Pharmacy Counselling Information: Hydroquinone, Tretinoin,

Hydrocortisone and Kojic Acid

You are receiving a compounded medication that has been custom made in our compounding lab
to the quality standards set by the Pharmacy Board of Australia. This medication has not been
assessed by the Therapeutic Goods of Australia.

Your cream contains multiple active ingredients.

Below is the medicines information for each of the prescription grade active ingredients in
your formula. If you have any questions about the information in this leaflet, contact your
doctor or pharmacist.

Topical Hydroquinone

What is Hydroquinone used for?

Hydroquinone is used to reduce skin pigmentation. It is a common ingredient in skin

whitening formulas as it bleaches the skin by blocking melanin production.

Melanin is the darkening agent of the skin and when its production is blocked it results in
lightening of the skin. Hydroquinone is most effective when applied to the skin in a cream or
lotion.

What do I need to tell my doctor BEFORE I take Hydroquinone?

Tell your doctor if you are pregnant or breastfeeding.

Tell your doctor if you have had a previous allergic reaction to hydroquinone in any form.

This is not a list of all medicines or health problems that interact with hydroquinone. Tell your
doctor and pharmacist about all medicines you're taking, including natural products and
vitamins. Tell your doctor and pharmacist about all health problems and medical conditions
before you start using hydroquinone.

When should I avoid using Hydroquinone?

• Do not use hydroquinone if you are pregnant or breastfeeding.

• If you fall pregnant while using hydroquinone, stop your treatment and speak with
your doctor as soon as possible.
• Do not use hydroquinone if you have had a previous allergic reaction to hydroquinone in
any form.

What are some things I need to know or do while using hydroquinone?

• Tell all of your health care providers that you take this drug. This includes your
doctors, nurses, pharmacists, and dentists.
• After stopping this drug, some of the colour change may come back. Speak with your
doctor about how to manage your symptoms ongoing.
• If you have a sulfite allergy, talk with your doctor.
• This drug may cause harm if swallowed. If this drug is swallowed, call a doctor or
poison control center right away.
• Avoid sun, sunlamps, and tanning beds. Use sunscreen and wear clothing and
eyewear that protects you from the sun.
 • Tell your doctor if you are pregnant, plan on getting pregnant, or are breast-feeding. You
will need to talk about the benefits and risks to you and the baby.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes
deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have
any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling
skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing,
swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or
throat.
• Blisters or sores.

Hydroquinone use can cause a rare but semi-permanent condition called ochronosis which
causes a semi-permanent change in skin colour to blue-black. It is more common in people with
darker skin tones and should be assessed as soon as possible by your doctor.

• If you notice any skin colour changes to blue-black stop using your treatment and
contact your doctor.

What are some other side effects of hydroquinone?

All drugs may cause side effects. However, many people have no side effects or only have minor
side effects. Call your doctor or get medical help if any of these side effects or any other side
effects bother you or do not go away:

• Dry skin
• Stinging
• Redness
• Skin irritation

These are not all of the side effects that may occur.

If you have any concerns relating to your medication, you can always call and speak to one of our
partner pharmacists. Simply call the number displayed on the medication label that is on your
bottle. You can also email [email protected] to report any side effects you are experiencing.

How is Hydroquinone best used?

• Follow all instructions provided to you by your doctor and pharmacist.

• DO NOT take this drug by mouth, use only on your skin and avoid your mouth, nose and
eyes when applying the cream.
• Wash your hands before and after use.
• It is important to have clean and dry skin before applying your hydroquinone cream.
• Apply a small amount of cream to the affected areas only avoiding unaffected areas. If
applied on unaffected skin it will lighten those areas as well.
• Avoid using other medicated products in the same area to avoid skin irritation.
• Avoid sun exposure as much as possible and use a broad spectrum sunscreen (SPF 30 or
greater) and protective clothing.
 What do I do if I miss a dose?

• Put on a missed dose as soon as you think about it.

