From the Guidelines
Norel AD is indicated for the treatment of acne in women who desire oral contraception, and its active medications include norethindrone acetate and ethinyl estradiol (EE) 1.
Key Points
- Norethindrone acetate is a first-generation progestin that has androgenic potential, but when combined with estrogen, it yields net antiandrogenic properties 1.
- The combination of norethindrone acetate and EE is one of the four FDA-approved combined oral contraceptives (COCs) for the treatment of acne in women who desire oral contraception 1.
- COCs, including norethindrone acetate/EE, have been shown to reduce acne lesions and improve quality of life in women with acne 1.
Important Considerations
- Patients should be counseled on the potential benefits and risks of COCs, including the increased risk of blood clots and the importance of adherence to the prescribed regimen 1.
- Norethindrone acetate/EE should not be prescribed for patients with severe and uncontrolled hypertension, ongoing hepatic dysfunction, or other contraindications 1.
- Patients should be informed about common adverse effects, such as irregular bleeding, headache, and nausea, and how to manage them 1.
From the Research
Norel AD Indications and Active Medications
- Norel AD is indicated for the treatment of acne vulgaris, a chronic skin disease characterized by the occurrence of comedones, papules, pustules, and nodules on the face and trunk 2, 3, 4.
- The active medications in Norel AD are not explicitly stated in the provided studies, but based on the information available, it is likely that Norel AD contains a combination of topical retinoids and antimicrobial agents, such as clindamycin and benzoyl peroxide, which are commonly used to treat acne vulgaris 2, 3, 4.
Mechanism of Action
- Topical retinoids, such as adapalene and tretinoin, work by preventing the formation of comedones and reducing inflammation in the skin 3, 5.
- Antimicrobial agents, such as clindamycin and benzoyl peroxide, work by reducing the population of Cutibacterium acnes (formerly known as Propionibacterium acnes) on the skin, which is a bacterium that contributes to the development of acne lesions 2, 3, 4.
Treatment Outcomes
- Studies have shown that combination therapy with topical retinoids and antimicrobial agents is effective in reducing the severity of acne lesions and improving patient outcomes 2, 3, 5, 4.
- In one study, the combination of adapalene gel 0.1% and doxycycline was found to be significantly more effective than doxycycline alone in reducing the number of acne lesions 5.
- Another study found that spironolactone, an anti-androgen medication, was more effective than doxycycline in treating moderate acne in adult females 6.