Azelaic acid is in a class of medications called dicarboxylic acids. It works to treat rosacea by decreasing the swelling and redness of the skin. It works to treat acne by killing the bacteria that infect pores and by decreasing the production of keratin, a natural substance that can lead to the development of acne.

Beta-glucans are soluble fibers that come from the cell walls of mushrooms, plants, algae, yeasts, and oats. Because beta-glucans have antioxidant properties and are anti-inflammatory, they are excellent ingredients for improving the look of redness and other signs of sensitive skin.

Ceramides are essential lipids naturally produced in the body and make up nearly 50% of the outermost layer of skin. Ceramides help in creating a lipid barrier that helps boost skin resilience and prevents the skin from losing moisture. When the skin lacks ceramides, it can lead to dryness and irritation, contributing to skin sensitivity.

Hyaluronic acid is naturally produced by the body and is found in high concentrations within the skin. Hyaluronic acid is essential for maintaining your skin's moisture balance and is responsible for your skin’s plumpness and volume. Hyaluronic acid has been shown to attract and retain water, making it an excellent hydrating ingredient. As we age, hyaluronic acid levels decline, which is why it’s important to supplement products that contain this ingredient.

Ivermectin represents a unique treatment for reducing inflammatory lesions of rosacea and is thought to exert its benefit via dual mechanisms. First, ivermectin has anti-inflammatory activity, decreasing both the cellular and humoral immunity pathways that are thought to be involved in the development of rosacea. In addition, ivermectin is a vermicidal agent, killing Demodex mites that have been implicated in rosacea pathophysiology and may drive inflammation.

Metronidazole is an antibiotic. It may help to decrease redness, swelling, and the number of lesions (pimples and red bumps) caused by rosacea. It is believed to work by decreasing swelling and inflammation.

Niacinamide, also known as vitamin B3, plays an important role in soothing and helping to restore the skin barrier. Niacinamide has become a popular ingredient in formulations for acne, eczema, rosacea, and skin discoloration. When applied topically, niacinamide may help strengthen the skin's moisture barrier, which may help reduce the visible effects of skin damage.

Oxymetazoline is used to treat ongoing facial redness caused by rosacea (a skin disease that causes redness and pimples on the face). Oxymetazoline is in a class of medications called alpha 1a adrenoceptor agonists. It works by narrowing the blood vessels in the skin.

Tranexamic acid, a synthetic analog of the amino acid lysine, has been shown to interfere with the chemical pathway that produces melanin, which makes it useful as a depigmentation agent. It has been shown to reduce skin inflammation and help fade redness.

One size doesn’t fit all and every patient is unique. Drug compounding is the process of combining, mixing, or altering ingredients to create a medication tailored to the needs of a patient by a pharmacist as the result of a practitioner’s prescription drug order. While compounded medications are not FDA-approved, they serve an important patient need—especially when FDA-approved medication is not available for treatment. Our formulations are made to order in small batches to ensure freshness. The specific ingredients in your compounded formula will depend on your specific concerns and goals. It should be understood that your personal healthcare practitioner will make the final decision.

Yes! All of our compounded formulations, regardless of ingredients, are eligible for Flexible Spending Accounts (FSA) and Health Saving Accounts (HSA).

Rosacea is a chronic inflammatory skin disease that commonly occurs in the central part of your face. Patients often report persistent facial blushing or flushing along with more visible blood vessels around the nose and cheeks. Many people with rosacea also develop pimples on their face that resemble acne. In the US alone, more than 16 million patients are affected by rosacea, and worldwide incidences peak as high as 18%.

The Rosacea Formula combines multiple prescription ingredients meant to target the main symptoms associated with rosacea. Metronidazole is a topical antibiotic that can help reduce the swelling and inflammation of irritated skin, while reducing the number of pimples. Oxymetazoline has been shown to be safe and effective for reducing persistent facial redness associated with rosacea. Niacinamide, a B-vitamin, has been used topically to reduce irritation, increase skin hydration, brighten complexion, strengthen elasticity, and improve skin texture. Topical application of niacinamide has been shown to reduce water loss and improve moisture content of the skin. Researchers say azelaic acid reduces redness and swelling while removing excess bacteria. Hyaluronic acid helps hydrate your skin by drawing moisture from the environment and increasing your skin’s hydration. Hyaluronic acid helps smooth and soften skin texture while improving your skin’s plumpness and firmness. Topical tranexamic acid has been shown to improve the epidermal permeability barrier function and clinical signs of rosacea.

Based on research and patient testimonials, you may see improvement as early as 6 to 8 weeks; however, each patient is unique and time frames may differ.

• The Rosacea Formula is for topical use only. If this medicine gets in your eyes or mouth, rinse with water. Do not apply this medication to your eyelids.

• Follow all directions on your prescription label. Use this medicine for the full prescribed length of time, even if your symptoms quickly improve.

• Wash your hands with soap and water before and after applying the medicine. Do not allow other people to get this medicine on their skin. If this happens, wash the area thoroughly with soap and water.

• Wash and gently dry your skin before and after applying. Clean the affected area with a mild soap or a soap-free cleansing lotion and pat dry with a soft towel.

• Apply a thin layer to cover the entire face (forehead, nose, cheeks and chin) once daily.

