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Metrogel vs Finacea
Introduction
For patients with rosacea, a skin condition that causes redness and visible blood vessels in your face, certain topical medications can help manage symptoms and improve the appearance of their skin. Metrogel and Finacea are two such drugs that are commonly prescribed for rosacea. Both have anti-inflammatory effects which can reduce the swelling, redness, and inflammation associated with this condition. Metrogel is a topical gel containing metronidazole, an antibiotic that works by reducing bacteria on the skin's surface. On the other hand, Finacea contains azelaic acid which reduces the growth of keratin surface cells on your skin that can block pores leading to acne-like symptoms often seen in rosaceans.
Metrogel vs Finacea Side By Side
| Attribute | Metrogel | Finacea |
|---|---|---|
| Brand Name | Metrogel | Finacea |
| Contraindications | Should not be used with certain antibiotics such as disulfiram or metronidazole orally, or with blood thinners like warfarin. | Not specified, but caution advised if worsening of rosacea symptoms occurs. |
| Cost | Brand-name: around $320 for a 55g tube, Generic: $0.70 - $2 per day | Brand-name: about $300 for a 50g tube, Generic: $1-$3/day |
| Generic Name | Metronidazole | Azelaic Acid |
| Most Serious Side Effect | Signs of an allergic reaction such as hives, difficulty breathing or swallowing, swelling in your face or throat. | Signs of a severe skin reaction like intense itching, burning sensation on treated areas followed by redness and dryness. |
| Severe Drug Interactions | Disulfiram, oral metronidazole, warfarin. | Not specifically mentioned, but as with any medication, interactions can occur. |
| Typical Dose | Once or twice a day, depending on the severity of the condition. | Apply to the affected area twice daily, once in the morning and once in the evening. |
What is Metrogel?
Metronidazole (the generic name for Metrogel) was the first topical gel treatment approved by the FDA for rosacea, a common skin condition. Much like how fluoxetine represented a major development in antidepressant drugs, metronidazole paved the way for advancements in topical treatments of inflammatory dermatoses such as rosacea. Metrogel works by reducing inflammation and redness caused by rosacea through its antimicrobial properties. It has minimal side effects due to its targeted action on the skin without significant absorption into blood circulation.
On the other hand, Azelaic Acid (the active ingredient in Finacea), which was approved later than metronidazole but still holds an important place among anti-rosacea agents. Just as Prozac selectively influences serotonin with lesser effects on other neurotransmitters resulting in fewer side effects, Finacea offers selective benefits that help manage symptoms of mild-to-moderate rosacea while minimizing potential adverse reactions. Its dual mode of action includes anti-inflammatory effect and inhibition of keratin production leading to fewer papules or pustules compared to traditional therapies.
What conditions is Metrogel approved to treat?
Metrogel and Finacea are both approved for the treatment of different skin conditions:
- Rosacea: MetroGel is specifically designed to treat inflammatory lesions (pimples) and redness associated with rosacea.
- Post-inflammatory hyperpigmentation: Finacea can help reduce dark spots caused by inflammation or injury to the skin, including those caused by acne. It's important to note that while they share some similarities in treating these conditions, their active ingredients differ and may result in varying side effects. Always consult your doctor before starting any new medication regimen.
How does Metrogel help with these illnesses?
Metrogel works to control the symptoms of rosacea by exhibiting antibacterial and anti-inflammatory effects. It achieves this through its active ingredient, metronidazole, which is thought to interact with bacterial DNA in a way that inhibits their ability to replicate and survive. This mechanism helps reduce inflammation and redness associated with rosacea outbreaks. On the other hand, Finacea also combats rosacea but it operates slightly differently; it contains azelaic acid as its active ingredient which not only has antimicrobial properties against some bacteria living on the skin's surface (therefore decreasing inflammation), but also helps normalize the growth of skin cells that could block pores leading to rosacea bumps and lesions. Hence both Metrogel and Finacea target different aspects contributing towards rosacea thereby helping patients manage their condition effectively.
What is Finacea?
