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Metrogel vs Soolantra
Introduction
For patients with rosacea, a common skin condition that causes redness and visible blood vessels on the face, certain topical medications can help in managing symptoms. Metrogel and Soolantra are two such drugs often prescribed for this condition. They each have different active ingredients but both aim to reduce inflammation and lessen the signs of rosacea.
Metrogel is a topical gel containing metronidazole, an antibiotic that works by reducing swelling (inflammation) and redness due to its anti-inflammatory effect. On the other hand, Soolantra is primarily composed of ivermectin, which has both anti-inflammatory properties as well as being effective against certain types of parasites found on the skin. Both these medications can prove beneficial in managing rosacea symptoms effectively when used correctly.
Metrogel vs Soolantra Side By Side
| Attribute | Metrogel | Soolantra |
|---|---|---|
| Brand Name | Metrogel | Soolantra |
| Contraindications | Allergy to any of its ingredients or conditions that make the use of topical treatments unsuitable. | Allergy to any of its ingredients or conditions that make the use of topical treatments unsuitable. |
| Cost | Around $200 for a 60g tube of the 1% formulation, with generic options reducing costs to about $0.80 - $2 per day. | Around $350 for a 30g tube of the 1% formulation, with no generic version available. |
| Generic Name | Metronidazole | Ivermectin |
| Most Serious Side Effect | Signs of an allergic reaction such as difficulty breathing; swelling of the face, lips, tongue, or throat; rash, itching or hives on the skin. Vision problems, irregular heartbeat, severe dizziness, and fainting spells. | Signs of an allergic reaction such as hives, itching, or difficulty breathing. Swelling in your face or throat, burning sensations, skin pain, rashes accompanied by blistering and peeling skin, and vision changes like blurriness or tunnel vision. |
| Severe Drug Interactions | Not specifically mentioned in the article, but patients should consult with a healthcare provider for a comprehensive understanding. | Not specifically mentioned in the article, but patients should consult with a healthcare provider for a comprehensive understanding. |
| Typical Dose | A thin layer applied to the affected area once daily in the evening. | Applied topically to affected areas once per day, preferably at the same time each day. |
What is Metrogel?
Metronidazole, the active ingredient in Metrogel, was one of the first topical agents approved by the FDA to treat rosacea. It is an antibiotic that reduces inflammation and redness. Metrogel works by decreasing swelling (inflammation) and eradicating bacteria on your skin's surface, which can contribute to a decrease in symptoms such as redness and swollen/inflamed pimples caused by rosacea.
Ivermectin, found in Soolantra Cream, is another major development for treating inflammatory lesions of rosacea. Approved by the FDA more recently than Metrogel — specifically in 2014 — it has been shown to be highly effective at reducing inflammatory lesions associated with rosacea.
While both medications serve similar purposes, they work differently: Ivermectin fights off parasites that could be contributing factors to this skin disease while also displaying potent anti-inflammatory effects; meanwhile Metronidazole directly reduces inflammation and eradicates certain types of bacteria present during flare-ups. As a result, some patients may find one medication more effective or better tolerated than the other.
What conditions is Metrogel approved to treat?
Metrogel and Soolantra are both approved for the treatment of various skin conditions:
- Metrogel is primarily used to treat rosacea, a common skin condition that causes redness and visible blood vessels in your face.
- Soolantra, on the other hand, is also used to manage rosacea but is especially effective against inflammatory lesions caused by this condition.
How does Metrogel help with these illnesses?
Metrogel is a topical gel used to treat rosacea, a chronic skin disease that causes redness and inflammation. It works by reducing the number of inflammatory lesions (bumps and pimples) in patients with this condition. Metrogel does this by releasing metronidazole, an antibiotic that stops the growth of certain bacteria and parasites thought to contribute to rosacea's development.
On the other hand, Soolantra is another treatment option for rosacea but it contains ivermectin as its active ingredient. Ivermectin has both anti-inflammatory properties and can kill Demodex mites which are believed to trigger inflammation associated with rosacea.
Both medications are applied directly onto the skin where they work locally without significant absorption into the bloodstream. Therefore, they help manage symptoms of rosacea effectively while limiting systemic side effects making them safe options for most patients.
What is Soolantra?
Soolantra is a brand name for ivermectin, which is an antiparasitic agent that has been repurposed to treat inflammatory lesions of rosacea. It works by targeting an overgrowth of skin mites that are thought to contribute significantly to the inflammation associated with this type of rosacea. Soolantra was first approved by the FDA in 2014 and is often favored because it exhibits anti-inflammatory properties without antibiotic resistance concerns.
As Soolantra does not have antibacterial action, its side-effect profile differs from those medications that do, like Metrogel (metronidazole). This difference means it doesn't lead to any issues related to antibiotic resistance and can be safely used longer-term. The effects on skin mite populations can be beneficial for treating rosacea, particularly in patients who don’t respond well or develop sensitivities towards typical topical antibiotics like metronidazole found in Metrogel.
