Papulopustular rosacea formula guide
How to use the prescribed topical ivermectin, metronidazole and niacinamide compounded gel without confusing it with oral ivermectin.
How to use
- 01
Step 1
What it is and how it works
The validated non-comedogenic gel contains topical ivermectin 1%, metronidazole 0.75% and niacinamide 2% for inflammatory papules and pustules. It is not oral ivermectin and must never be replaced with ivermectin tablets.
- 02
Step 2
Apply it as prescribed
Apply a thin layer once daily to clean, dry skin over the prescribed area. Avoid the eyes, lips, mucosa, broken skin and the breast area, and wash your hands afterwards. Use only the labelled 30 g gel supplied by the pharmacy.
- 03
Step 3
Skin care and interactions
Do not add oral ivermectin, another metronidazole product or another facial medicine without clinical review. Tell the prescriber about anticoagulants or blood disorders. Use gentle cleansing, moisturiser and daily sunscreen, and track personal rosacea triggers.
Dose schedule
- 01
Step 1
Timing and review
Apply once daily for the prescribed 3-month course. Review response and tolerance at 6–12 weeks. Do not continue or repeat the compounded gel beyond 3 months without reassessment.
- 02
Step 2
If you miss an application
Apply it when you remember unless the next scheduled application is near. In that case, skip it and continue as usual. Do not apply extra product to make up for it.
Side effects
Local irritation
Mild redness, dryness, stinging or peeling can occur, especially at the start. Use a gentle moisturiser and follow the prescribed adjustment plan. Stop and seek advice if the reaction is marked or persistent.
Inflammation or allergy
Burning, itching or redness can occur. Stop and seek advice for marked swelling, a spreading rash, blistering or symptoms that do not settle after a short pause.
04 · Do not use if
Do not use this treatment if
- You are allergic to ivermectin, metronidazole, niacinamide or the final vehicle
- You are pregnant, trying to conceive or breastfeeding and the formula has not been individually reviewed
- The skin is broken or severely inflamed, or the labelled preparation does not match the prescribed topical formula
05 · When to contact your doctor
Contact your doctor if
- Facial swelling, breathing difficulty, widespread blistering, eye pain, light sensitivity or altered vision — seek urgent medical care
- You become pregnant, plan a pregnancy or are breastfeeding — stop and request an individual review
- There is no satisfactory response at the 6–12-week review or papules and pustules are worsening
Storage
Keep the compounded preparation in its labelled container, out of children's reach. Follow the pharmacy's storage conditions and beyond-use date; these depend on the final vehicle. Do not transfer it to another container.
What to expect
Inflammatory lesions should improve gradually during the 3-month course. The 6–12-week review confirms whether the diagnosis, adherence and formula remain appropriate; do not substitute tablets or change the formula yourself.