Skip to content
ClinCalc Pro
Menu
Calculators Drugs Pathways AI Dx Donate Get the App
Topical retinoid + antimicrobial Pregnancy: Contraindicated in pregnancy and in women planning a pregnancy. There are no or limited data from topical adapalene use in pregnant women; animal studies by the oral route have shown reproductive toxicity at high systemic exposure. If used during pregnancy, or if the patient becomes pregnant, treatment should be discontinued. Can be used during breast-feeding, but application to the chest should be avoided to prevent contact exposure of the infant.

Adapalene with benzoyl peroxide

Brand names: Epiduo

This fixed-combination topical gel pairs the retinoid adapalene with benzoyl peroxide for mild-to-moderate acne with both comedonal and inflammatory lesions.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Apply a thin film of gel to the entire acne affected areas, on clean and dry skin
Route: Topical (cutaneous use only)
Frequency: Once a day, in the evening
Source is the UK SPC for Adapalene / Benzoyl Peroxide Zentiva 0.1%/2.5% gel — a true fixed-dose combination label, so both components are covered. Apply with the fingertips, avoiding the eyes and lips. If irritation occurs, the patient should be directed to apply non-comedogenic moisturisers, to use the medication less frequently (e.g. every other day), to suspend use temporarily, or to discontinue use altogether. The duration of treatment should be determined by the doctor on the basis of the clinical condition; early signs of clinical improvement usually appear after 1 to 4 weeks of treatment. Patients should wash their hands after applying. Should not be applied to damaged skin (broken, cuts or abrasions, eczematous or sunburned) and should not come into contact with the eyes, mouth, nostrils or mucous membranes — if the product enters the eye, wash immediately with warm water. Avoid excessive exposure to sunlight or UV radiation. Avoid contact with any coloured material including hair and dyed fabrics as this may cause bleaching and discoloration. Paediatric: safety and effectiveness have not been studied in children below 9 years of age (no paediatric dose stated). Verify any under-18 use against a children's formulary.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

  • Hypersensitivity to adapalene, benzoyl peroxide or to any of the excipients
  • Pregnancy
  • Women planning a pregnancy

Side effects

  • Dry skin (common)
  • Irritative contact dermatitis and skin irritation (common)
  • Skin burning sensation (common)
  • Erythema (common)
  • Skin exfoliation / scaling (common)
  • Pruritus and sunburn (uncommon); post-marketing: allergic contact dermatitis, facial swelling, skin pain (stinging), blisters, skin discolouration, urticaria, application site burn (including second-degree or severe burns), eyelid oedema, throat tightness, dyspnoea, anaphylactic reaction

Interactions

  • No interaction studies have been performed; from previous experience with adapalene and benzoyl peroxide there are no known interactions with other medicinal products used cutaneously and concurrently
  • Other retinoids, benzoyl peroxide, or medicinal products with a similar mode of action should not be used concurrently
  • Cosmetics with desquamative, irritant or drying effects — caution, may produce additive irritant effects
  • Systemic interaction is unlikely: absorption of adapalene through human skin is low, and benzoyl peroxide penetration is low with complete metabolism to rapidly eliminated benzoic acid

Clinical monograph

How it works

Adapalene normalises follicular keratinisation while benzoyl peroxide is bactericidal against Cutibacterium acnes and keratolytic, giving complementary actions on acne pathways.

Prescribing in practice

  • Avoid in pregnancy because of the retinoid component, and advise effective contraception in women of childbearing potential.
  • Benzoyl peroxide bleaches hair and dyed fabrics, so warn patients about contact with clothing, towels and bedding.
  • Combined irritation can be greater than with either agent alone, so introduce gradually and apply to dry skin.

Monitoring

No laboratory monitoring is needed; assess skin tolerability and acne response at review.

Counselling the patient

  • Apply once daily in the evening to clean, dry skin after washing.
  • It may bleach coloured fabrics and hair, and increases sun sensitivity, so use sun protection.
  • Expect some dryness and peeling early on, which usually improves with continued use.

Evidence & guidelines

NICE recommends fixed topical combinations including adapalene with benzoyl peroxide as first-line options for acne vulgaris.

Reference: NICE NG198 acne 2021; BAD Acne Guideline; SmPC Epiduo; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Calculators
Pathways