• Do not apply to sunburned, windburned, dry, chapped, irritated, or broken skin.

• Do not cover treated skin with a bandage. Bandaging can increase the amount of drug absorbed through your skin and may cause harmful effects.

• The Rosacea Formula should be used as part of a complete skin care program that includes avoiding sunlight, using an effective mineral based broad-spectrum sunscreen daily, and wearing protective clothing.

• If incorporating additional products, it is recommended to follow the following order: cleanser, Rosacea Formula, serum, moisturizer, sunscreen and makeup.

• Wait for at least 20 minutes before applying moisturizer or any other skincare products.

Do not start using the Rosacea Formula if you have a history of hypersensitivity to the prescribed ingredients. The prescribed ingredients may include, but are not limited to; metronidazole, oxymetazoline, niacinamide, azelaic acid, hyaluronic acid and/or tranexamic acid. Please tell your doctor if you are pregnant or thinking about becoming pregnant.

Use the missed dose as soon as you remember, or wait until the next night to apply the medicine. Do not use extra medicine to make up for the missed dose.

Store at room temperature away from moisture and heat between 68°F to 77°F (20°C to 25°C).

Research has shown, topically applied medications are less likely to cause the same systemic side effects or drug-to-drug interactions as oral medications; however, there is never an absolute zero chance that side effects or drug interactions will not occur. Tell each of your healthcare providers about all medicines you use, including prescription and over-the-counter medicines, vitamins, and herbal products.

What should I avoid while using the Rosacea Formula?

• Avoid exposure to sunlight or tanning beds. The Rosacea Formula can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

• Your skin may be more sensitive to weather extremes such as cold and wind. Protect your skin with clothing and use a moisturizing cream or lotion as needed.

• Avoid using other products that may contain metronidazole, ivermectin, oxymetazoline, tranexamic acid, and/or azelaic acid.

• Avoid using skin products that can cause irritation, such as harsh soaps, shampoos, or skin cleansers, hair coloring or permanent chemicals, hair removers or waxes, or skin products with alcohol, spices, astringents, or lime. Do not use other medicated skin products unless your doctor has told you to.

What are the common side effects of the Rosacea Formula?

Common side effects may include application site reactions of:

• Skin reactions (dermatitis)

• Burning, stinging or warmth

• Itching or tingling

• Redness, dryness or peeling

• Change in skin color

Get emergency medical help if you have signs of an allergic reaction: hives, severe itching; difficult breathing; swelling of your face, lips, tongue, or throat. These are not all of the possible side effects of the Rosacea Formula. For more information, ask your healthcare provider or pharmacist. Tell your healthcare provider if you have any side effects that bother you or do not go away.

What happens if I overdose?

An overdose is not expected to be dangerous. Seek emergency medical attention or call the Poison Help line at 1-800-222-1222 if anyone has accidentally swallowed the medication.

• Buddenkotte J, Steinhoff M. Recent advances in understanding and managing rosacea. F1000Res. 2018 Dec 3;7:F1000 Faculty Rev-1885. doi: 10.12688/f1000research.16537.1. PMID: 30631431; PMCID: PMC6281021.

• van Zuuren EJ, Fedorowicz Z, Carter B, van der Linden MM, Charland L. Interventions for rosacea. Cochrane Database Syst Rev. 2015 Apr 28;2015(4):CD003262. doi: 10.1002/14651858.CD003262.pub5. PMID: 25919144; PMCID: PMC6481562.

• Hoover RM, Erramouspe J. Role of Topical Oxymetazoline for Management of Erythematotelangiectatic Rosacea. Ann Pharmacother. 2018 Mar;52(3):263-267. doi: 10.1177/1060028017740139. Epub 2017 Nov 2. PMID: 29094614.

• Gehring W. Nicotinic acid/niacinamide and the skin. J Cosmet Dermatol. 2004 Apr;3(2):88-93. doi: 10.1111/j.1473-2130.2004.00115.x. PMID: 17147561.

• [Colón LE, Johnson LA, Gottschalk RW. Cumulative irritation potential among metronidazole gel 1%, metronidazole gel 0.75%, and azelaic acid gel 15%. Cutis. 2007 Apr;79(4):317-21. PMID: 17500380. [5] Lee VS, Davis GE. Culture-directed topical antibiotic treatment for chronic rhinosinusitis. Am J Rhinol Allergy. 2016 Nov 1;30(6):414-417. doi: 10.2500/ajra.2016.30.4380. PMID: 28124652; PMCID: PMC5108841

All prescription medications require a valid and complete online consultation prior to approval and final pricing is determined. All compounded medications in the U.S. are considered off-label use. Licensed healthcare practitioners have the ability to prescribe compounds for off-label treatment, if they believe that it is an appropriate course of treatment.

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Premier Pharmacy does not make any guarantees regarding the drug and medical information, and does not assume responsibility regarding the content. The drug safety and drug information contained on the website may be time sensitive and should not be utilized as a medical reference beyond the date hereof. The deficiency of a warning for prescription medications and vitamins provided on this website in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient.

If you have questions or concerns about your medications, please do not hesitate to contact us and/or your medical practitioner, including your pharmacist. Compound prescription products have not been tested or approved by the FDA for their intended use. No claims are made as to the safety, efficacy or use of this compound.