Duac Once Daily Gel

What is Duac Once Daily Gel?

Duac Once Daily Gel is a prescription-only topical treatment for acne that contains two active ingredients working in synergy: clindamycin phosphate (10 mg/g) and benzoyl peroxide (30 mg/g). This combination product belongs to a class of medications known as 'anti-acne preparations'.

Mechanism of Action

Duac Once Daily Gel employs a dual-action approach to combat acne:

• Clindamycin is a lincosamide antibiotic that works by inhibiting bacterial protein synthesis. In acne treatment, it specifically targets Cutibacterium acnes (formerly Propionibacterium acnes), the bacteria primarily responsible for inflammatory acne lesions. By preventing these bacteria from reproducing, clindamycin reduces their population on the skin and decreases inflammation.
• Benzoyl peroxide is a keratolytic and antimicrobial agent with three main actions:
  1. It releases free oxygen radicals that kill C. acnes bacteria
  2. It helps unclog pores by promoting exfoliation of dead skin cells
  3. It has mild anti-inflammatory properties that reduce redness and swelling

Biological pathway analogy: Think of acne development like a blocked drain. First, excess oil and dead skin cells clog the pore (the drain). Bacteria then multiply in this clogged environment, causing inflammation and redness. Duac works by both clearing the blockage (benzoyl peroxide) and eliminating the bacteria (clindamycin), addressing both aspects of the problem.

What is Duac Once Daily Gel Used For?

Duac Once Daily Gel is indicated for the topical treatment of mild to moderate acne vulgaris in patients aged 12 years and older. It is particularly effective against inflammatory acne lesions including papules and pustules, as well as comedones (blackheads and whiteheads).

Before Using Duac Once Daily Gel

Before starting treatment with Duac Once Daily Gel, it is important to consider the following medical history and conduct appropriate assessments:

Medical History Assessment Checklist

• History of allergy to clindamycin, lincomycin, benzoyl peroxide, or any component of the gel
• Previous gastrointestinal issues, especially:
  • Regional enteritis (Crohn's disease)
  • Ulcerative colitis
  • Antibiotic-associated colitis
• Recent use of other clindamycin or erythromycin-containing products
• Current or planned use of other acne treatments
• History of sensitivity to sunlight or artificial UV light
• Planned surgical procedures (due to potential interaction with neuromuscular blocking agents)

Required Baseline Evaluations

While no specific laboratory tests are routinely required before starting Duac, your doctor will:

1. Conduct a thorough skin examination to assess acne severity and distribution
2. Review your current skincare routine and products
3. Assess for any signs of skin irritation or conditions that might contraindicate use
4. Evaluate your medical history for gastrointestinal conditions

Duac Once Daily Gel Contraindications

Absolute contraindications mean the medication should not be used under any circumstances. Relative contraindications mean the medication may be used if the potential benefits outweigh the risks, under close medical supervision.

Special Population Considerations

Elderly Patients

No specific dosage adjustment is required for elderly patients, but they may have more sensitive skin and should be monitored for increased irritation.

Renal or Hepatic Impairment

Systemic absorption of topical clindamycin and benzoyl peroxide is minimal, so no special precautions are needed for patients with renal or hepatic impairment. However, as with all medications, use with caution and under medical supervision.

Paediatric and Adolescent Patients

Duac Once Daily Gel is approved for use in adolescents aged 12 years and over. Safety and efficacy in children under 12 years have not been established, so it is not recommended for this age group.

Duac and Other Medicines

Duac Once Daily Gel may interact with several other medications and topical products:

High-Risk Medication Combinations

• Erythromycin-containing products: Concurrent use may reduce efficacy of both medications and increase risk of bacterial resistance. Avoid combination.
• Other topical acne medications (especially those containing tretinoin, isotretinoin, or tazarotene): May increase skin irritation. Consider using at different times of day (e.g., one in morning, one in evening).
• Neuromuscular blocking agents (used in general anaesthesia): Topical clindamycin may potentiate their effects. Inform your anaesthetist if you're using Duac before surgery.

