This combination product contains two medications, tretinoin and erythromycin, and is used to treat certain types of acne. Tretinoin helps acne by exfoliating the skin's outer layer, which helps to reduce the formation of blackheads, whiteheads, and other acne lesions. Erythromycin belongs to the family of medications known as antibiotics. It works by killing bacteria that cause acne. You may see improvement in your acne after 2 to 3 weeks of using this medication, with full effect after 8 to 10 weeks of treatment.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

Tretinoin - erythromycin topical should be applied once daily (preferably at bedtime) to lightly cover the areas being treated. Your doctor may suggest that you apply this medication every other day for the first few weeks of treatment. Wash your hands thoroughly before and after applying this medication.

The area of application should be thoroughly cleansed with a mild soap and water and patted dry with a soft towel. Apply a small amount on your fingertip and spread it on the skin where acne lesions appear. Use only enough medication to cover the affected areas lightly. You may feel a warm or stinging sensation briefly after applying. In the morning wash your face using a mild soap.

Keep the medication away from the corners of the nose, mouth, eyes, and mucous membranes. Avoid applying excess amounts as the medication may run into the eyes and other areas that should be avoided. Avoid areas of the skin where you have other problems such as eczema, severely inflamed skin, or open skin lesions. After you wash your skin in the morning, it is recommended that you apply a moisturizer or a moisturizer with sunscreen that will not aggravate your acne. If you experience severe inflammation you should stop using the product.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is important to use this medication exactly as prescribed by your doctor. If you miss an application, skip the missed application and continue with your regular dosing schedule. Do not apply a double amount to make up for a missed application. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature and keep it out of the reach of children. Gel products are flammable and should be kept away from heat or flame.

Do not use erythromycin - tretinoin if you:

• are allergic to tretinoin, other retinoids, erythromycin, or to any of the ingredients of the medication.
• are pregnant

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

It is normal for you to feel a brief warm or stinging sensation when applying this product. Your skin may also become drier or oilier than normal. You may also experience a temporary increase or decrease of skin colour. Contact your doctor or pharmacist if these side effects are severe or bothersome.

If your skin becomes excessively irritated, you may need to temporarily stop using this product or use it less frequently.

Check with your doctor as soon as possible if any of the following side effects occur:

• excessively red, swollen, blistered, crusted, or cracked skin
• pain, burning sensation, tenderness, severe irritation, or itchy skin

Stop taking the medication and seek immediate medical attention if any of the following occur:

• symptoms of a serious allergic reaction (e.g., hives; swelling of the face, mouth, hands, or feet; and difficulty breathing)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Application: Avoid contact with the eyes, eyelids, angles of the nose, mouth, easily irritated areas, or other areas where treatment is not intended. Do not apply tretinoin - erythromycin topical to severely inflamed skin or to open lesions. Do not use more of this medication than recommended by your doctor. Doing so will not speed up treatment and will irritate your skin.

Skin care: Cosmetics may be used, but thoroughly cleanse the areas to be treated before applying the medication. Try to avoid products applied to the skin that have high concentrations of alcohol, spices, or lime as they cause stinging and burning on treated skin. If possible, avoid using harsh abrasives and other skin treatments, including sunlamps, while using this medication.

Hair removal is permitted (e.g., plucking, electrolysis, depilatories), but avoid these procedures at night before applying tretinoin - erythromycin topical as they may result in skin irritation.

Permanent wave solutions, waxing preparations, and medicated soaps and shampoos can sometimes irritate skin that is not being treated with this medication. Use caution so that these products do not come into contact with skin treated with tretinoin.

Skin irritation: Some people may experience temporary skin irritation, especially in early weeks of treatment. Should excessive reactions occur and the skin becomes extremely red, swollen, and crusted, the medication should be stopped and you should contact your doctor.

An apparent worsening may develop due to the medication's effect on existing deep lesions. This is a normal part of the treatment effect. Treatment should be continued.

Sunlight exposure: Exposure to sunlight, including ultraviolet sunlamps, may cause more irritation. Therefore, avoid or minimize this type of exposure during the use of tretinoin. If you cannot avoid exposure to sunlight, use sunscreen products (minimum SPF 15) and wear protective clothing over treated areas. If you get a sunburn, stop using this medication until skin redness and peeling resolves.

Pregnancy: This medication is not recommended for use during pregnancy. Women who may become pregnant should use an effective method of birth control while they are using this medication. If you become pregnant while using this medication, stop using it and contact your doctor.

Breast-feeding: Erythromycin passes into breast milk. It is not known if tretinoin passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children.

There may be an interaction between tretinoin - erythromycin and any of the following:

• clindamycin containing products
• medicated or abrasive soaps and cleansers
• medications that increase the skin's sensitivity to sunlight (e.g., isotretinoin, sulfamethoxazole, trimethoprim, minocycline)
• other medications applied to the skin
• products with high concentrations of alcohol, astringents, spices, or lime
• skin preparations containing sulfur, resorcinol, benzoyl peroxide, or salicylic acid
• soaps and cosmetics with a strong drying effect

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.