Finacea, a brand name for azelaic acid, is an effective treatment option for mild to moderate rosacea. It works by reducing the production of keratin - a protein that can block pores and lead to acne symptoms. Finacea was first approved by the FDA in 2002. Unlike metronidazole (the active ingredient in Metrogel), which has antibacterial and anti-inflammatory properties, Finacea operates primarily as a comedolytic agent – it helps prevent the formation of comedones or skin blemishes. This unique mechanism of action means its side-effects profile differs from other treatments like Metrogel; common side effects with Finacea use may include burning, stinging or tingling sensation on application site. The benefits of using azelaic acid can be seen particularly in patients struggling with inflammatory lesions and post-acne hyperpigmentation where typical rosacea treatments might not provide satisfactory results.
What conditions is Finacea approved to treat?
Finacea is a topical medication that has been approved by the FDA for the treatment of:
- Mild to moderate rosacea, a skin condition that causes redness and pimples on your nose, cheeks, chin, and forehead.
- Acne vulgaris which is commonly referred to as acne. This includes blackheads, whiteheads, papules (pinheads), pustules (pimples), nodules (large papules) and cysts.
How does Finacea help with these illnesses?
Azelaic acid, the active ingredient in Finacea, plays a role in skin cell turnover and reduces inflammation on the skin surface. These effects help to treat pimples and redness caused by rosacea, a common skin condition. Finacea works by interfering with certain natural substances that lead to faster growth of skin cells and swelling (inflammation), thereby alleviating some symptoms of rosacea. Its action on both keratinization process (skin cell turnover) and inflammation may also contribute to its effectiveness as a topical treatment for rosacea. Since it does not significantly affect bacterial growth like Metrogel (metrodonazole), which is an antibiotic primarily used for its antimicrobial properties, Finacea can be prescribed when patients do not respond well to typical antibacterial treatments or may even be combined with them for better results.
How effective are both Metrogel and Finacea?
Both metronidazole (Metrogel) and azelaic acid (Finacea) are effective topical treatments for rosacea, a common skin condition that causes redness and visible blood vessels in the face. Metrogel was approved by the FDA several years before Finacea. They act on different biological pathways to reduce inflammation, hence they may be prescribed under varying circumstances depending upon individual patient requirements.
The effectiveness of Metrogel and Finacea was directly compared in a double-blind clinical trial in 2003; both exhibited similar efficacy in managing symptoms of rosacea along with promising safety profiles. Throughout this study, none of the metrics used to measure success differed significantly between patients receiving Metrogel or those receiving Finacea.
A 2016 review indicated that Metrogel seems to be more effective than placebo at treating rosacea but its side effect profile is not as favorable as some other treatments due primarily to skin irritation. That said, it remains one of most widely prescribed drugs for this condition worldwide.
On the other hand, a 2010 review pointed out that Finacea also appears more effective than placebo at symptom reduction and exhibits fewer reported side effects such as burning sensation or itching when compared with Metrogel. Nonetheless, while both medications have proven successful over time for many patients suffering from Rosacea, each person's response could differ based on personal factors including their specific type of disease manifestation or sensitivity to medication ingredients.
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At what dose is Metrogel typically prescribed?
Topical applications of Metrogel are recommended once or twice a day, depending on the severity of the condition. However, studies have suggested that applying it just once daily is sufficient for treating rosacea in most individuals. For children and adolescents with pediatric dermatological conditions, usage should start as directed by a healthcare provider. In all cases, if there is no improvement after several weeks of use, consult your doctor about increasing the frequency. It's important to note that excessive application does not lead to more rapid or better results and may cause increased skin irritation.
At what dose is Finacea typically prescribed?
Finacea treatment is generally started at a dosage of applying the gel to the affected area twice daily, once in the morning and once in the evening. This treatment can then be continued for several weeks, depending on your skin's response to it. Consistency with application is key when using Finacea; apply it at roughly the same times every day for optimal results. If there is no noticeable improvement in symptoms after several weeks of regular use, consult your healthcare provider for advice or potential adjustments to this skincare regimen.
What are the most common side effects for Metrogel?
