Therapeutic AreaFormulary ChoicesCost for 28
(unless otherwise stated)
Rationale for decision / comments
13.6.2 Oral preparations for acne
AntibacterialsDoxycycline100mg capsules: £1.13 (8)Oral antibiotic treatment should be reviewed after 3 months; however maximum benefit may only be seen after 4 to 6 months.
Oxytetracycline has been removed from this section: possibility of poor compliance with dosing requirements in long term use.
or
Lymecycline
408mg capsules: £9.55 (28)
Minocycline is not recommended owing to safety concerns: requires LFT monitoring when used >6 months.
Higher cost and lack of evidence of superiority over Lymecycline in acne.
HormonalCo-Cyprindiol2000/35mcg tablets: £5.42 (63)The risk of VTE with Co-Cyprindiol is higher than with conventional low-dose COCPs and recommend that:
• it should only to be used after systemic antibiotics have failed or are not tolerated
• it should only be used in licensed indication
• it should not be used solely for contraception
• it should be discontinued 3-4 months after resolution of symptoms
The evidence in favour of co-cyprindiol over other oral contraceptives in reducing acne lesion counts is limited.