Topical Products to Use With Caution

• Medicated or abrasive soaps and cleansers
• Products with strong drying effects
• Cosmetics or skincare containing high amounts of alcohol or astringents
• Other topical antibiotics

Timing recommendation: If using other topical acne treatments alongside Duac, apply them at different times of day (e.g., other product in morning, Duac in evening) to minimise irritation.

Pregnancy & Breastfeeding

Pregnancy

Animal studies with topical clindamycin have shown no direct harmful effects, but adequate human studies are lacking. Systemic absorption through the skin is minimal but cannot be completely ruled out. Your doctor will weigh the potential benefits against unknown risks.

Breastfeeding

When taken orally or by injection, clindamycin passes into breast milk. While topical application results in much lower systemic absorption, it is not known whether the ingredients in Duac pass into breast milk in significant amounts. Do not apply Duac to the breast area if breastfeeding.

Contraception Requirements

No specific contraception requirements are mandated with Duac use, but women of childbearing potential should use effective contraception if sexually active, as with any medication use during reproductive years.

Driving & Machine Operation

Duac Once Daily Gel has no known effects on the ability to drive or operate machinery. The medication is applied topically and systemic absorption is minimal, so it does not cause drowsiness or impair cognitive function.

However, if you experience significant eye irritation due to accidental contact with the gel, you should avoid driving or operating machinery until your vision clears completely.

Duac Once Daily Gel Ingredients

Active Ingredients (per 1g of gel)

• Clindamycin phosphate: 10 mg (equivalent to 10 mg/g or 1% w/w clindamycin)
• Hydrous benzoyl peroxide: 30 mg (equivalent to 30 mg/g or 3% w/w anhydrous benzoyl peroxide)

Excipients (Other Ingredients)

• Carbomer: Gelling agent that helps maintain gel consistency
• Dimeticone: Silicone-based ingredient that improves spreadability
• Disodium lauryl sulfosuccinate: Surfactant that helps with even distribution
• Disodium edetate: Chelating agent that stabilises the formulation
• Glycerol: Humectant that helps prevent excessive drying
• Silica (colloidal hydrated): Thickening agent
• Poloxamer 182: Non-ionic surfactant that aids in drug delivery
• Purified water: Solvent base
• Sodium hydroxide: pH adjuster

Allergen warning: This product contains no common allergens like gluten, lactose, or nuts. However, individuals with specific chemical sensitivities should review the ingredient list with their doctor.

How to Use Duac Once Daily Gel

Follow these steps carefully for proper application of Duac Once Daily Gel:

1. Cleanse: Remove all makeup and wash the affected area with a mild cleanser. Rinse thoroughly with warm water and gently pat dry with a clean towel.
2. Prepare: Ensure your hands are clean before handling the gel.
3. Dispense: Squeeze a pea-sized amount (approximately 0.5g) onto your fingertip.
   • For face only: Amount from fingertip to first joint ("fingertip unit")
   • For face and back: Two and a half "fingertip units"
4. Apply: Spread a thin film of gel evenly over all affected areas, not just individual spots. Use gentle dabbing or circular motions until absorbed.
5. Complete: Wash hands thoroughly after application to avoid transferring gel to other areas.
6. Follow-up: Wait for gel to dry completely before applying moisturiser or makeup (if desired).

Application tip: If the gel does not rub in easily, you are using too much. A thin, even layer is more effective than a thick application.

Duac Dosage Guidelines

Titration Schedule

Unlike some medications, Duac does not require gradual titration. Start with once-daily application as directed. If irritation occurs, you may reduce frequency to every other day temporarily, then resume daily application as tolerance improves.

Administration Instructions

Optimal Timing

Apply Duac Once Daily Gel in the evening as part of your bedtime skincare routine. This allows the medication to work overnight without interference from makeup, sunscreen, or environmental factors.

