Erythromycin / Benzoyl Peroxide (Benzamycin)

Topical Antibiotic / Topical Antibacterial

Erythromycin / Benzoyl peroxide is available as a prescription topical treatment. It is available in gel form.

  • Available forms:

    • Topical treatment: 

      • Gel / Jelly:
        • Brand names (US):
          • Benzamycin®
          • Aktipak®
          • Benzamycin Pak®
            Generic available (US)
  • Available in these doses: (Erythromycin / Benzoyl peroxide)

    • Gel / Jelly: 3% erythromycin / 5% benzoyl peroxide

Dosing information:

Erythromycin / Benzoyl peroxide is available in a gel-form and is usually applied twice a day.

  • Who is it for? 

    • Gender:
      • Males and females
    • Severity of acne:
      • Moderate-to-severe
    • Age:
      • Children of 12 years and older, adolescents, and adults 

How to use it:

Erythromycin / Benzoyl peroxide is a topical treatment and is available as a gel or jelly, and is usually applied twice a day. Try to apply the gel around the same time every day, to make sure that you do not forget it.

Wait 30 minutes to apply the medication after washing or shaving because the alcohol present in the medication may irritate freshly washed of shaved skin. 

Do not wash the acne-affected skin too often because this may dry the skin and make your acne worse. Washing with water and a mild cleanser two times a day should be sufficient. Check this with your physician and ask your physician to recommend you a moisturizer if necessary.

Continue applying the medication even if you do not see a lot of improvement at the start because it may take up to 8 to 12 weeks to see the full effect of this medication. Increasing the dose or frequency will not make the medication work faster. Check with your physician if there is no effect after 3 to 4 weeks or if your acne becomes worse.

If your physician has prescribed another topical treatment for your acne, it is best to apply the second treatment at least 1 hour after you applied the first treatment to avoid skin irritation. Furthermore, the treatments may not work properly if the medications are used close together. 

Mild stinging of burning may occur when using erythromycin / benzoyl peroxide which may last up to a few minutes. If the skin irritation persists, consult your physician. 

Do not get erythromycin / benzoyl peroxide in your eyes, nose, or mouth. If it does get into your eyes, wash your eyes with a generous amount of water and seek medical attention if there is any irritation. 

Erythromycin / Benzoyl peroxide should not be used on skin that is not intact. If any erythromycin / benzoyl peroxide gets into a cut or scrape, rinse it off with water. 

Follow the instructions on your prescription carefully and use erythromycin / benzoyl peroxide exactly as prescribed by your physician. Do not change the dose or the frequency of your medication. Increasing the dose or frequency may cause skin irritation. Do not use the medication after the expiration date because the medication may not work properly anymore. If you have any questions about the medication or the prescription, ask your physician or pharmacist. 

  • Gel / Jelly:
    • Wash your hands with soap and water before using the medication.
    • Before applying erythromycin / benzoyl peroxide gel / jelly, wash the acne-affected skin with water and a mild cleanser. Pat the skin dry with a soft towel. 
    • Apply a pea-sized amount of gel / jelly and spread evenly on the acne-affected skin.
    • After applying the medication, check in the mirror of there is a white film on your skin which means that you have used too much gel / jelly. 
  • Single-dose pouch:
    • Open the pouch with your fingers or scissors and squeeze the contents onto the palm of your hand. Use your fingertips to thoroughly blend the clear and white gel, coming from the two compartments of the pouch, using 5 to 10 circular motions before applying on the acne-affected skin. Do not blend the gel near an open flame and apply the gel immediately after mixing.
    • After application of the medication, throw away the pouch (if applicable) and wash your hands.

Be aware of: 

  • Before using erythromycin / benzoyl peroxide, let your physician or pharmacist know if you are allergic to erythromycin, benzoyl peroxide, or any of the other ingredients in the gel. 
  • Before using erythromycin / benzoyl peroxide, inform your physician about the prescription and non-prescription medications, vitamins, nutritional supplements, and herbal products you are using/taking. You will find a complete list of drug interactions below.
  • Before using erythromycin / benzoyl peroxide, inform your physician if you have currently suffer from or have ever suffered from any medical condition.
  • Before using erythromycin / benzoyl peroxide, tell your physician of you suffer from severe diarrhea or fungal infections because erythromycin / benzoyl peroxide may make these conditions worse.
  • Erythromycin and benzoyl peroxide may make your skin more sensitive to direct sunlight. Avoid unnecessary or prolonged exposure to real and artificial sunlight (including tanning beds and sunlamps), and use sunscreen with an SPF of at least 15, especially if you tend to get sunburned easily. Wear sunglasses and protective clothing.
  • Erythromycin / benzoyl peroxide gel / jelly is flammable so do not mix, apply, or store near an open flame.
  • You may use cosmetics while using erythromycin / benzoyl peroxide however it is best to use “oil-free” cosmetics. Heavily or frequent use of cosmetics may make you acne worse. Consult your physician if you have any questions. 
  • Do not use other topical treatment, including peeling agents, without consulting your physician first because this may cause skin irritation or dryness. 
  • Erythromycin / Benzoyl peroxide may cause bleaching of hair or colored fabric. 
  • If you are using erythromycin / benzoyl peroxide and are pregnant or are planning on becoming pregnant, talk to your physician about using erythromycin / benzoyl peroxide during pregnancy.
  • If you are using erythromycin / benzoyl peroxide and are breastfeeding, talk to your physician about using erythromycin / benzoyl peroxide during this period.
  • If erythromycin / benzoyl peroxide was prescribed for acne, you can continue your regular diet unless your physician advises otherwise.
  • Do not share your medication with anyone else. 
  • Keep your regular appointments with your physician to track your response to erythromycin / benzoyl peroxide.

