Attention, chocolate lovers: You may not be able to help yourselves. Swiss and British scientists have linked the widespread love of chocolate to a chemical "signature" that may be programmed into our metabolic systems.
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E R Y G E L®
ERYTHROMYCIN TOPICAL GEL USP 2%
RX Only
For Dermatologic Use Only - Not for Ophthalmic Use
DESCRIPTION:
ERYGEL® Topical Gel contains erythromycin ((3R*, 4S*, 5S*, 6R*, 7R*, 9R*, 11R*, 12R*, 13S*, 14R*)-4-[(2, 6-Dideoxy-3-C-methyl-3-O-methyl-α-L-ribo-hexopyranosyl)oxy]-14-ethyl-7, 12, 13-trihydroxy-3, 5, 7, 9, 11, 13-hexamethyl-6-[[3, 4, 6,-trideoxy-3-(dimethylamino)-Β-D-xylo-hexopyranosyl]oxy] oxacyclotetradecane-2, 10-dione), for topical dermatological use. Erythromycin is a macrolide antibiotic produced from a strain of Saccaropolyspora erythraea (formerly Streptomyces erythreus). It is a base and readily forms salts with acids.
Chemically, erythromycin is C37H67NO13. It has the following structural formula:
Erythromycin has a molecular weight of 733.94. It is a white or slightly yellow, odorless or practically odorless, bitter crystalline powder. Erythromycin is very soluble in very polar organic solvents such as alcohols, acetone, chloroform, acetonitrile and ethyl acetate. It is moderately soluble in less polar solvents such as ether, dichloroethylene and amyl acetate. It is slightly soluble in nonpolar solvents such as hexane. It is very poorly soluble in water.
Each gram of ERYGEL® Topical Gel contains 20 mg of erythromycin, USP in a base of alcohol 92% and hydroxypropyl cellulose.
CLINICAL PHARMACOLOGY:
The exact mechanism by which erythromycin reduces lesions of acne vulgaris is not fully known; however, the effect appears to be due in part to the antibacterial activity of the drug.
MICROBIOLOGY:
Erythromycin acts by inhibition of protein synthesis in susceptible organisms by reversibly binding to 50S ribosomal subunits, thereby inhibiting translocation of aminoacyl transfer-RNA and inhibiting polypeptide synthesis. Antagonism has been demonstrated in vitro between erythromycin, lincomycin, chloramphenicol, and clindamycin.
INDICATIONS AND USAGE:
ERYGEL® Topical Gel is indicated for the topical treatment of acne vulgaris.
CONTRAINDICATIONS:
ERYGEL® Topical Gel is contraindicated in those individuals who have shown hypersensitivity to any of its components.
WARNINGS:
Pseudomembranous colitis has been reported with nearly all antibacterial agents, including erythromycin, and may range in severity from mild to life-threatening. Therefore, it is important to consider this diagnosis in patients who present with diarrhea subsequent to the administration of antibacterial agents.
Treatment with antibacterial agents alters the normal flora of the colon and may permit overgrowth of clostridia. Studies indicate that a toxin produced by Clostridium difficile is one primary cause of “antibiotic-associated colitis”.
After the diagnosis of pseudomembranous colitis has been established, therapeutic measures should be initiated. Mild cases of pseudomembranous colitis usually respond to drug discontinuation alone. In moderate to severe cases, consideration should be given to management with fluids and electrolytes, protein supplementation and treatment with an antibacterial drug clinically effective against C. difficile colitis.
PRECAUTIONS:
ADVERSE REACTIONS:
In controlled clinical trials, the incidence of burning associated with ERYGEL® Topical Gel was approximately 25%. The following additional local adverse reactions have been reported occasionally: peeling, dryness, itching, erythema, and oiliness. Irritation of the eyes and tenderness of the skin have also been reported with the topical use of erythromycin. A generalized urticarial reaction, possibly related to the use of erythromycin, which required systemic steroid therapy has been reported.
DOSAGE AND ADMINISTRATION:
ERYGEL® Topical Gel should be applied sparingly as a thin film to affected area(s) once or twice a day after the skin is thoroughly cleansed and patted dry. If there has been no improvement after 6 to 8 weeks, or if the condition becomes worse, treatment should be discontinued, and the physician should be reconsulted. Spread the medication lightly rather than rubbing it in. There are no data directly comparing the safety and efficacy of b.i.d. versus q.d. dosing.
HOW SUPPLIED:
ERYGEL® (Erythromycin Topical Gel USP) 2% is supplied in plastic tubes in the following sizes: 30g - NDC 0259-4312-30 and 60g - NDC 0259-4312-60.
Note: FLAMMABLE. Keep away from heat and flame. Store and dispense in original container. Keep tube tightly closed. Store between 15° and 25°C (59° and 77°F).
Manufactured for: Merz Pharmaceuticals, Greensboro, NC 27410
© 1996 Allergan, Inc. Rev 10/01 Printed in U.S.A.
70-2057-00
03-6070-0