Metrolotion 0.75% Top Lotn 59ml
It is used to treat rosacea.It may be given to you for other reasons. Talk with the doctor.
Drug Class
Anti-rosacea agent
Pharmacologic Class
Nitroimidazole
Pregnancy Category
Category B
FDA Approved
Mar 1998
DEA Schedule
Not Controlled
Overview
What is this medicine?
Metrolotion is a topical medication used to treat rosacea, a skin condition that causes redness and bumps on the face. It helps reduce inflammation and the number of pimple-like lesions.
How to Use This Medicine
Proper Use of This Medication
To use this medication correctly, follow your doctor's instructions and read all the information provided. Wash your hands before and after applying the medication. Use it as directed, even if your symptoms improve.
Application Instructions
Do not take this medication by mouth. It is for skin use only. Avoid getting it in your mouth, nose, or eyes, as it may cause burning.
Clean the affected area before applying the medication and dry it thoroughly.
Apply a thin layer to the affected skin and gently rub it in.
You can apply makeup after the skin has dried.
Important Interactions and Precautions
Before using other drugs or products on your skin, including soaps, consult with your doctor.
Storage and Disposal
Store this medication at room temperature and do not freeze it.
Keep all medications in a safe place, out of the reach of children and pets.
* Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so. If you have questions about disposal, consult your pharmacist. You may also have access to drug take-back programs in your area.
Missed Dose Instructions
If you miss a dose, apply it as soon as you remember. However, if it is close to the time for your next dose, skip the missed dose and continue with your regular schedule. Do not apply two doses at the same time or use extra doses.
To use this medication correctly, follow your doctor's instructions and read all the information provided. Wash your hands before and after applying the medication. Use it as directed, even if your symptoms improve.
Application Instructions
Do not take this medication by mouth. It is for skin use only. Avoid getting it in your mouth, nose, or eyes, as it may cause burning.
Clean the affected area before applying the medication and dry it thoroughly.
Apply a thin layer to the affected skin and gently rub it in.
You can apply makeup after the skin has dried.
Important Interactions and Precautions
Before using other drugs or products on your skin, including soaps, consult with your doctor.
Storage and Disposal
Store this medication at room temperature and do not freeze it.
Keep all medications in a safe place, out of the reach of children and pets.
* Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so. If you have questions about disposal, consult your pharmacist. You may also have access to drug take-back programs in your area.
Missed Dose Instructions
If you miss a dose, apply it as soon as you remember. However, if it is close to the time for your next dose, skip the missed dose and continue with your regular schedule. Do not apply two doses at the same time or use extra doses.
Lifestyle & Tips
- Cleanse affected areas before applying the lotion.
- Apply a thin layer to the entire affected area, not just individual lesions.
- Wash hands thoroughly after applying the medication.
- Avoid contact with eyes, nose, mouth, and other mucous membranes. If contact occurs, rinse thoroughly with water.
- Avoid known rosacea triggers such as sun exposure, hot beverages, spicy foods, alcohol, and extreme temperatures.
- Use a broad-spectrum sunscreen daily.
- Cosmetics can be applied after the lotion has dried.
Available Forms & Alternatives
Available Strengths:
Generic Alternatives:
Dosing & Administration
Adult Dosing
Standard Dose:
Apply a thin layer to affected areas of the face once daily, in the morning.
Condition-Specific Dosing:
Rosacea:
Apply a thin layer to affected areas of the face once daily, in the morning. Patients may use cosmetics after the application has dried.
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established
Child:
Not established
Adolescent:
Not established
Dose Adjustments
Renal Impairment:
Mild:
No adjustment needed
Moderate:
No adjustment needed
Severe:
No adjustment needed
Dialysis:
No adjustment needed due to minimal systemic absorption.
Hepatic Impairment:
Mild:
No adjustment needed
Moderate:
No adjustment needed
Severe:
No adjustment needed
Pharmacology
Mechanism of Action
The exact mechanism of action of metronidazole in the treatment of rosacea is unknown, but it is believed to involve both anti-inflammatory effects and possibly antimicrobial activity against *Demodex* mites or certain bacteria. It has been shown to reduce reactive oxygen species.
