|Therapeutic Area||Formulary Choices||Cost for 28|
(unless otherwise stated)
|Rationale for decision / comments|
|13.6.2 Oral preparations for acne|
|Antibacterials||Doxycycline||100mg capsules: £0.91 (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.
|408mg capsules: £4.56 (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.
|Hormonal||Co-Cyprindiol||2000/35mcg 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.