What Is Efracea?

Efracea is a once-daily oral capsule containing 40mg of doxycycline monohydrate, a member of the tetracycline class of antibiotics. It is uniquely formulated to provide a gradual release of the medication, ensuring steady levels in the body to reduce inflammation effectively over time.

Unlike conventional antibiotics, Efracea is used specifically for its anti-inflammatory effects rather than its antimicrobial properties. This makes it particularly suitable for long-term use in the treatment of rosacea without significantly disrupting the body’s natural bacterial balance.

What Is Efracea Used For?

Rosacea Treatment: Used for treating moderate to severe papulopustular rosacea.
Inflammatory Lesion Relief: Helps reduce papules and pustules caused by rosacea.
Redness and Swelling: Minimises facial redness and swelling linked to rosacea.
Long-Term Therapy: Provides long-term anti-inflammatory benefits without antibiotic resistance.
Skin Clarity Boost: Improves overall skin clarity and comfort for rosacea-prone individuals.

How Does Efracea Work? 

Although the precise cause of rosacea remains unclear, various triggers such as UV light, spicy food, stress, and alcohol are known to provoke flare-ups. Efracea addresses the inflammation behind rosacea symptoms by regulating the body’s inflammatory response.

The doxycycline in Efracea acts by inhibiting the enzymes and cellular processes responsible for inflammation, helping to reduce skin redness, swelling, and the formation of pustules and papules.

Alternative Medications

While Efracea (doxycycline 40mg modified-release) is a widely used treatment for rosacea, several other medications are available in the UK that may better suit individual needs. Here are some alternatives:

Metronidazole (Rozex, Metrosa): A topical antibiotic available as a 0.75% gel or cream, metronidazole reduces inflammation and bacterial growth associated with rosacea. It's often prescribed for mild to moderate cases and is widely available in the UK.

Azelaic Acid (Finacea, Skinoren): Azelaic acid is a naturally occurring acid that helps to reduce inflammation and redness in rosacea. Available as a 15% gel (Finacea) or 20% cream (Skinoren), it's suitable for mild to moderate rosacea and is accessible in the UK.

Ivermectin (Soolantra): Ivermectin 10mg/g cream is an anti-inflammatory and anti-parasitic medication effective in treating inflammatory lesions of rosacea. Applied once daily, it's particularly useful for moderate to severe cases and is available in the UK.

Lymecycline: An oral tetracycline antibiotic, lymecycline, is used to treat moderate to severe rosacea by reducing inflammation and bacterial growth. It's an alternative to doxycycline and is available in the UK.
Please consult with your healthcare provider to determine the most appropriate treatment for your rosacea.

How to Take Efracea

Timing:
Take one Efracea capsule daily, preferably in the morning. To ensure proper absorption, it should be taken on an empty stomach—at least one hour before or two hours after a meal.

How to Take:
Swallow the capsule whole with a full glass of water. Do not crush or chew the capsule. After taking it, remain upright for at least 30 minutes to help prevent irritation in the oesophagus.

Avoid With:
Do not take Efracea with dairy products such as milk, cheese, or yoghurt. Also avoid calcium or iron supplements, antacids, or multivitamins, as they can interfere with absorption and reduce the effectiveness of the medication. If needed, wait 2–3 hours after taking Efracea before consuming these products.

Course Duration

Treatment Length:
Efracea is typically prescribed for an 8- to 16-week treatment course. Most users begin to see improvements within four weeks.

Expected Results:
Optimal results are generally achieved between 12 to 16 weeks of continued use. If no improvement is noticed after six weeks, consult your doctor to reassess the treatment.

After Treatment:
Rosacea symptoms may return after stopping treatment. If this happens, Efracea can usually be prescribed again following a one-month break, based on your doctor's recommendation.

Who Can Take Efracea
Efracea is suitable for adult patients diagnosed with moderate to severe papulopustular rosacea. However, certain groups should avoid this medication:

Do not take Efracea if you:

Are pregnant or planning to become pregnant.
Are breastfeeding.
Are under 12 years of age.
Are allergic to doxycycline or other tetracycline antibiotics.
Have conditions such as achlorhydria, liver disease, or a history of oesophageal irritation.

Speak to your doctor before use if you:

• Are you using oral retinoids
• Are taking medications containing calcium, magnesium, aluminium, or iron.
• Have any chronic illnesses or are you taking long-term medication?

Efracea contains both active and inactive ingredients that work together to effectively treat rosacea while maintaining the capsule's stability and structure.

Active Ingredient:

The active ingredient in Efracea is Doxycycline monohydrate (40 mg). This low-dose antibiotic reduces inflammation in the skin without promoting antibiotic resistance, making it suitable for long-term rosacea treatment.

Inactive Ingredients:

Efracea also includes several inactive ingredients such as hypromellose, methacrylic acid-ethyl acrylate copolymer, triethyl citrate, talc, titanium dioxide, macrogol 400, yellow iron oxide, red iron oxide, polysorbate 80, and sugar spheres (sucrose and maize starch). These components help maintain the capsule’s structure, aid in controlled release, and ensure proper absorption.

Note - Inactive ingredients can vary from manufacturer to manufacturer. 

Capsule Shell Components:

The capsule's shell is made from gelatin, black iron oxide, red iron oxide, yellow iron oxide, and titanium dioxide.

Printing Ink:

The capsule’s text is printed using a combination of shellac, propylene glycol, brilliant blue FCF, allura red AC, and indigo carmine aluminium lake.

Always read the patient information leaflet (PIL) in your pack for the complete list of ingredients, and to check for any you might be allergic to.

Possible Side Effects

Efracea is generally well tolerated by most individuals, especially due to its low-dose formulation. However, like all medications, it may still cause side effects. Most are mild and temporary, but some may require medical attention.

Common Side Effects:

These may affect up to 1 in 10 users:

• Nasal or Sinus Inflammation: Congestion or discomfort in the nasal passages or sinuses.
• Heartburn or Upper Stomach Pain: A burning sensation or discomfort after taking the capsule.
• Nausea or Diarrhoea: Mild digestive issues are occasionally reported.
• Fungal Infections: Includes conditions like oral thrush or yeast infections.
• Dry Mouth: A reduced flow of saliva, possibly leading to discomfort.
• Headaches: A common and generally mild side effect.
• Skin Sensitivity to Sunlight: Increased risk of sunburn; sun protection is advised.
• Anxiety or Back Pain: Emotional or physical discomfort may occasionally occur.
  
  

Less Common but Serious Side Effects:

Though rare, the following side effects require medical attention:

• Raised Pressure Inside the Skull (Benign Intracranial Hypertension): May lead to serious headaches or vision problems.
• Visual Disturbances: Blurred or altered vision in rare cases.
  
  

Seek Immediate Medical Help If You Experience:

Severe, persistent headache
Any changes in vision
Severe or prolonged diarrhoea
Signs of an allergic reaction, such as rash, swelling of the face or throat, or difficulty breathing

Important Advice:

If you notice any unusual or worrying symptoms while taking Efracea, don’t ignore them. Prompt medical attention can prevent complications. Always inform your prescriber of any pre-existing conditions or other medications you are taking to ensure Efracea is safe and suitable for you.

Safety and Precautions

Do not exceed the prescribed dose.
Do not double dose if a capsule is missed; skip and continue the next day.
Use sun protection and avoid tanning beds while on treatment.

Always inform your healthcare provider of any other medications you are taking.