Acne DNS Gel (Dapsone / Niacinamide / Spironolactone) (30 mL)

Acne DNS Gel 200 is a topical treatment designed to help manage acne and related skin concerns. It works by reducing inflammation, controlling excess oil production, and preventing the growth of acne-causing bacteria on the skin. This gel is often recommended for mild to moderate acne and can help in healing existing pimples while preventing new ones from forming.

The “200” in the name refers to the strength or concentration of the active ingredient, which is carefully balanced to be effective while minimizing irritation. When applied regularly, Acne DNS Gel 200 helps to keep the skin clean, reduce redness, and promote clearer skin over time.

Acne DNS Gel 200 is not meant for severe acne cases and should be used under the guidance of a healthcare provider. Avoid applying it on broken or irritated skin, and always use sunscreen during the day, as acne treatments can make your skin more sensitive to sunlight.

Overall, Acne DNS Gel 200 offers a practical and effective way to support acne care, helping individuals achieve healthier, clearer skin with consistent use.

Dapsone is a medicine used to treat infections and certain skin problems. It works by stopping a specific enzyme in harmful organisms, helping to fight bacteria. It may also calm the immune system, though experts are still learning exactly how it works for skin conditions. Dapsone can be taken as a pill or applied to the skin, and once inside the body, it spreads to many areas like muscles, skin, liver, and kidneys. The body breaks it down into different substances, and some of these may cause side effects like blood problems, so it’s important to monitor treatment closely.

Niacinamide, a form of vitamin B3, is important for overall health. The body can also make niacinamide from another nutrient called tryptophan, which is present in milk and eggs. A shortage of this vitamin can lead to serious problems like diarrhea, skin irritation, and mental confusion, known as pellagra. Thanks to food fortification, this deficiency is now rare in many countries. Niacinamide is often confused with other forms of vitamin B3, but it has unique effects in the body and must be used carefully depending on the health condition being treated.

Dapsone
In cases of severe anemia, G6PD deficiency (glucose 6 phosphate dehydrogenase deficiency), or meoverthecountermoglobin reductase deficiency, dapsone has to be administered with care since hemolytic anemia overthecounter could result. The protection of dapsone topical gel (Aczone) was assessed in a doubleblind, randomized, goover study on 64 G6PD deficient patients with acne vulgaris. Hemoglobin fell by 0.32 g/dL on average after two weeks; but, overthecounter week 12, hemoglobin Levels often regress to baseline phases. Comparable ratios of patients inside overthe counter Aczone gel institution and overthecounter Car Organization (Aczone: eight out of fifty-eight; vehicle: seven out of fifty-six). The research found no evidence of clinically significant hemolytic anemia after over-the counter usefulness of dapsone topical gel. Laboratory abnormalities indicative of modest hemolysis Certain subjects had previously stated that before using systemically administered dapsone, all patients must get degrees of glucose 6 phosphate dehydrogenase. In patients with G6PD deficiency or with records, baseline whole blood counts including over the counter a reticulocyte depend have to be collected. of anemia. For patients at risk, daily observationup for full blood count and reticulocyte count number must be used.

Overthecounter preliminary ranges of systemic dapsone treatment have been proposed for toxic hepatitis, cholestatic jaundice, and hyperbilirubinemia. Regularly examining liver function tests is advised. In individuals with already existing hepatic disease, dapsone should be administered with care.

duplicating power. Some governments have promoted overthecounter assistance dapsone overthecounterover counter to be maintained, since it is required by overthecounter fact dapsone overthecounterr. In instances of leprosy or dermatitis herpetiformis, over-the-counter pregnancy information on topical dapsone in pregnant patients is not accessible; nevertheless, systemic The public knows little about over-the-counter topical gel compared with oral dapsone therapy—roughly one hundred events fewer.

Dapsone, Niacinamide, and Spironolactone are medications used to treat different conditions, but like all drugs, they can have side effects.

Dapsone, often used for skin conditions and infections like leprosy or Pneumocystis pneumonia, can affect the blood. It may cause a mild drop in hemoglobin or red blood cells in most patients, especially at higher doses. People with G6PD deficiency are more likely to develop more serious blood problems, such as hemolytic anemia. Rare but serious side effects include agranulocytosis (a dangerous drop in white blood cells), liver issues, and nerve problems. Skin rashes, photosensitivity, and application site reactions (like dryness or redness) may occur, particularly with topical use. Headache and upset stomach can also happen. In rare cases, allergic reactions or lupus-like symptoms have been reported.

Niacinamide (a form of vitamin B3) is usually well tolerated at normal doses, but high doses of niacin (a related compound) can cause flushing, warmth, or redness, especially on the face. Some people may experience dizziness, itching, or headaches. Less commonly, it can affect the liver, cause upset stomach, or raise blood sugar and uric acid levels—especially in those with diabetes or gout. Rarely, it may lead to serious liver damage or muscle breakdown (rhabdomyolysis), especially when combined with statins. Eye issues like blurred vision and skin changes such as dryness or darkening may also occur.

