use the cream or gel, follow these steps:
- Wash the affected skin with water and a mild soap or soapless cleansing lotion and pat dry with a soft towel. Ask your doctor to recommend a cleanser, and avoid alcoholic cleansers, tinctures, abrasives, astringents, and peeling agents, especially if you have rosacea.
- Apply a thin layer of cream or gel to the affected skin. Gently and thoroughly massage it into the skin. Be careful not to get the medication in your eyes or mouth. If you do get azelaic acid in your eyes, wash with plenty of water and call your doctor if your eyes are irritated.
- Do not cover the affected area with any bandages, dressings,or wrappings. You may apply non-irritating make up over the medication after it is dry.
- Wash your hands with soap and water after you finish handling the medication.

# Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

# Special precautions
Before taking azelaic acid:
- tell your doctor and pharmacist if you are allergic to azelaic acid or any other medications.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking.
- tell your doctor if you have or have ever had any medical condition.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking azelaic acid, call your doctor.
- you should know that azelaic acid may cause changes in your skin color, especially if you have a dark complexion. Tell your doctor if you notice any changes in your skin color.

# Special dietary instructions
If you have rosacea, you should avoid foods and drinks that cause you to flush or blush. These may include alcoholic drinks, spicy foods, and hot drinks such as coffee and tea.
If you have acne, continue your normal diet unless your doctor tells you otherwise.

# What to do if you forget a dose
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

# Side Effects

## Minor Side Effects
Azelaic acid may cause side effects. The following symptoms are likely to affect the skin you are treating with azelaic acid cream or gel. Tell your doctor if any of these symptoms are severe or do not go away:
- itching
- burning
- stinging
- tingling

## Severe Side Effects
Some side effects can be serious. The following symptom is uncommon, but if you experience it, call your doctor immediately:
- rash
Azelaic acid may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online  or by phone .

# Storage conditions needed for this medication
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

# Other information
Keep all appointments with your doctor.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

# Brand names
- Azelex
- Finacea

# Other names
- Heptanedicarboxylic acid
- Lepargylic acid