Drug interactions: 

Inform your physician or pharmacist about all the prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take before starting erythromycin benzoyl peroxide. Also inform your physician or pharmacist of the skin products you use including soaps, cleansers, moisturizers, and cosmetics. 

Drugs that should not be used with erythromycin / benzoyl peroxide at all are:

  • Amifampridine
  • Amisulpride
  • Astemizole
  • Bepridil
  • Cisapride
  • Colchicine
  • Dihydroergotamine
  • Dronedarone
  • Ergoloid Mesylates
  • Ergonovine
  • Ergotamine
  • Flibanserin
  • Fluconazole
  • Grepafloxacin
  • Levomethadyl
  • Lomitapide
  • Lovastatin
  • Mesoridazine
  • Methylergonovine
  • Methysergide
  • Pimozide
  • Piperaquine
  • Posaconazole
  • Saquinavir
  • Simvastatin
  • Sparfloxacin
  • Terfenadine
  • Thioridazine
  • Ziprasidone
Full list of drug interactions (From PubMed and Medline Plus)
  • Acalabrutinib
  • Acecainide
  • Afatinib
  • Ajmaline
  • Alfentanil
  • Alprazolam
  • Amiodarone
  • Amitriptyline
  • Amlodipine
  • Amoxapine
  • Anagrelide
  • Anisindione
  • Apomorphine
  • Aprepitant
  • Aprindine
  • Aripiprazole
  • Aripiprazole Lauroxil
  • Arsenic Trioxide
  • Ascorbic Acid
  • Asenapine
  • Atorvastatin
  • Avanafil
  • Azimilide
  • Azithromycin
  • Bedaquiline
  • Benzhydrocodone
  • Bexarotene
  • Bosutinib
  • Bretylium
  • Brexpiprazole
  • Bromocriptine
  • Budesonide
  • Buprenorphine
  • Buserelin
  • Buspirone
  • Carbamazepine
  • Ceritinib
  • Cerivastatin
  • Chloral Hydrate
  • Chloroquine
  • Chlorpromazine
  • Cholera Vaccine, Live
  • Cilostazol
  • Ciprofloxacin
  • Citalopram
  • Clarithromycin
  • Clindamycin
  • Clomipramine
  • Clozapine
  • Cobicistat
  • Cobimetinib
  • Codeine
  • Colchicine
  • Conivaptan
  • Crizotinib
  • Cyclobenzaprine
  • Cyclosporine
  • Dabrafenib
  • Darunavir
  • Dasatinib
  • Deflazacort
  • Degarelix
  • Delamanid
  • Desipramine
  • Deslorelin
  • Deutetrabenazine
  • Diazepam
  • Dibenzepin
  • Dicumarol
  • Digoxin
  • Dihydrocodeine
  • Diltiazem
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Domperidone
  • Donepezil
  • Doxepin
  • Doxorubicin
  • Doxorubicin Hydrochloride Liposome
  • Droperidol
  • Efavirenz
  • Eliglustat
  • Encainide
  • Enflurane
  • Eplerenone
  • Escitalopram
  • Fentanyl
  • Fingolimod
  • Flecainide
  • Fluoxetine
  • Fosaprepitant
  • Foscarnet
  • Gatifloxacin
  • Gemifloxacin
  • Gonadorelin
  • Goserelin
  • Granisetron
  • Halofantrine
  • Haloperidol
  • Halothane
  • Histrelin
  • Hydrocodone
  • Hydroquinidine
  • Hydroxychloroquine
  • Hydroxyzine
  • Ibrutinib
  • Ibutilide
  • Idelalisib
  • Ifosfamide
  • Iloperidone
  • Imipramine
  • Inotuzumab Ozogamicin
  • Isoflurane
  • Isradipine
  • Ivabradine
  • Ivacaftor
  • Ketoconazole
  • Lapatinib
  • Leuprolide
  • Levofloxacin
  • Lidoflazine
  • Lopinavir
  • Lorcainide
  • Lovastatin
  • Lumacaftor
  • Lumefantrine
  • Lurasidone
  • Macimorelin
  • Mefloquine
  • Meperidine
  • Methadone
  • Methylprednisolone
  • Metronidazole
  • Midazolam
  • Mifepristone
  • Morphine
  • Morphine Sulfate Liposome
  • Moxifloxacin
  • Nafarelin
  • Naloxegol
  • Neratinib
  • Netupitant
  • Nilotinib
  • Norfloxacin
  • Nortriptyline
  • Octreotide
  • Ofloxacin
  • Olaparib
  • Ondansetron
  • Oxycodone
  • Paliperidone
  • Panobinostat
  • Pasireotide
  • Pazopanib
  • Pentamidine
  • Pentazocine
  • Phenprocoumon
  • Phenytoin
  • Pimavanserin
  • Pirmenol
  • Pitavastatin
  • Pitolisant
  • Pixantrone
  • Prajmaline
  • Probucol
  • Procainamide
  • Prochlorperazine
  • Promethazine
  • Propafenone
  • Protriptyline
  • Quetiapine
  • Quinidine
  • Quinine
  • Ranolazine
  • Ribociclib
  • Risperidone
  • Roflumilast
  • Salmeterol
  • Sematilide
  • Sertindole
  • Sertraline
  • Sevoflurane
  • Sildenafil
  • Simeprevir
  • Simvastatin
  • Sirolimus
  • Sodium Phosphate
  • Sodium Phosphate, Dibasic
  • Sodium Phosphate, Monobasic
  • Solifenacin
  • Sonidegib
  • Sorafenib
  • Sotalol
  • Spiramycin
  • Sufentanil
  • Sulfamethoxazole
  • Sulpiride
  • Sultopride
  • Sunitinib
  • Suvorexant
  • Tacrolimus
  • Tadalafil
  • Tedisamil
  • Telaprevir
  • Telavancin
  • Telithromycin
  • Tetrabenazine
  • Tezacaftor
  • Theophylline
  • Tizanidine
  • Tolterodine
  • Tolvaptan
  • Topotecan
  • Toremifene
  • Tramadol
  • Trazodone
  • Triazolam
  • Trifluoperazine
  • Trimethoprim
  • Trimetrexate
  • Trimipramine
  • Triptorelin
  • Troleandomycin
  • Valproic acid
  • Vandetanib
  • Vardenafil
  • Vasopressin
  • Vemurafenib
  • Venetoclax
  • Verapamil
  • Vinblastine
  • Vincristine
  • Vincristine Sulfate Liposome
  • Vinflunine
  • Voriconazole
  • Warfarin
  • Zafirlukast
  • Zolmitriptan
  • Zotepine
  • Zuclopenthixol