Concurrent Skincare

• Moisturiser: If experiencing dryness, use an oil-free, fragrance-free, hypoallergenic moisturiser. Apply after Duac has completely dried.
• Sun protection: Use a broad-spectrum sunscreen (SPF 30+) every morning, as Duac can increase sun sensitivity.
• Cleansers: Use only mild, non-medicated cleansers. Avoid abrasive scrubs or exfoliants.

What to Avoid

• Do not apply to eyes, lips, mouth, inside nose, or mucous membranes
• Avoid contact with coloured fabrics (can cause bleaching)
• Minimize sun exposure and avoid sunbeds/lamps
• Do not use on broken, cut, or sunburned skin

Missed Dose Management

Important: Do not apply a double dose to make up for a missed application. Applying more than directed will not improve results faster and may increase skin irritation.

Overdose Information

Topical Overapplication

Applying too much gel or applying more frequently than directed may cause increased skin irritation, redness, dryness, and peeling. If this occurs:

1. Reduce frequency of application (e.g., switch to every other day)
2. Consider taking a short break (1-3 days) to allow skin recovery
3. Use a gentle moisturiser to soothe irritated skin
4. Resume treatment with a smaller amount once irritation subsides

Accidental Ingestion

If Duac gel is accidentally swallowed:

1. Seek medical attention immediately
2. Do not induce vomiting unless instructed by healthcare professional
3. You may experience symptoms similar to oral antibiotic use (stomach upset, diarrhoea)
4. Bring the medication package or leaflet to show medical staff

Duac Once Daily Gel Side Effects

Like all medicines, Duac Once Daily Gel can cause side effects, although not everyone experiences them. Most side effects are mild and temporary, occurring mainly during the first few weeks of treatment as your skin adjusts.

Frequency-Based Side Effect Categorisation

Very Common (≥1 in 10 people)

• Skin burning sensation (especially during first few weeks)
• Peeling or flaking skin
• Itching at application site
• Dry skin
• Redness of skin (erythema)

Common (≥1 in 100 to <1 in 10 people)

• Headache
• Increased sensitivity to sunlight
• Skin pain or discomfort
• Red, itchy skin rash (dermatitis)

Uncommon (≥1 in 1,000 to <1 in 100 people)

• Tingling sensation (paraesthesia) at application site
• Temporary worsening of acne (usually improves with continued use)

Other Side Effects (frequency unknown)

• Allergic reactions
• Intestinal inflammation, diarrhoea (including bloody diarrhoea), stomach pain
• Skin reactions, discoloration of skin
• Raised itchy rash (hives/urticaria)

Managing Common Side Effects

• Dryness/peeling: Use an oil-free, fragrance-free moisturiser. Apply after Duac has dried.
• Redness/irritation: Reduce application frequency temporarily (every other day).
• Sun sensitivity: Use broad-spectrum sunscreen daily and limit sun exposure.

Reporting side effects: If you experience any side effects, talk to your doctor or pharmacist. You can also report side effects directly via the UK Yellow Card Scheme at www.mhra.gov.uk/yellowcard.

How to Store Duac Once Daily Gel

Storage Conditions

Important Storage Notes

• Do not freeze the gel
• Keep in original container with lid tightly closed
• Store away from direct heat and sunlight
• Keep out of sight and reach of children
• Do not use after the expiry date printed on tube and carton

Disposal Protocol

Do not dispose of medications via wastewater or household waste. Return unused or expired medication to your pharmacy for proper disposal. This helps protect the environment and prevents accidental ingestion.

Duac Once Daily Gel Pack Information

Available Presentations

• Tube of 30g - White to slightly yellow-coloured gel
• Tube of 60g - White to slightly yellow-coloured gel

Note: Not all pack sizes may be available through all pharmacies.

Pack Contents

• Aluminium tube containing gel
• Cardboard outer carton
• Package leaflet (this information)

Marketing Authorisation Holder

GlaxoSmithKline UK Limited
79 New Oxford Street
London WC1A 1DG
United Kingdom

Where to Buy Duac Once Daily Gel in the UK