• If it is close to the time for your next dose, skip the missed dose and go back to your
normal time.
• Do not put on 2 doses at the same time or extra doses.

How do I store and/or throw out this drug?

Store in a cool dry place, out of reach from children where the temperature stays below 25°C. Do not
refrigerate or freeze. Efficacy and safety cannot be guaranteed if used after the expiry date (specified
on the medication label, located on the bottle). Ask your pharmacist how to throw away medicines
you no longer use.

Topical Tretinoin

What is topical tretinoin used for?

Topical tretinoin can be used to treat a number of skin conditions including pimples and acne,
wrinkles, rough skin and skin spots or discoloured skin.

What do I need to tell my doctor BEFORE I use topical tretinoin?

• If you are allergic to this drug; any part of this drug; or any other drugs, foods, or
substances. Tell your doctor about the allergy and what signs you had. • If your skin is
sunburned, sensitive to light, or you have any other skin problems.
• If you are taking any drugs that may make your skin more sensitive to light. There are
many drugs that can do this. Ask your doctor or pharmacist if you are not sure. • If you are
pregnant.

This is not a list of all drugs or health problems that interact with this drug. Tell your doctor and
pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health
problems. You must check to make sure that it is safe for you to take this drug with all of your
drugs and health problems. Do not start, stop, or change the dose of any drug without checking
with your doctor.

What are some things I need to know or do while I use topical tretinoin?

• Tell all of your health care providers that you take this drug. This includes your doctors,
nurses, pharmacists, and dentists. • It may take several weeks to see the full effects. •
Do not use more than what your doctor told you to use. Do not use more often or longer
than what you were told. Doing any of these things may raise the chance of very bad
side effects.
• Do not put on sunburned skin. • Do not put on cuts, scrapes, eczema, or damaged skin. •
Practice good skin care and avoid the sun. • You may get sunburned more easily. Avoid
sun, sunlamps, and tanning beds. Use sunscreen and wear clothing and eyewear that
protects you from the sun. • Some weather conditions may irritate the skin. Talk with the
doctor. • Use of other skin products while using this drug may cause more irritation.
 • Talk with your doctor before you use other drugs or products on your skin. • You may use
make-up unless your doctor has told you not to. If you will be using make-up, clean the
area to be treated before putting this drug on. • This drug may cause harm if swallowed. If
this drug is swallowed, call a doctor or poison control center right away.
• This drug may cause harm to the unborn baby if you take it while you are pregnant. If you
are pregnant or you get pregnant while taking this drug, call your doctor right away. • Tell
your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes
deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have
any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling
skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing,
swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or
throat.
• Skin reaction that is very bad, bothers you, or does not go away.

What are some other side effects of topical tretinoin?

All drugs may cause side effects. However, many people have no side effects or only have minor
side effects. Call your doctor or get medical help if any of these side effects or any other side
effects bother you or do not go away: • Feeling of warmth.

• Burning or stinging. • Change in color of skin. • Some skin reactions may happen with this
drug. These include dry skin, redness, swelling, blisters, and peeling. If these skin reactions
happen, talk with your doctor. Your doctor may want you to stop using this drug for some
time, change how much you use, or change how often you use this drug. These are not all
of the side effects that may occur. If you have questions about side effects, call your
doctor. Call your doctor for medical advice about side effects.

If you have any concerns relating to your medication, you can always call and speak to one of our
partner pharmacists. Simply call the number displayed on the medication label that is on your
bottle. You can also email [email protected] to report any side effects you are experiencing.

How is topical tretinoin best used?

Use this drug as ordered by your doctor. Read all information given to you. Follow all
instructions closely.

• Do not take this drug by mouth. Use on your skin only. Keep out of your mouth, nose, and
eyes (may burn).
• If you get this drug in any of these areas, rinse well with water.
• Some products are to be used at bedtime. For some products it does not matter. Check
with the pharmacist about how to use this drug.
• Wash your hands before and after use.
• Wash affected skin and pat dry and wait 20-30 minutes before applying to the skin.
• Put a thin layer on the affected skin and rub in gently.
 • Do not wash your face for at least 1 hour after putting on this drug.
• Do not use other skin products or makeup for at least 1 hour after putting it on.
• Put on a moisturising sunscreen in the morning (SPF 30 or higher).