What if I overdose? 

In case of overdose, contact an emergency facility or call the American Association of Poison Control Centers at 1 (800) 222-1222 (available 24/7).

If immediate assistance is necessary because the victim has collapsed, had a seizure, has trouble breathing, or cannot be awakened, call 911 at once.

Information can also be found online at https://www.poisonhelp.org/help

What if I miss a dose?

As soon as you recall that you have missed a dose, apply the missed dose. However, skip the missed dose if it is almost time for your next dose and continue with your prescribed dosing schedule. Do not increase the quantity or frequency of dosing to make up for the missed dose.

Storage:

Store your medication in the container that the pharmacist provided and keep it out of reach and out of sight of children. Many containers can be opened by children. Keep the container tightly closed. Always lock safety caps and immediately place the medication in a safe location that is up and away from the sight of young children, to prevent poisoning (www.upandaway.org).

Store the medication at room temperature. Keep the medication away from excessive heat and moisture – do not store in the bathroom. Do not freeze erythromycin / benzoyl peroxide.

Aktipak® and Benzamycin Pak® 

Do not open the foil pouch until use. Store the medication at room temperature. Keep the medication away from excessive heat, direct light, and moisture (do not store in bathroom). Do not freeze Aktipak® or Benzamycin Pak®.

Benzamycin® topical gel

Store the medication in the refrigerator, away from excessive heat and direct light. You can still store the medication in the refrigerator if you have forgotten to do so for 1 day. Do not freeze Benzamycin®. Dispose of unused medication after 3 months.

Disposal:

Do not keep outdated medication and medication that you no longer use. Unneeded medications should be disposed of in a way that pets, children, and other people cannot consume them. Do not flush the medication down the toilet. Contact your pharmacist to learn about the availability of a medicine take-back program in your neighborhood, or get in touch with your local garbage/recycling department to ensure safe disposal. If you do not have access to a take-back program, you can find more information on safe disposal of medication on the FDA website: (https://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/EnsuringSafeUseofMedicine/SafeDisposalofMedicines/ucm186187.htm)

References
  1. MedlinePlus. (2018). Erythromycin and benzoyl peroxide [online]. Available at: https://medlineplus.gov/druginfo/meds/a603024.html. [Accesses 12 Sept. 2018]. 
  2. PubMed Health. (2018). Erythromycin and benzoyl peroxide. Available at: https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0045181/. [Accessed 12 Sept. 2018].
  3. Uptodate.com. (2018). Erythromycin and benzoyl peroxide [online] Available at: https://www-uptodate-com.eresources.mssm.edu/contents/erythromycin-and-benzoyl-peroxide-drug-information?search=erythromycin%20benzoyl%20peroxide&source=search_result&selectedTitle=1~11&usage_type=default&display_rank=1. [Accessed 12 Sept. 2018].