Spironolactone is a diuretic often used for acne, high blood pressure, or hormonal conditions. It can raise potassium levels, which, if too high, may lead to dangerous heart rhythm problems. Bloodwork monitoring is important, especially for kidney function. Hormonal side effects are common—men may develop breast tenderness or enlargement, while women may notice menstrual irregularities or voice changes. Other possible side effects include fatigue, dizziness, stomach upset, or allergic skin reactions. In rare cases, spironolactone has been linked to serious skin rashes, liver issues, or blood cell problems.

Pregnancy and Breastfeeding: What to Know About Dapsone, Niacinamide, and Spironolactone

If you’re pregnant or breastfeeding and taking medications like dapsone, niacinamide, or spironolactone, it’s important to understand how they may affect you and your baby.

Dapsone has been used during pregnancy, especially in women with conditions like leprosy or dermatitis herpetiformis. So far, studies in pregnant women haven’t shown any harm to the baby, and some doctors recommend continuing the medication when it’s medically needed. While there’s no data on topical dapsone use in pregnancy, the amount absorbed through the skin is much lower than with oral forms. When it comes to breastfeeding, dapsone does pass into breast milk in significant amounts, and there’s a risk it could cause a blood condition (hemolytic anemia) in infants with a rare enzyme deficiency (G6PD). Still, dapsone is generally considered compatible with breastfeeding when necessary, especially with close monitoring.

Niacinamide (a form of vitamin B3) is considered safe during pregnancy and breastfeeding when taken in standard nutritional doses—like those found in prenatal vitamins. Problems may arise when taking large doses, like those used to treat high cholesterol. In those cases, the effects on pregnancy and breastfeeding are less clear. Manufacturers often advise against high-dose niacin use during pregnancy unless absolutely necessary. Niacin is passed into breast milk in small amounts, mostly in the form of niacinamide. Breastfeeding women usually only need additional niacin if their diet is lacking.

Spironolactone is generally not recommended during pregnancy, especially if the baby is male. Animal studies have shown that spironolactone could interfere with male hormone development, possibly affecting the baby’s sex characteristics. While limited human data hasn’t confirmed these risks, it’s often best to avoid spironolactone during pregnancy unless no safer alternatives are available. Regarding breastfeeding, spironolactone itself doesn’t show up in breast milk, but a small amount of its active form (canrenone) does. No harmful effects have been seen in breastfed infants so far, and previous guidelines considered it usually safe for nursing mothers.

Store this medication in its original container at 68°F to 77°F (20°C to 25°C) and away from heat, moisture and light. Keep all medicine out of the reach of children. Throw away any unused medicine after the beyond use date. Do not flush unused medications or pour down a sink or drain.