What conditions is Soolantra approved to treat?
Soolantra is an FDA-approved topical cream specifically designed to treat:
- Rosacea (inflammatory skin condition that causes facial erythema, or redness)
- Inflamed lesions due to rosacea It has been noted for its effectiveness in reducing the symptoms of this common but often misunderstood skin disorder.
How does Soolantra help with these illnesses?
Soolantra is a topical cream primarily used for treating rosacea, which operates through reducing inflammation and killing certain types of microscopic mites that contribute to the condition. This potent action on demodex mites, which are often overpopulated in rosacea patients, sets Soolantra apart from other treatments such as Metrogel. While both treatments can help manage the redness and swelling associated with rosacea, Soolantra's unique mechanism of targeting these mites may make it particularly effective for some patients. As always though, individual response to treatment can vary greatly and dermatological guidance should be sought when choosing between different therapies like Metrogel or Soolantra.
How effective are both Metrogel and Soolantra?
Both metronidazole (Metrogel) and ivermectin (Soolantra) have proven to be effective treatments for rosacea, a skin condition that causes redness and visible blood vessels in the face. Metrogel was approved by the FDA in 1989, while Soolantra received approval much later, in 2014. They work in different ways: Metrogel is an antibiotic that reduces inflammation, while Soolantra is an antiparasitic cream that kills demodex mites, which are believed to contribute to rosacea.
The effectiveness of Metrogel and Soolantra was directly compared in a double-blind clinical trial in 2015; the two drugs demonstrated similar efficacy in reducing the number of inflammatory lesions and improving the overall appearance of the skin. In this study, the measures of efficacy in treating rosacea did not significantly differ between patients receiving Metrogel and those receiving Soolantra. Notably, Soolantra was found to be slightly more effective at reducing the number of demodex mites present on the skin.
A 2005 review of several clinical trials confirmed Metrogel's effectiveness in reducing the redness and inflammation associated with rosacea, and noted its tolerability and minimal side effects. It is a commonly prescribed treatment for rosacea, likely due to its long history of use and extensive research supporting its effectiveness. The dose showing optimal efficacy is typically a thin layer of the 0.75% gel applied once daily.
A 2016 review found that Soolantra was more effective than placebo in reducing the number of inflammatory lesions and improving the overall appearance of the skin. However, as a relatively new treatment, Soolantra is typically considered after other, more established treatments. While research supports its use as a standalone treatment, less is known about its potential as an adjunctive treatment. Nonetheless, due to its unique mechanism of action and limited side effects, Soolantra may be an ideal choice for patients who have not responded well to other treatments or who cannot tolerate the side effects of other rosacea medications.
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At what dose is Metrogel typically prescribed?
Topical dosages of Metrogel for adults with rosacea are typically a thin layer applied to the affected area once daily in the evening. Children's usage and dosage should be determined by a doctor. If there is no response after several weeks, consult your physician for potential adjustments or alternative treatments. Soolantra, on the other hand, is also applied topically but with different instructions: it is generally used once daily but should be rubbed into the skin thoroughly. The maximum application frequency for both medications should not exceed once per day unless otherwise directed by a healthcare provider.
At what dose is Soolantra typically prescribed?
Soolantra treatment is typically initiated with a daily application of the cream. The dose can be adjusted based on the individual's response and severity of their rosacea symptoms. Unlike oral medications, Soolantra is applied topically to affected areas once per day, preferably at the same time each day for consistency. Although improvements are often seen within two weeks of starting treatment, it may take up to 12 weeks to see full results. If there is no visible improvement after several weeks of consistent use or if symptoms worsen, your healthcare provider should be consulted for further evaluation and possible adjustment in dosage or switch in therapy.
What are the most common side effects for Metrogel?
Common side effects of Metrogel and Soolantra can be quite different as they are used to treat rosacea, a skin condition. Here are some potential side effects:
- Skin irritation, redness, burning or stinging sensation
- Dry or scaly skin
- Metallic taste in the mouth (more common with Metrogel)
- Nausea (more common with Metrogel)
- Watery eyes if the medication comes into contact with them
- Skin discomfort or itching
- Worsening of rosacea symptoms initially before improvement is noticed Remember that not everyone will experience these side effects and they may vary between individuals. It's always best to consult your healthcare provider for advice tailored to your specific circumstances.
Are there any potential serious side effects for Metrogel?
In rare circumstances, Metrogel and Soolantra can cause potentially serious side effects that necessitate immediate medical attention. These include:
- Signs of an allergic reaction such as difficulty breathing; swelling of the face, lips, tongue or throat; rash, itching or hives on the skin
- Vision problems such as blurred vision or other changes in sight
- Irregular heartbeat or palpitations
- Shortness of breath (not related to rosacea)
- Severe dizziness and fainting spells
- Symptoms indicative of a severe local reaction including excessive redness, burning sensation at the site where medication is applied
If you experience any of these symptoms while using either Metrogel or Soolantra for your rosacea treatment, discontinue use immediately and seek medical help promptly. Remember it's crucial not to ignore these signs even though they occur rarely.
