NIACINAM-SPIRONOLACT-TRETINOIN

Niacinamide 2%, Topical gel

Alcohol

· Severity: Moderate

· Notes for Consumers: Do not drink alcohol while taking this medication. Drinking alcohol while taking this medication may cause facial flushing or redness.

· Notes for Professionals: Alcohol-containing beverages or hot beverages/foods can exacerbate cutaneous vasodilation caused by niacin and should be avoided around the time of niacin ingestion.

Niacinamide 2%, Topical gel

Food

· Severity: Moderate

· Notes for Consumers: Avoid drinking hot beverages or eating hot food around the times you take Niacin. Ingesting hot food or beverages may worsen skin flushing (example: warm and reddened skin of the face, neck, or chest) while taking Niacin. Alcoholic beverages may also have this effect, so also avoid drinking alcohol around the time of your Niacin dose. Taking Niacin with meals may help to decrease skin flushing.

· Notes for Professionals: Hot beverages and foods can exacerbate cutaneous vasodilation caused by niacin and should be avoided around the time of niacin ingestion. In general, this interaction would not be harmful, but might decrease patient tolerance of niacin.

Spironolactone 5%, Topical gel

Foods containing licorice

· Severity: Major

· Notes for Consumers: Licorice candy and foods containing licorice extract should be avoided when taking Spironolactone. Licorice can counteract (work against) the beneficial diuretic (resulting in water and sodium loss) actions of Spironolactone. If you are taking Spironolactone to treat high blood pressure or edema, and notice an increase in leg or ankle swelling (edema) or an increase in your blood pressure, tell your health care provider.

· Notes for Professionals: Licorice extract, which contains glycyrrhizic acid, possesses aldosterone-like properties. Thus, licorice candy and foods containing licorice extract should be avoided by patients taking spironolactone in order to not antagonize the drug's therapeutic actions.

Tretinoin 0.025%, Topical gel

Grapefruit juice

· Severity: Major

· Notes for Consumers: Do not drink grapefruit juice or eat grapefruit while taking this medication. Grapefruit may alter the effects of your medication. Serious side effects may occur. Contact your care team right away if you experience new or worsening side effects.

· Notes for Professionals: Advise patients to avoid grapefruit and grapefruit juice during tretinoin treatment due to the risk of increased tretinoin exposure and adverse reactions. Tretinoin is a CYP3A substrate and grapefruit juice is a CYP3A inhibitor.

<b>DISCLAIMER:</b><em> This drug information content is provided for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Patients should always consult their physician with any questions regarding a medical condition and to obtain medical advice and treatment. Drug information is sourced from GSDD (Gold Standard Drug Database ) provided by Elsevier.</em>