While Metrogel and Finacea are both commonly prescribed for rosacea, they do come with their specific side effects. For Metrogel, these can include:
- Dryness or oiliness of the skin
- Mild burning or stinging after application
- Skin irritation around eyes
- Metallic taste in your mouth
For Finacea on the other hand, common side effects may involve:
- Burning, stinging, tingling or itching sensation upon application
- Dryness or scaling of the skin
- Rash and swelling at the site of application
- Changes in skin color
Remember that although these side effects are possible, they do not occur in everyone. It is also important to note that your healthcare provider has weighed the benefits against these potential risks before prescribing either medication.
Are there any potential serious side effects for Metrogel?
While Metrogel and Finacea are both commonly used to treat rosacea, they can have different side effects. Some potentially severe side effects of Metrogel include:
- Signs of an allergic reaction such as hives, difficulty breathing or swallowing, swelling in your face or throat
- Severe burning or stinging where the medication was applied
- Watery eyes
- Redness or other irritation of treated skin.
On the other hand, Finacea could cause:
- Signs of a severe skin reaction like intense itching, burning sensation on treated areas followed by redness and dryness.
- Swelling in your face or throat
- A light-headed feeling like you might pass out.
In rare cases with either medication - if symptoms such as irregular heartbeat become noticeable it is recommended to seek medical attention immediately. Both medications can also cause mild symptoms such as tingling and numbness, however if these persist consult with a healthcare provider promptly.
What are the most common side effects for Finacea?
Common side effects of Finacea may include:
- Mild burning or stinging of the skin
- Dryness, itching, tingling or other irritation where the medication was applied
- Numbness or tingly feeling in hands or feet
- Cold symptoms such as stuffy nose, sneezing, sore throat
- Headache and dizziness
- Changes in skin color at the place of application It's important to note that while these are common side effects, they're usually mild and go away over time. However, if any persistent discomfort emerges following its usage, it is recommended to consult a healthcare provider.
Are there any potential serious side effects for Finacea?
While Finacea is generally well-tolerated, it's important to be aware of potential side effects. These may include:
- Signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue or throat.
- Severe burning or stinging sensations on the skin after applying the medication.
- Worsening of asthma symptoms such as wheezing (sudden and severe), chest tightness, trouble breathing.
- Changes in skin color at the application site.
If you experience any severe reactions like these after using Finacea, stop usage immediately and seek medical attention. It's always crucial to monitor your body's response when starting a new treatment regimen.
Contraindications for Metrogel and Finacea?
Both Metrogel and Finacea, as with most other rosacea medications, may worsen symptoms of rosacea in some people. If you notice your rosacea worsening or an increase in redness, swelling, or irritation after applying these medications, please seek immediate medical attention.
Neither Metrogel nor Finacea should be used if you are taking certain antibiotics such as disulfiram or metronidazole orally. Always tell your physician which medications you are taking; these antibiotics will require a period of about 2 weeks to clear from the system to prevent dangerous reactions with Metrogel and Finacea. Similarly, using them concurrently with blood thinners like warfarin can lead to bleeding complications requiring medical intervention.
How much do Metrogel and Finacea cost?
For the brand-name versions of these drugs:
- The price of a 55g tube of Metrogel (1%) averages around $320, which works out to $5.80–$11.60 per day, depending on your dose.
- The price for a 50g tube of Finacea (15%) is about $300, working out to approximately $6/day.
Thus, if you are using less than half a gram of Metrogel per day then it may be more cost-effective compared with Finacea. However, cost should not be the primary consideration in determining which one is right for you as both have different active ingredients and indications.
For the generic versions:
- Metronidazole gel (the active ingredient in Metrogel) costs considerably less at about $0.70 - $2 per day based on typical dosages used.
- Azelaic acid gel (the active ingredient in Finacea) also has significantly reduced costs at around an average of just over a dollar ($1-$3/day).
Remember that prices can vary widely depending on where you buy these medications and whether or not they're covered by insurance.
Popularity of Metrogel and Finacea
Metrogel (metronidazole) and Finacea (azelaic acid) are two topical medications frequently prescribed for the treatment of rosacea, a chronic skin condition that causes redness and visible blood vessels in your face.
