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Two medicines, side by side

Azelaic acid vs adapalene

Azelaic acid and adapalene are both labeled for acne. Drugs@FDA records approvals of azelaic acid since 1995 and of adapalene since 1996. Pharmacies paid $0.441 per gram (Azelaic acid 15% gel) and $0.504 per gram (Adapalene 0.3% gel) (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like.

Check it at the source: the azelaic acid FDA label on DailyMed (effective November 11, 2021); the adapalene FDA label on DailyMed (effective December 27, 2023).

Highlights of the azelaic acid record

Azelaic acid (Finacea) · label of November 11, 2021

Used for

From the label: indications

Azelaic acid gel, 15% is indicated for topical treatment of the inflammatory papules and pustules of mild to moderate rosacea. Azelaic acid gel, 15% is indicated for topical treatment of the inflammatory papules and pustules of mild to moderate rosacea ( 1 ). Limitations of Use Efficacy for treatment of erythema in rosacea in the absence of papules and pustules has not been evaluated. […]

On the market

Earliest approval on file
September 13, 1995
Generic labelers
5 labelers
Pharmacy cost
$0.441 per gram

Supply and safety

Shortage
No current entry
Recalls
3

Highlights of the adapalene record

Adapalene (Differin) · label of December 27, 2023

Used for

From the label: indications

DIFFERIN Gel is indicated for the topical treatment of acne vulgaris in patients 12 years of age and older. DIFFERIN Gel, 0.3%, is a retinoid, indicated for the topical treatment of acne vulgaris in patients 12 years of age and older.

On the market

Earliest approval on file
May 31, 1996
Generic labelers
33 labelers
Pharmacy cost
$0.504 per gram

Supply and safety

Shortage
No current entry
Recalls
0

Source: FDA drug labels via openFDA (Azelaic acid label of November 11, 2021, Adapalene label of December 27, 2023); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)

How do azelaic acid and adapalene differ on the record?

How each works, in its label's words: Azelaic acid, “The mechanism(s) by which azelaic acid interferes with the pathogenic events in rosacea are unknown.”; Adapalene, “Adapalene binds to specific retinoic acid nuclear receptors but does not bind to cytosolic receptor protein.”

Generics: azelaic acid since 2018; adapalene since 2010 (Drugs@FDA).

Azelaic acidAdapalene
Labeled forAcneAcne
Pharmacologic classn/aRetinoid
How it works (label)The mechanism(s) by which azelaic acid interferes with the pathogenic events in rosacea are unknown.Adapalene binds to specific retinoic acid nuclear receptors but does not bind to cytosolic receptor protein.
Half-life (label)n/aThe terminal apparent half-life, determined in 15 of 16 subjects, ranged from 7 to 51 hours, with a mean of 17.2 ± 10.2 hours.
Earliest approval on file (Drugs@FDA)September 13, 1995May 31, 1996
First generic approvedNovember 19, 2018June 2, 2010
Generic labelers (NDC)5 labelers33 labelers
Pharmacy cost (NADAC, each one's most listed form; strengths differ)$0.441 per gram (Azelaic acid 15% gel)$0.504 per gram (Adapalene 0.3% gel)
12-month price change-32%-10%
Boxed warningNoNo
Shortage nowNo current entryNo current entry
Recalls recorded30
FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used)939181,062
DEA schedulenonenone

Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)

What next?

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