What do I do if I miss a dose?

• Skip the missed dose and go back to your normal time. • Do not put on 2 doses at the
same time or extra doses.

How do I store and/or throw out topical tretinoin?

Store in a cool dry place, out of reach from children where the temperature stays below 25°C. Do not
refrigerate or freeze. Efficacy and safety cannot be guaranteed if used after the expiry date (specified
on the medication label, located on the bottle). Ask your pharmacist how to throw away medicines
you no longer use.

Topical Hydrocortisone

What is Hydrocortisone used for?

Hydrocortisone is commonly used to treat skin irritation and skin rashes. The use of
hydrocortisone in your cream formulation is to help reduce potential skin irritation caused by
other active ingredients and to reduce the production of melanin.

What do I need to tell my doctor BEFORE I use hydrocortisone?

• If you are allergic to this drug; any part of this drug; or any other drugs, foods, or
substances. Tell your doctor about the allergy and what signs you had.

What are some things I need to know or do while I use hydrocortisone?

• Tell all of your health care providers that you take this drug. This includes your
doctors, nurses, pharmacists, and dentists.
• Do not apply directly onto cuts, scrapes, or damaged skin.
• This drug may cause harm if swallowed. If this drug is swallowed, call a doctor or
poison control center right away.
• Do not use this drug for longer than you were told by your doctor.
• Tell your doctor if you are pregnant, plan on getting pregnant, or are breast-feeding. You
will need to talk about the benefits and risks to you and the baby.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes
deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have
any of the following signs or symptoms that may be related to a very bad side effect:
 • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling
skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing,
swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue,
or throat.
• Change in eyesight.
• Very bad headache.
• Severe irritation where this drug is used
• Signs of skin infection like oozing, heat, swelling, redness, or pain
• Skin changes (pimples, stretch marks, slow healing, hair growth)
• Thinning of the skin.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have
minor side effects. Call your doctor or get medical help if any of these side effects or any
other side effects bother you or do not go away:

• Burning or stinging.
• Dryness.
• Tingling.

These are not all of the side effects that may occur. If you have any concerns relating to your
medication, you can always call and speak to one of our partner pharmacists. Simply call the
number displayed on the medication label that is on your bottle. You can also email
[email protected] to report any side effects you are experiencing.

How is hydrocortisone best used?

Use this drug as ordered by your doctor. Read all information given to you. Follow all
instructions closely.

• DO NOT take this drug by mouth. Use on your skin only. Keep out of your mouth, nose,
and eyes (may burn).
• Use as you have been directed, even if your skin get better.
• Wash your hands before and after use
• Clean affected part before use. Make sure to dry well.
• Put a thin layer on the affected skin and rub in gently.
• Do not use coverings (bandages, dressings) unless told to do so by the doctor.

What do I do if I miss a dose?

• Apply a missed dose as soon as you think about it.

• If it is close to the time for your next dose, skip the missed dose and go back to your
normal time.
• Do not use 2 doses at the same time or extra doses.

How do I store and/or throw out hydrocortisone?

Store in a cool dry place, out of reach from children where the temperature stays below 25°C. Do
not refrigerate or freeze. Efficacy and safety cannot be guaranteed if used after the expiry date
(specified on the medication label, located on the bottle). Ask your pharmacist how to throw away
medicines you no longer use.
General drug facts

• If your symptoms or health problems do not get better or if they become worse, call
your doctor.
• Do not share your drugs with others and do not take anyone else's drugs.
• Some drugs may have another patient information leaflet. If you have any questions
about this drug, please talk with your doctor, nurse, pharmacist, or other health care
provider.
• If you think there has been an overdose, call your poison control center or get medical
care right away. Be ready to tell or show what was taken, how much, and when it
happened.