Patients should consult their physician before taking any additional prescriptions, over-the-counter medications, nutritional supplements or herbal medications. Interactions of particular concern to individuals taking acne medications depend on the medication taken and may include:

• Benzoyl peroxide and tretinoin. These medications may neutralize each other.
  
  
• Topical retinoids. May cause a cumulative drying effect when used with medicated soaps and cleansers, topical peeling agents (including benzoyl peroxide) or alcohol–containing preparations.
  
  
• Isotretinoin and alcohol. Alcohol consumption while taking isotretinoin may increase levels of particular blood fats (triglycerides) and liver enzymes.
  
  
• Oral clindamycin and erythromycin. Erythromycin may reduce the effectiveness of clindamycin. Erythromycin may also increase the effectiveness of some anticoagulant medications, requiring reduced dosages.
  
  
• Tetracyclines. May increase the effectiveness of some anticoagulants, requiring reduced dosages. May reduce the effectiveness of oral contraceptives, causing breakthrough bleeding and an increased risk of pregnancy. Antacids may reduce the effects of tetracyclines.