1. Mold JW, Thompson DM. Management of brown recluse spider bites in primary care. J Am Board Fam Pract 2004;17:347-52.
2. Hogan CJ, Barbaro KC, Winkel K. Loxoscelism: old obstacles, new directions. Ann Emerg Med 2004;44(6):608-24.
3. Swanson DL, Vetter RS. Bites of brown recluse spiders and suspected necrotic arachnidism. N Engl J Med 2005;352:700-7.
4. Masur H. Prevention and treatment of pneumocystis pneumonia. N Engl J Med 1992;327:1853-60.
5. Girard PM, Landman R, Gaudebout C, et al. Dapsone-pyrimethamine compared with aerosolized pentamidine as primary prophylaxis against Pneumocystis carinii pneumonia and toxoplasmosis in HIV infection. N Engl J Med 1993;328:1514-20.
6. Aczone (dapsone gel 5%) package insert. Irvine CA: Allergan Inc.; 2018 May
7. Aczone (dapsone gel 7.5%) package insert. Exton, PA: Almirall, LLC; 2019 Sept.
8. Niaspan (niacin extended-release) tablet package insert. North Chicago, IL: Abbott Laboratories; 2015 Apr.
9. HPS2-THRIVE Collaborative Group. Effects of extended-release niacin with laropiprant in high-risk patients. N Engl J Med 2014;371:203-12.
10. Taylor AJ, Villines TC, Stanck EJ, et al. Extended-release niacin or ezetimibe and carotid intima-media thickness. N Engl J Med 2009. Epub ahead of print, doi:10.1056/NEJMoa907569.
11. Lee JMS, Robson MD, Yu LM, et al. Effects of high-dose modified-release nicotinic acid on atherosclerosis and vascular function: A randomized, placebo-controlled, magnetic resonance imaging study. J Am Coll Cardiol 2009;54:1787—94.
12. McKenney JM, et al. A comparison of the efficacy and toxic effects of sustained- vs immediate-release niacin in hypercholesterolemic patients. JAMA 1994;271:672-7.
13. Pitt B, Zannad F, Remme WJ. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. N Engl J Med 1999;341:709-717.
14. Taylor AJ, Villines TC, Stanck EJ, et al. Extended-release niacin or ezetimibe and carotid intima-media thickness. N Engl J Med 2009. Epub ahead of print, doi:10.1056/NEJMoa907569.
15. Dapsone tablet package insert. Pine Brook, NJ: Alvogen, Inc.; 2015 Jun.
16. American Academy of Pediatrics (AAP) Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics 2001;108(3):776-789.
17. Panel on Opportunistic Infections in HIV-Exposed and HIV-infected Children. Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-exposed and HIV-infected children: Department of Health and Human Services. Accessed Dec 18
18. Verdel BM, Souverein PC, Egberts AC, et al. Difference in risks of allergic reaction to sulfonamide drugs based on chemical structure. Ann Pharmacother 2006;40:1040-6.
19. Strom BL, Schinnar R, Apter AJ, et al. Absence of cross-reactivity between sulfonamide antibiotics and sulfonamide nonantibiotics. New Engl J Med 2003;349:1628-35.
20. Hemstreet BA, Page RL. Sulfonamide allergies and outcomes related to use of potentially cross-reactive drugs in hospitalized patients. Pharmacotherapy 2006;26:551-7.
21. Johnson KK, Green DL, Rife JP, et al. Sulfonamide cross-reactivity: fact or fiction? Ann Pharmacother 2005;39:290-301.
22. Colletti RB, Neufeld EJ, Roff NK, et al. Niacin treatment of hypercholesterolemia in children. Pediatrics 1993;92:78-82.
23. Expert Panel: National Cholesterol Education Program. Report of the expert panel on blood cholesterol levels in children and adolescents. Pediatrics 1992;89(suppl 2):525-84.
24. Niacinamide. In: Drugs in Pregnancy and Lactation. A Reference Guide to Fetal and Neonatal Risk. Briggs GG, Freeman RK, Yaffe SJ, (eds.) 7th ed., Philadelphia PA: Lippincott Williams and Wilkins; 2005:1140-1
25. Health Care Financing Administration. Interpretive Guidelines for Long-term Care Facilities. Title 42 CFR 483.25(l) F329: Unnecessary Drugs. Revised 2015.
26. Aldactone (spironolactone) package insert. New York, NY: G.D. Searle LLC Division of Pfizer Inc.; 2020 Jun.
27. Carospir (spironolactone) oral suspension package insert. Farmville, NC: CMP Pharma, Inc.;2021 Jun.
28. Bornstein SR, Allolio B, Arlt W, et al. Diagnosis and treatment of primary adrenal insufficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2016;101:364-389.
29. Esposito D, Pasquali D, Johannsson G. Primary adrenal insufficiency: managing mineralocorticoid replacement therapy. J Clin Endocrinol Metab. 2018;103:376-387.
30. Inder WJ, Meyer C, Hunt PJ. Management of hypertension and heart failure in patients with Addison’s disease. Clin Endocrinol. 2015;82:789-792.
31. Hunt SA, Abraham WT, Chin MH, et al. 2009 Focused Update Incorporated into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults. Circulation 2009;119:e391-e479.
32. Luthy IA, Begin DJ, Labrie F. Androgenic activity of synthetic progestins and spironolactone in androgen-sensitive mouse mammary carcinoma (Shionogi) cells in culture. J Steroid Biochem. 1988;31(5):845-852.
33. Bedussi F, Galli D, Fragni M, et al. Amiloride is effective in the management of abiraterone-induced mineralocorticoid excess syndrome without interfering with its antineoplastic activity. Pharmacology. 2017;100:261-268.
34. Richards J, Lim AC, Hay CW, et al. Interactions of abiraterone, eplerenone, and prednisolone with wild-type and mutant androgen receptor: a rationale for increasing abiraterone exposure or combining with MDV3100. Cancer Research. 2012;72(9):2176-2182.
35. Barthelemy P, Erdmann E, Duclos B, et al. Spironolactone: a selective androgen receptor modulator in castration-resistant prostate cancer. J Clin Oncol. 2014;32(4 suppl):abstract 212.
36. Sundar S and Dickinson PD. Spironolactone, a possible selective androgen receptor modulator, should be used with caution in patients with metastatic carcinoma of the prostate. BMJ Case Reports. 2012;doi:10.1136/bcr.11.2011.5238.
37. Flynn T, Guancial EA, Kilari M, and Kilari D. Case report: spironolactone withdrawal associated with a dramatic response in a patient with metastatic castrate-resistant prostate cancer. Clinical Genitourinary Cancer. 2017;15(1):e95-e97.
38. The American Geriatrics Society 2019 Beers Criteria Update Expert Panel. American Geriatrics Society 2019 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc 2019;00:1-21.
39. Carospir (spironolactone) oral suspension package insert. Farmville, NC: CMP Pharma, Inc.;2021 Jun.
40. Piette WW, Taylor S, Pariser D, et al. Hematologic safety of dapsone gel, 5%, for topical treatment of acne vulgaris. Arch Dermatol. 2008 ;144:1564-70.
41. Niacor (Niacin tablets) package insert. Minneapolis, MN: Upsher-Smith Laboratories, Inc.; 2000 Feb.