Pharmacokinetics
Absorption:
Bioavailability:
<10% (systemic absorption after topical application)
Tmax:
Not clinically relevant for topical application due to minimal systemic absorption.
FoodEffect:
Not applicable for topical formulation.
Distribution:
Vd:
Not clinically relevant for topical application.
ProteinBinding:
Not clinically relevant for topical application.
CnssPenetration:
Limited (due to minimal systemic absorption)
Elimination:
HalfLife:
Not clinically relevant for topical application.
Clearance:
Not clinically relevant for topical application.
ExcretionRoute:
Not clinically relevant for topical application.
Unchanged:
Not clinically relevant for topical application.
Pharmacodynamics
OnsetOfAction:
Several weeks (clinical improvement)
PeakEffect:
Up to 9-12 weeks for maximal effect
DurationOfAction:
Maintained with continued use
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
Although rare, this medication can cause severe and potentially life-threatening side effects. If you experience any of the following symptoms, contact your doctor or seek immediate medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Irritation at the site where the medication was applied
Nervous system problems, including:
+ Abnormal burning, numbness, or tingling sensations
+ Changes in balance or vision
+ Dizziness or fainting
+ Headache
+ Insomnia
+ Seizures
+ Speech difficulties
Mood changes, such as:
+ Confusion
+ Depression
+ Irritability
+ Fatigue
+ Weakness
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms, contact your doctor or seek medical help:
Dry skin
Scaling
Itching
Burning or stinging sensations
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, this medication can cause severe and potentially life-threatening side effects. If you experience any of the following symptoms, contact your doctor or seek immediate medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Irritation at the site where the medication was applied
Nervous system problems, including:
+ Abnormal burning, numbness, or tingling sensations
+ Changes in balance or vision
+ Dizziness or fainting
+ Headache
+ Insomnia
+ Seizures
+ Speech difficulties
Mood changes, such as:
+ Confusion
+ Depression
+ Irritability
+ Fatigue
+ Weakness
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms, contact your doctor or seek medical help:
Dry skin
Scaling
Itching
Burning or stinging sensations
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Severe burning, stinging, or irritation that does not subside.
- Excessive dryness or peeling of the skin.
- Worsening of rosacea symptoms.
- Signs of an allergic reaction such as rash, hives, swelling of the face/lips/tongue, or difficulty breathing (seek immediate medical attention).
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced.
If you have taken disulfiram in the past 2 weeks.
If you are breastfeeding or plan to breastfeed, as you may need to avoid breastfeeding while taking this medication.
This medication can interact with other medications and health conditions. Therefore, it is crucial to provide your doctor and pharmacist with a comprehensive list of:
All prescription and over-the-counter medications you are taking
Any natural products or vitamins you are using
Your existing health problems
Before starting, stopping, or changing the dose of any medication, including this one, consult with your doctor to ensure your safety. It is your responsibility to verify that it is safe to take this medication with all your other medications and health conditions.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced.
If you have taken disulfiram in the past 2 weeks.
If you are breastfeeding or plan to breastfeed, as you may need to avoid breastfeeding while taking this medication.
This medication can interact with other medications and health conditions. Therefore, it is crucial to provide your doctor and pharmacist with a comprehensive list of:
All prescription and over-the-counter medications you are taking
Any natural products or vitamins you are using
Your existing health problems
Before starting, stopping, or changing the dose of any medication, including this one, consult with your doctor to ensure your safety. It is your responsibility to verify that it is safe to take this medication with all your other medications and health conditions.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Before consuming alcohol or using products containing alcohol, consult with your doctor, as you may need to avoid them during treatment and for a period after your last dose. If you are using a product that contains propylene glycol, discuss this with your doctor. Long-term use of metronidazole has been associated with an increased risk of cancer in animal studies, such as mice and rats; therefore, it is crucial to discuss this with your doctor. This medication has been prescribed for a specific health condition, and you should not use it to treat other health problems. If you are pregnant or planning to become pregnant, inform your doctor, as you will need to discuss the potential benefits and risks of using this medication during pregnancy.
