Version July 2025
Acne vulgaris: Children ≥9 years and Adolescents: Topical: Apply a thin layer to affected area once daily.
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
(For additional information see "Tretinoin and benzoyl peroxide: Drug information")
Acne vulgaris: Topical: Apply a thin layer to affected skin once daily. Consider starting with the lowest possible concentration to minimize skin irritation and increase potency as tolerated. For moderate to severe acne, may be used as part of an appropriate combination regimen (Ref).
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
Also see individual agents.
>10%: Local: Application site pain (11%)
1% to 10%:
Dermatologic: Application-site scaling (4%), local dryness of skin (5%; application site)
Local: Application-site dermatitis (1%), application site erythema (4%), application site irritation (1%), application-site pruritus (1%)
Hypersensitivity to benzoyl peroxide, tretinoin, or any component of the formulation.
Concerns related to adverse effects:
• Bleaching effects: May bleach hair and colored fabric.
• Hypersensitivity reaction: Hypersensitivity reactions, including anaphylaxis, angioedema, and urticaria, have been reported with use of benzoyl peroxide-containing products. Discontinue use and initiate appropriate therapy if a serious hypersensitivity reaction occurs.
• Photosensitivity: Use is associated with increased susceptibility/sensitivity to UV light; avoid or minimize excessive exposure to sunlamps or sunlight. Daily sunscreen (SPF ≥15) use and other protective measures (eg, clothing over treated areas) are recommended. Discontinue use with first sunburn.
• Skin irritation: Skin irritation (eg, dryness, pain, exfoliation, erythema, dermatitis, pruritus) may occur. Depending on the severity of irritation, use a moisturizer, reduce the amount or frequency of application, or discontinue use until irritation disappears.
Concurrent drug therapy issues:
• Sulfone products: Concomitant use of benzoyl peroxide with sulfone products (eg, dapsone, sulfacetamide) may cause temporary discoloration (yellow/orange) of facial hair and skin. Application of products at separate times during the day or washing off benzoyl peroxide prior to application of other products may avoid skin discoloration (Dubina 2009).
Other warnings/precautions:
• Appropriate use: For external use only; avoid contact with eyes, lips, angles of nose, mucous membranes, cuts, or abraded, eczematous, or sunburned skin.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Cream, External:
Twyneo: Tretinoin 0.1% and benzoyl peroxide 3% (30 g) [contains alcohol, usp, cetyl alcohol]
No
Cream (Twyneo External)
0.1-3% (per gram): $19.68
Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.
For external use only; not for oral, ophthalmic, or intravaginal use.
Topical: Skin should be clean and dry before applying. Apply thin layer to affected areas avoiding contact with eyes, lips, inside of nose, mouth, all mucous membranes, and areas of broken, eczematous, or sunburned skin. Wash hands immediately after applying.
Topical: For topical external use only; not for oral, ophthalmic, or intravaginal use. Apply thin layer to clean, dry skin avoiding contact with eyes, lips, angles of nose, mucous membranes, cuts, or abraded, eczematous, or sunburned skin. Wash hands before and after use. May bleach hair or colored fabrics.
Tretinoin is a hazardous agent (NIOSH 2024 [table 2]).
Use appropriate precautions for receiving, handling, storage, preparation, dispensing, transporting, administration, and disposal. Follow NIOSH and USP 800 recommendations and institution-specific policies/procedures for appropriate containment strategy (NIOSH 2023; NIOSH 2024; USP-NF 2020).
Note: Facilities may perform risk assessment of some hazardous drugs to determine if appropriate for alternative handling and containment strategies (USP-NF 2020). Refer to institution-specific handling policies/procedures.
Prior to dispensing, store in refrigerator between 2°C to 8°C (36°F to 46°F); do not freeze. Once dispensed, store at 20°C to 25°C (68°F to 77°F), protect from freezing, and use within 12 weeks after dispensing or 60 days after first opening, whichever is sooner.
Topical treatment of acne vulgaris (FDA approved in ages ≥9 years and adults).
Refer to individual components.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program by clicking on the “Launch drug interactions program” link above.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program
Aminolevulinic Acid (Systemic): Photosensitizing Agents may increase photosensitizing effects of Aminolevulinic Acid (Systemic). Risk X: Avoid
Aminolevulinic Acid (Topical): Photosensitizing Agents may increase photosensitizing effects of Aminolevulinic Acid (Topical). Risk C: Monitor
Dapsone (Topical): Benzoyl Peroxide may increase adverse/toxic effects of Dapsone (Topical). Specifically, the use of these agents in combination may cause skin and facial hair to temporarily turn a tan or yellow/orange color. Risk C: Monitor
Methoxsalen (Systemic): Photosensitizing Agents may increase photosensitizing effects of Methoxsalen (Systemic). Risk C: Monitor
Porfimer: Photosensitizing Agents may increase photosensitizing effects of Porfimer. Risk X: Avoid
Verteporfin: Photosensitizing Agents may increase photosensitizing effects of Verteporfin. Risk C: Monitor
Animal reproduction studies have not been conducted with this combination.
Refer to individual monographs for additional information.
See individual agents.
See individual agents.