In 2020, Metrogel was estimated to have been prescribed to approximately 4.7 million people in the US. This accounted for nearly 30% of all prescriptions given out for rosacea treatments. Metrogel has maintained a steady prevalence since it was first introduced as an effective treatment option.
Finacea, on the other hand, saw about 3 million prescriptions filled in the same year. While it accounts for around 20% of rosacea medication prescriptions, its usage has been increasing over time due to its dual anti-inflammatory and keratolytic properties that can help alleviate both papules/pustules and background erythema associated with mild-to-moderate rosacea.
Conclusion
Both Metrogel (metronidazole) and Finacea (azelaic acid) have a long-standing record of usage in patients with rosacea, backed by numerous clinical studies indicating that they are more effective than placebo treatments. These topical medications may sometimes be used together to manage different symptoms of rosacea but this is subject to careful consideration by a physician due to possible skin irritation from concomitant use.
Metrogel works primarily as an anti-inflammatory agent, while Finacea has dual functionality: it acts as an anti-inflammatory agent and also helps unblock pores. The choice between these two largely depends on the specific symptoms present in the patient's condition. Metrogel is often considered first-line treatment for inflammatory lesions in rosacea, whereas Finacea might be preferred if comedones ("blackheads" or "whiteheads") are significantly present.
Both drugs are available in generic form, which can offer significant cost savings especially for patients who must pay out-of-pocket. Both Metrogel and Finacea require consistent application over several weeks before improvement begins to show.
The side effect profile of both drugs includes potential skin irritation such as dryness, stinging or burning sensations; however these reactions tend to lessen over time or upon reduction of frequency of application. Patients should monitor their skin response closely when starting treatment and seek immediate medical help if severe discomfort occurs or if symptoms do not improve after regular use.
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Refrences
- Elewski, B. E., Fleischer, A. B., & Pariser, D. M. (2003, November 1). A Comparison of 15% Azelaic Acid Gel and 0.75% Metronidazole Gel in the Topical Treatment of Papulopustular Rosacea. Archives of Dermatology. American Medical Association (AMA).http://doi.org/10.1001/archderm.139.11.1444
- Gollnick, H., & Layton, A. (2008, September 19). Azelaic acid 15% gel in the treatment of rosacea. Expert Opinion on Pharmacotherapy. Informa Healthcare.http://doi.org/10.1517/14656566.9.15.2699
- Frampton, J. E., & Wagstaff, A. J. (2004). Azelaic Acid 15% Gel. American Journal of Clinical Dermatology. Springer Science and Business Media LLC.http://doi.org/10.2165/00128071-200405010-00009
- Dahl, M. V., Jarratt, M., Kaplan, D., Tuley, M. R., & Baker, M. D. (2001, November). Once-daily topical metronidazole cream formulations in the treatment of the papules and pustules of rosacea. Journal of the American Academy of Dermatology. Elsevier BV.http://doi.org/10.1067/mjd.2001.116219
- Thomas, K., Yelverton, C. B., Yentzer, B. A., Balkrishnan, R., Fleischer, A. B., Jr, & Feldman, S. R. (2009, January 1). The cost-effectiveness of rosacea treatments. Journal of Dermatological Treatment. Informa UK Limited.http://doi.org/10.1080/09546630802314662
- Scheinfeld, N., & Berk, T. (2010, January). A Review of the Diagnosis and Treatment of Rosacea. Postgraduate Medicine. Informa UK Limited.http://doi.org/10.3810/pgm.2010.01.2107
- Elewski, B. E., Fleischer, A. B., & Pariser, D. M. (2003, November 1). A Comparison of 15% Azelaic Acid Gel and 0.75% Metronidazole Gel in the Topical Treatment of Papulopustular Rosacea. Archives of Dermatology. American Medical Association (AMA).http://doi.org/10.1001/archderm.139.11.1444
- Dahl, M. V., Katz, H. I., Krueger, G. G., Millikan, L. E., Odom, R. B., Parker, F., … Czernielewski, J. M. (1998, June 1). Topical Metronidazole Maintains Remissions of Rosacea. Archives of Dermatology. American Medical Association (AMA).http://doi.org/10.1001/archderm.134.6.679