{ "schema_version": 1, "kind": "condition", "id": "acne-rosacea", "name": "Acne rosacea (papulopustular rosacea)", "category": "chronic", "sources": "Egyptian National Drug Formulary - Antimicrobial 2023 (doxycycline monograph) · Rozex 0.75% w/w Gel SmPC sections 4.2 and 4.4 (eMC product 925) · UK eMC Skinoren 15% Gel / Finacea 15% Gel SmPC (LEO Pharma), product id 10926 · Rosacea - disease-level clinical article (acne-rosacea-full.txt)", "review_status": "reviewed", "verified_against": "Egyptian National Drug Formulary - Antimicrobial 2023 (doxycycline monograph) · Rozex 0.75% w/w Gel SmPC sections 4.2 and 4.4 (eMC product 925) · UK eMC Skinoren 15% Gel / Finacea 15% Gel SmPC (LEO Pharma), product id 10926 · Rosacea - disease-level clinical article (acne-rosacea-clinical.txt) · Acne rosacea (papulopustular rosacea) - disease-level clinical article (acne-rosacea-full.txt) · Rosacea - disease-level clinical article (acne-rosacea-full.txt)", "verified_date": "2026-08", "treatments": [ { "id": 19, "generic": "Metronidazole", "line": 1, "is_adjunct": false, "form": "topical", "strength_mg": null, "adult_dose": "Apply 0.75% gel or cream thin layer to affected facial areas twice daily", "adult_duration": "The average period of treatment is three to four months.", "dose_source": "Rozex 0.75% w/w Gel SmPC sections 4.2 and 4.4 (eMC product 925)", "rationale": "Topical anti-inflammatory antibiotic that calms the papules and pustules of rosacea, most likely by damping local reactive oxygen species and inflammatory activity rather than by killing bacteria outright; well tolerated on facial skin, which is why it is used first-line.", "cautions": [ "Avoid contact with eyes and mucous membranes.", "Local skin irritation, erythema, and dryness may occur.", "Avoid exposure to strong UV light during treatment.", "Rosacea takes time - the label puts the average course at three to four months, and it may be continued beyond that if it is clearly working. Keep treated skin out of the sun." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Paediatric population : Not recommended. Safety and efficacy have not been established.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "ROSAGEL 0.75% GEL 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 11.5, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FIPCODAZOLE 10 MG GEL", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "D B K > BOSTON HEALTH", "price_egp": 62.0, "pack_count": null, "unit_price": null, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "acne-rosacea" }, { "id": 20, "generic": "Azelaic acid", "line": 1, "is_adjunct": false, "form": "topical", "strength_mg": null, "adult_dose": "Apply a thin layer of 15% gel or 20% cream twice daily (morning and evening) to affected areas of the face", "adult_duration": null, "dose_source": "UK eMC Skinoren 15% Gel / Finacea 15% Gel SmPC (LEO Pharma), product id 10926", "rationale": "Topical dicarboxylic acid with anti-inflammatory, antimicrobial, and mild comedolytic action that reduces the papules and pustules of rosacea; a first-line topical alternative to metronidazole.", "cautions": [ "Initial transient skin burning, stinging, or pruritus is common in first 1-2 weeks.", "There is a hypopigmentation risk in dark-skinned individuals; monitor closely." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "The safety and efficacy of Finacea Gel for the treatment of papulopustular rosacea in children below the age of 18 years have not been established.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "AZECLEAR 20% CREAM 30 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BIOPHARM EGYPT > SAJA PHARMA", "price_egp": 21.6, "pack_count": null, "unit_price": null, "strength_mg": 30000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "EZALIC 20% CREAM 30 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MULTI-APEX", "price_egp": 26.4, "pack_count": null, "unit_price": null, "strength_mg": 30000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SKINOREN 20% CREAM 30 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "INTENDIS MANUFACTURING SPA-ITALY > BAYER HEALTHCARE", "price_egp": 35.5, "pack_count": null, "unit_price": null, "strength_mg": 30000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AZADERM 20% CREAM 30 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 87.0, "pack_count": null, "unit_price": null, "strength_mg": 30000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "acne-rosacea" }, { "id": 21, "generic": "Referral & safety-netting (no drug therapy)", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": null, "adult_duration": null, "dose_source": "Rosacea - disease-level clinical article (acne-rosacea-clinical.txt)", "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.", "cautions": [ "RED FLAG - Ocular symptoms need ophthalmic evaluation or referral." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": null, "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [], "condition_id": "acne-rosacea" }, { "id": 18, "generic": "Doxycycline", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 50.0, "adult_dose": "By what the rosacea is doing, and for 8 to 12 weeks in each case. Papules and pustules: sub-antimicrobial modified-release doxycycline 40 mg daily (30 mg immediate-release plus 10 mg delayed-release beads). Inflamed phyma: 100 mg once or twice daily. Ocular rosacea: sub-antimicrobial modified-release 40 to 100 mg daily.", "adult_duration": "6-12 weeks", "dose_source": "Rosacea - disease-level clinical article (acne-rosacea-full.txt)", "rationale": "At the low, sub-antimicrobial dose used here, doxycycline works through its anti-inflammatory action, inhibiting the enzymes and neutrophil activity that drive rosacea's inflammation, rather than acting as an antibiotic; added orally when topical treatment alone is not enough.", "cautions": [ "Contraindicated in pregnancy and children <8 years (permanent dental staining and bone growth inhibition). Doxycycline 100 mg Capsules SmPC says, in section 4.2, \"Doxycycline should not be used in children aged younger than 8 years due to the risk of teeth discolouration\", in section 4.3, \"Doxycycline is contraindicated in pregnancy\", and in section 4.4 that tetracyclines used during tooth development \"may cause permanent discolouration of the teeth (yellow-grey-brown)\" and that \"Enamel hypoplasia has also been reported\".", "Photosensitivity reaction; instruct patient to use broad-spectrum sun protection.", "Take with full glass of water while standing to avoid esophageal ulceration." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Use under 8 years only for a severe or potentially life-threatening infection, or where no better alternative exists - the risk is permanent tooth discoloration and enamel hypoplasia during tooth development. Where it is justified: 2.2 mg/kg every 12 hours, maximum 100 mg per dose.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "DOXYCOST 50MG 30 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PENTA PHARMA", "price_egp": 51.0, "pack_count": 30, "unit_price": 1.7, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "acne-rosacea" } ] }