What is ivermectin / metronidazole / niacinamide cream used for?

It is a compounded topical cream most often prescribed for rosacea, including the inflammatory papules, pustules, and redness that come with the condition. Ivermectin and metronidazole are each FDA-approved individually as topical rosacea treatments, and niacinamide is added to support the skin barrier.

Do I need a prescription for this cream?

Yes. This is a prescription-only compounded medication, so a licensed healthcare provider must evaluate you and issue a valid prescription before the pharmacy can dispense it.

How does ordering and shipping work?

After you place your order, a licensed provider or pharmacist reviews your prescription and medical information. Once approved, the cream is compounded and shipped to you directly from a licensed U.S. pharmacy.

How long does it take to see results?

Many people notice gradual improvement in rosacea bumps and redness over several weeks, and studies of the individual ingredients often measure results at 12 to 16 weeks. Use the cream consistently as prescribed and follow up with your provider if you are not improving.

Can I drink alcohol while using this cream?

Topical metronidazole is absorbed in small amounts, but disulfiram-like reactions with alcohol have been reported with metronidazole. Ask your prescriber whether you should avoid alcohol while using this product.

Is this combination FDA-approved?

The exact three-ingredient combination is compounded by a pharmacy and is not itself an FDA-approved product. However, topical ivermectin 1% and metronidazole 0.75% are each FDA-approved for rosacea, and your prescriber determines whether this compounded formulation is appropriate for you.

What should I do if my skin gets irritated?

Mild stinging, dryness, or redness can occur, especially when starting treatment. If irritation is severe, worsening, or accompanied by blistering or swelling, stop use and contact your provider promptly.

Ivermectin 1% / Metronidazole 0.75% / Niacinamide 4% Cream

Name: Ivermectin 1% / Metronidazole 0.75% / Niacinamide 4% Cream
Brand: All Family Pharmacy
SKU: ivermectin-1-metronidazole-0-75-niacinamide-4-cream
Availability: InStock

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Ivermectin 1% / Metronidazole 0.75% / Niacinamide 4% Cream — All Family Pharmacy

Ivermectin 1% / Metronidazole 0.75% / Niacinamide 4% Cream is a compounded topical medication that combines two active ingredients FDA-approved individually for rosacea — ivermectin and metronidazole — with niacinamide, a form of vitamin B3 that supports the skin barrier. It is prescribed to help reduce the inflammatory bumps, pustules, and redness associated with rosacea. After a licensed provider reviews your prescription, your order ships from a licensed U.S. pharmacy.

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Buy Ivermectin 1% / Metronidazole 0.75% / Niacinamide 4% Cream Online

A compounded topical antiparasitic and antibiotic cream for rosacea, inflammatory papules and pustules, and facial redness

Medically reviewed by David Paul Mackarey, RPh, Pharmacist-in-Charge

Ivermectin 1% / Metronidazole 0.75% / Niacinamide 4% Cream Quick Facts

Drug class	Topical antiparasitic / antibiotic combination
Treats	Rosacea, inflammatory papules and pustules, facial redness
Form	Ointment
Typical dosing	Apply 1 pump (1 mL) as a thin layer to the affected areas of the face once daily, preferably in the evening, or as directed by the provider.
Prescription required	Yes — prescription only

What Is Ivermectin 1% / Metronidazole 0.75% / Niacinamide 4% Cream?

Ivermectin 1% / Metronidazole 0.75% / Niacinamide 4% Cream is a compounded prescription topical that brings together three ingredients commonly used in rosacea care. Ivermectin has anti-inflammatory activity and works against Demodex mites, which are thought to contribute to rosacea, while metronidazole is a topical antibiotic with anti-inflammatory effects. Niacinamide (vitamin B3) is added to help support the skin barrier and calm visible redness. Because it is compounded, this exact combination is prepared by a pharmacy based on your provider's prescription rather than sold as a single FDA-approved product.

What Does Ivermectin 1% / Metronidazole 0.75% / Niacinamide 4% Cream Treat?

Inflammatory lesions (papules and pustules) of rosacea
Papulopustular rosacea
Persistent facial redness associated with rosacea
Demodex-associated skin inflammation
Adjunctive skin barrier support in rosacea-prone skin

Ivermectin 1% / Metronidazole 0.75% / Niacinamide 4% Cream Dosage

Apply a pea-sized amount to the affected areas of the face topically once daily, or as directed by your prescriber.
Avoid the eyes, lips, and mucous membranes.
Continue for the duration prescribed; improvement may take several weeks.

Your prescriber will determine the dose and duration that are right for you. Always follow the directions on your prescription label.

Ivermectin 1% / Metronidazole 0.75% / Niacinamide 4% Cream Side Effects

Common side effects

Skin burning or stinging at application site
Dryness or flaking
Itching (pruritus)
Mild redness or irritation
Skin tightness
Temporary worsening of rosacea symptoms early in treatment

Serious side effects

Stop taking this medication and seek medical attention right away if you experience:

Severe allergic reaction (rash, swelling of face or throat, difficulty breathing)
Severe or worsening skin irritation, blistering, or peeling
Contact dermatitis that does not improve
Eye irritation or swelling if product contacts the eyes

Warnings & Interactions

For external (topical) use only; not for oral, ophthalmic, or intravaginal use
Do not use if allergic to ivermectin, metronidazole, niacinamide, or any component of the cream
Avoid alcohol while using metronidazole-containing products, as some patients report disulfiram-like reactions
Metronidazole may interact with warfarin; tell your provider about all medications
Use during pregnancy or breastfeeding only if directed by your provider
Avoid contact with eyes and mucous membranes; wash hands after applying
This compounded combination is not an FDA-approved product; its components are individually FDA-approved

Tell your prescriber about all medications, supplements, and health conditions before starting ivermectin 1% / metronidazole 0.75% / niacinamide 4% cream.