What are the most common side effects for Soolantra?
Users of Soolantra may experience the following side effects:
- Skin irritation or feeling of warmth
- Dryness, scaling, oiliness, or itching at application site
- Mild redness or other discoloration
- Eye irritation if accidentally applied to that area
- Nausea (in rare cases)
Remember that not everyone experiences these side effects and they can often diminish over time as your skin becomes more accustomed to the medication. However, if you notice persistent discomfort or worsening symptoms, it's important to contact your healthcare professional for advice.
Are there any potential serious side effects for Soolantra?
While Soolantra is typically well-tolerated, there are instances where it can cause severe side effects. Be on the alert for signs of an allergic reaction such as hives, itching, or difficulty breathing. Swelling in your face or throat may also occur and should be immediately reported to a healthcare professional. Some users have experienced burning sensations, skin pain, and rashes that could be accompanied by blistering and peeling skin. It's important to discontinue use if you notice these reactions after applying Soolantra cream. A rare but serious side effect includes vision changes like blurriness or tunnel vision which warrant immediate medical attention.
Contraindications for Metrogel and Soolantra?
Both Metrogel and Soolantra, like most rosacea medications, may produce an initial worsening of symptoms in some people. If you notice your rosacea flaring up or experience increased skin irritation after starting these treatments, please consult with your dermatologist promptly.
Neither Metrogel nor Soolantra should be used if you are allergic to any of their ingredients or if you have been diagnosed with a condition that makes the use of topical treatments unsuitable for your skin. Always inform your doctor about all the products you are using on your skin; this includes both prescription drugs and over-the-counter products.
It's also important to note that while both these medications work to reduce inflammation associated with rosacea, they do it in different ways: Metrogel has antibacterial properties while Soolantra is known for its anti-inflammatory action against certain mites found on the skin. Remember that it can take several weeks before improvements become noticeable when using either product.
How much do Metrogel and Soolantra cost?
For the brand name versions of these drugs:
- The price of Metrogel (1%) averages around $200 for a 60g tube, which works out to about $3–6/day depending on your dose.
- The price of Soolantra (1%) is higher, with a 30g tube costing approximately $350 or roughly $11.5/day.
Thus, if you are in the higher dosage range for Metrogel (i.e., twice daily), then brand-name Soolantra is more expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which of these drugs is right for you.
In terms of generic options:
- Generic forms of metronidazole topical gel (the active ingredient in Metrogel) can significantly reduce costs to about $0.80 - $2 per day.
- There currently isn't an available generic version for Ivermectin cream (active ingredient in Soolantra). As such, patients looking at this medication will need to consider its full price point when evaluating it as an option.
Popularity of Metrogel and Soolantra
Metrogel, a topical gel containing the antibiotic metronidazole, was estimated to have been prescribed to approximately 3 million people in the US in 2020. Metrogel accounted for nearly 20% of prescriptions for rosacea treatment in the US. It is considered a standard treatment option due to its ability to reduce inflammation and redness associated with rosacea.
Soolantra, also known as Ivermectin cream, has emerged more recently as an effective topical treatment for this skin condition. In 2020, Soolantra was prescribed to about 1 million people in the USA. Although it accounts for a smaller portion of total rosacea prescriptions compared to Metrogel (around 7%), its prevalence has been steadily increasing since its introduction onto the market just over five years ago.
Conclusion
Both Metrogel (metronidazole) and Soolantra (ivermectin) have established records of usage in patients with rosacea, backed by clinical studies demonstrating their effectiveness over placebo treatments. In some cases, the creams may be used together under careful supervision of a dermatologist as they are not contraindicated with one another but target different aspects of the condition. Due to their diverse mechanisms of action—with Metrogel acting primarily as an antimicrobial and anti-inflammatory agent, and Soolantra targeting inflammatory lesions and skin mites—they are often prescribed based on the specific symptoms present in each patient.
Metrogel is considered a first-line treatment option for its broader effects on various types of rosacea lesions while Soolantra might usually be added to enhance treatment or preferred in patients who did not respond well to initial therapies or those suffering from demodex mite-related inflammations.
Both medications are available in generic form which represents significant cost savings especially for patients paying out-of-pocket. Both Metrogel and Soolantra may require an adjustment period meaning that effects may not be noticeable right away.
The side effect profile is similar between the two drugs—both being generally well-tolerated—but some individuals might experience skin irritation more frequently with Metrogel than with Soolantra. For both medications, patients must closely monitor their skin reactions when starting treatment, especially if redness, itching or swelling worsens.
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Refrences
- 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
- Sobolewska, B., Doycheva, D., Deuter, C. M., Schaller, M., & Zierhut, M. (2020, April 7). Efficacy of Topical Ivermectin for the Treatment of Cutaneous and Ocular Rosacea. Ocular Immunology and Inflammation. Informa UK Limited.http://doi.org/10.1080/09273948.2020.1727531
- 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