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Topical Antibiotic/Antiprotozoal — Rosacea

Metronidazole Topical

Brand names: Rozex, Metrogel, Metrosa

Used in: Sepsis Acute Appendicitis

Topical metronidazole is an antimicrobial and anti-inflammatory preparation applied to the face for the inflammatory papules and pustules of rosacea.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

In rosacea its benefit is attributed mainly to anti-inflammatory and antioxidant effects on the skin rather than to a classical antibacterial mechanism.

Prescribing in practice

  • For external use only; avoid contact with the eyes and apply only to affected areas of the face.
  • Advise avoidance of excessive sunlight, as some patients report photosensitivity.
  • Apply a thin film to the affected skin once or twice daily as directed, and expect a gradual response over weeks.

Monitoring

Monitoring is clinical, assessing improvement in inflammatory rosacea lesions and any local irritation or dryness.

Counselling the patient

  • Apply a thin layer to the affected areas as directed and keep it away from the eyes.
  • Improvement is gradual, so continue the treatment course even if results are slow.
  • Avoid known rosacea triggers and protect your face from strong sun.

Evidence & guidelines

Topical metronidazole is an established first-line option for papulopustular rosacea and is recommended within NICE clinical guidance.

Reference: BAD Rosacea Guidelines 2017; ATTRACT Trial (Taieb et al. Br J Dermatol 2015); NICE CKS Rosacea; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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