Contact of the gel with the mouth, eyes, lips, other mucous membranes, or irritated or broken skin should be avoided. Application to sensitive areas of skin should be performed with appropriate caution. In the event of accidental contact, rinse the affected areas with water.
Duac should be used with caution in patients with a history of regional enteritis, ulcerative colitis, or antibiotic-associated colitis.
Duac should be administered with caution to atopic patients, in whom further drying of the skin may occur.
During the first weeks of treatment, most patients may experience increased skin peeling and redness. Depending on the severity of these effects, patients may use a non-comedogenic moisturiser, temporarily reduce the frequency of gel application or temporarily discontinue use; however, the efficacy of the product when used less often than once daily has not been established.
Other concomitant topical acne treatments should be used with caution, as cumulative irritation of greater severity may occur, particularly with the concurrent use of peeling, desquamating or abrasive agents.
If marked local irritation develops (e.g. severe erythema, marked skin dryness and pruritus, marked stinging/burning), Duac should be discontinued.
Because benzoyl peroxide may cause increased sensitivity to sunlight, patients should avoid tanning beds and deliberate or prolonged exposure to sunlight, which should be avoided or, where this is not possible, kept to a minimum. If exposure to strong sunlight cannot be avoided, patients should be advised to use sunscreens for protection against UV radiation and to wear protective clothing.
If a patient is sunburned, the skin should be allowed to recover before initiating treatment with Duac.
If a patient experiences prolonged or severe diarrhoea or abdominal cramps, Duac should be discontinued immediately, as these symptoms may indicate antibiotic-associated colitis. In such cases, the patient should be evaluated using appropriate diagnostic methods to detect Clostridium difficile and its toxin, including colonoscopy, and alternative treatment options should be considered in light of the suspected colitis.
The product may bleach hair or coloured fabrics. Avoid contact with hair, textiles, furniture or floor coverings.
Resistance to clindamycin
In patients who have recently used clindamycin or erythromycin, whether systemically or topically, there is an increased likelihood of pre-existing antimicrobial resistance in Propionibacterium acnes and the commensal flora (see section 5.1).
Cross-resistance
The use of antibiotic monotherapy may give rise to cross-resistance to other antibiotics such as lincomycin and erythromycin (see section 4.5).