Overdose Information
Overdose Symptoms:
- Overdose with topical metronidazole is highly unlikely due to minimal systemic absorption. Ingestion of the entire tube would be required for systemic effects, which could include nausea, vomiting, diarrhea, metallic taste, or seizures (rare).
What to Do:
If accidental ingestion occurs, contact a poison control center (1-800-222-1222) or seek emergency medical attention. Treatment is generally supportive.
Drug Interactions
Monitoring
Baseline Monitoring
Clinical assessment of rosacea severity
Rationale: To establish baseline for treatment efficacy evaluation.
Timing: Prior to initiation of therapy
Routine Monitoring
Clinical assessment of rosacea improvement (reduction in inflammatory lesions and erythema)
Frequency: Periodically, e.g., every 4-8 weeks initially, then as needed
Target: Reduction in lesion count and erythema
Action Threshold: Lack of improvement after 12 weeks may warrant re-evaluation of diagnosis or treatment.
Skin irritation (e.g., dryness, redness, burning, stinging)
Frequency: At each follow-up visit and patient self-monitoring
Target: Minimal to no irritation
Action Threshold: Severe or persistent irritation may require temporary discontinuation or reduced frequency of application.
Symptom Monitoring
- Burning
- Stinging
- Dryness
- Redness
- Itching
- Worsening of rosacea symptoms
- Signs of allergic reaction (e.g., rash, swelling, severe itching)
Special Patient Groups
Pregnancy
Metronidazole topical is classified as Pregnancy Category B. Animal studies have not shown harm to the fetus, and human data are limited but do not suggest an increased risk of major birth defects. Due to minimal systemic absorption, the risk to the fetus is considered low.
Trimester-Specific Risks:
First Trimester:
Low risk due to minimal systemic absorption.
Second Trimester:
Low risk due to minimal systemic absorption.
Third Trimester:
Low risk due to minimal systemic absorption.
Lactation
Metronidazole is excreted into breast milk after systemic administration, but systemic absorption after topical application is minimal. Therefore, the amount transferred to breast milk is expected to be very low, and adverse effects in breastfed infants are unlikely. Considered L2 (safer).
Infant Risk:
Low risk of adverse effects in breastfed infants.
Pediatric Use
Safety and efficacy of metronidazole topical for the treatment of rosacea have not been established in pediatric patients. Rosacea is rare in children.
Geriatric Use
No specific dose adjustments are necessary for geriatric patients. Clinical studies did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects, but no overall differences in safety or effectiveness have been observed.
Clinical Information
Clinical Pearls
- Patients should be advised that therapy may take several weeks to show noticeable improvement.
- Metronidazole topical is for external use only. Avoid contact with eyes, nose, mouth, and other mucous membranes.
- Patients should continue to avoid known rosacea triggers while using metronidazole.
- If irritation occurs, patients may temporarily reduce the frequency of application or discontinue use until irritation subsides, then resume as tolerated.
- This medication does not cure rosacea but helps manage its symptoms.
Alternative Therapies
- Azelaic acid topical (e.g., Finacea, Azelex)
- Ivermectin topical (e.g., Soolantra)
- Brimonidine topical (e.g., Mirvaso) for erythema
- Oxymetazoline topical (e.g., Rhofade) for erythema
- Oral antibiotics (e.g., doxycycline, minocycline) for more severe inflammatory rosacea
- Laser or light therapy for persistent redness or telangiectasias
Cost & Coverage
Average Cost:
Varies widely (e.g., $50 - $300+) per 59ml lotion
Generic Available:
Yes
Insurance Coverage:
Tier 2 or 3 (often covered by most prescription plans)
General Drug Facts
If your symptoms or health issues persist or worsen, it is essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so it's a good idea to check with your pharmacist. If you have any questions or concerns about this medication, don't hesitate to discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide detailed information about the overdose, including the medication taken, the amount, and the time it occurred.