Ivermectin / Niacinamide / Oxymetazoline HCl 1/2/0.75% 30 mL Pump
This topical gel is specifically formulated to treat the inflammatory effects and response of rosacea. This RX Grade product is acceptable to most skin types and suitable for both men and women in most cases.
*Please Be Advised: This is an RX Grade Product and will not be shipped without a TeleMedicine phone appointment performed by our office. The appointment cost is complimentary with each purchase. Someone from MedClub will contact you after purchasing to complete the exam and get your product shipped. If you want to pickup the product in person please call ahead to schedule a skin exam time slot.
Ivermectin (dihydroavermectin B1) is an antiparasitic agent of the avermectin class. Ivermectin has structural similarities to the macrolide antibiotics but lacks antibacterial activity. Avermectins are produced naturally by the actinomycete Streptomycetes avermetilis. Ivermectin lotion is used topically to treat Pediculosis capitis (head lice). Ivermectin cream is used topically for the treatment of inflammatory lesions of rosacea. Oral ivermectin is used in treating infections due to Onchocerca volvulus (onchocerciasis) or Strongyloides stercoralis(strongyloidiasis). Ivermectin is only active against the tissue microfilariae of Onchocerca volvulus and the intestinal stage of Strongyloides stercoralis; ivermectin has no activity against adult Onchocerca volvulus. Although not FDA-approved for infections due to Sarcoptes scabiei (scabies), crusted (Norwegian) scabies, or superinfected scabies, ivermectin has been used successfully to treat these conditions.12 Ivermectin is effective against the circulating microfilariae of Wuchereria bancrofti (responsible for Bancroft's filariasis) and other major filarial diseases (i.e., Loa loa).3 However, ivermectin is not effective against Mansonella perstans.4 Ivermectin has also demonstrated promise for the treatment of nematodes such as cutaneous larva currens and localized and disseminated cutaneous larva migrans. Ivermectin is recommend by The World Health Organization (WHO) for treating onchocerciasis (river blindness) and lymphatic filariasis (Bancroft's filariasis). Resistance to ivermectin has not been reported. Ivermectin oral tablets were FDA-approved in November 1996.
Niacin (nicotinic acid or 3-pyridinecarboxylic acid) is a B-complex vitamin. Good dietary sources of niacin are animal proteins, beans, green vegetables, liver, mushrooms, peanuts, whole wheat, and unpolished rice. Niacin is also present in cereal grains but is largely bound to plant proteins, and thus is poorly absorbed after ingestion. Niacin is one of the substances used in the enrichment of refined flour, and our dietary intake of pre-formed niacin comes primarily from enriched grains. However, the body's niacin requirement is also met by the biosynthesis of niacin from tryptophan, an amino acid. For example, milk and eggs do not contain niacin, but do contain large amounts of tryptophan from which niacin is derived. Each 60 mg of excess tryptophan (after protein synthesis) is converted to approximately 1 mg of niacin. Synthesis of the vitamin from tryptophan in proteins supplies roughly half the niacin requirement in man. Iron-deficiency or inadequate pyridoxine or riboflavin status will decrease the conversion of tryptophan to niacin and may contribute to deficiency, due to an interdependence of coenzymes in the niacin production pathway. A late and serious manifestation of niacin deficiency is pellagra, a clinical symptom complex principally affecting the GI tract, skin, and CNS, producing symptoms of diarrhea, dermatitis, and dementia, respectively. Pellagra may result from a niacin- and protein-deficient diet, isoniazid therapy, or certain diseases that result in poor utilization of tryptophan. Pellagra was the only vitamin-deficiency disease to ever reach epidemic proportions in the US; pellagra is rare today in industrialized countries due to the enrichment of refined flours.
Several synonyms for niacin and niacinamide exist. Synthetic niacin could be produced by the oxidation of nicotine, and the term 'nicotinic acid' evolved. Scientists also coined the terms 'nicotinamide' and 'niacinamide' for the amide form of nicotinic acid. The term 'niacin' has been used generically since the 1940's to label foods and to avoid association of the vitamins with the nicotine alkaloid from tobacco. Thus, the name 'niacin' has been used to denote both chemical forms, which are equivalent as vitamins on a weight basis. Both nicotinic acid and nicotinamide are synthesized for inclusion in nutritional supplements. However, since nicotinic acid and nicotinamide have different pharmacologic properties outside of their use as vitamins, it is important to distinguish between the two forms in pharmaceutical products.
In clinical medicine, nicotinic acid is used as an antilipemic, but nicotinamide (niacinamide) is not effective for this purpose. Nicotinic acid was the first hypolipidemic agent shown to decrease the incidence of secondary myocardial infarction (MI) and reduce total mortality in MI patients. However, no incremental benefit of coadministration of extended-release niacin with lovastatin or simvastatin on cardiovascular morbidity and mortality over and above that demonstrated for extended-release niacin, simvastatin, or lovastatin monotherapy has been established. In addition, the AIM-HIGH trial demonstrated that the concurrent use of extended-release niacin (1500—2000 mg/day PO) and simvastatin does not result in a greater reduction in the incidence of cardiovascular events than simvastatin alone.5 These results are consistent with those of the larger HPS2-THRIVE trial in which the addition of extended-release niacin to effective statin-based therapy did not result in a greater reduction in the incidence of cardiovascular events. Furthermore, there was an increased risk of serious adverse events including an increased incidence of disturbances in diabetes control and diabetes diagnoses, as well as serious gastrointestinal, musculoskeletal, dermatological, infectious, and bleeding adverse events. There was also a statistically insignificant 9% proportional increase in the incidence of death from any cause in the niacin group.6 The ARBITER 6-HALTS trial demonstrated that the addition of extended-release niacin 2000 mg/day to statins results in significant regression in atherosclerosis as measured by carotid intima-media thickness, and is superior to the combination of ezetimibe and a statin.7 In an MRI study, the addition of extended-release niacin 2000 mg/day to statin therapy resulted in a significant reduction in carotid wall area compared to placebo.8 However, the NIA Plaque study, which was presented at the American Heart Association (AHA) 2009 Scientific Sessions, did not find a significant reduction in the progression of atherosclerosis associated with the addition of niacin to statin therapy as compared to statin monotherapy. Additionally, nicotinic acid has been used as a therapy for tinnitus, but efficacy data are scant. Some sustained-release nicotinic acid formulations have a lower incidence of flushing but a higher incidence of hepatotoxicity when compared to immediate-release forms.9 Some dosage forms are available without prescription. The FDA officially approved niacin in 1938.
Oxymetazoline is an alpha adrenoreceptor agonist that acts as a topically applied sympathomimetic vasoconstrictor. Oxymetazoline is available as a topical cream, ophthalmic solution, and an intranasal spray. The topical cream is approved to treat persistent facial erythema in adults with rosacea. Oxymetazoline administered as an ophthalmic preparation relieves redness of the eye due to minor eye irritants. The intranasal formulation is indicated to treat nasal congestion associated with acute or chronic rhinitis, sinusitis, the common cold, hay fever, and other allergies. The maximum recommended treatment duration for the intranasal spray is 3 days; excessive or prolonged use can cause nasal mucosa irritation and recurrent nasal congestion. This drug was approved by the FDA in 1964.
Apperal items may be returned within 15 days of purchase due to factory defects only.
All Cosmetic and MD Skin Care product sales are final, no returns will be accepted. If you have an issue with a product please contact our office directly at (561) 214-3323