Two medicines, side by side
Azelaic acid vs clindamycin
Azelaic acid and clindamycin are both labeled for acne. Drugs@FDA records approvals of azelaic acid since 1995 and of clindamycin since 1970. Pharmacies paid $0.441 per gram (Azelaic acid 15% gel) and $0.137 per gram (Clindamycin ph 1% gel) (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Only the clindamycin label carries a boxed warning.
Check it at the source: the azelaic acid FDA label on DailyMed (effective November 11, 2021); the clindamycin FDA label on DailyMed (effective March 10, 2026).
Highlights of the azelaic acid record
Azelaic acid (Finacea) · label of November 11, 2021
Used for
From the label: indicationsAzelaic 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 clindamycin record
Clindamycin (Cleocin) · label of March 10, 2026
Clostridioides difficile -associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including clindamycin hydrochloride and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon, leading to overgrowth of C. difficile.
Used for
From the label: indicationsClindamycin is indicated in the treatment of serious infections caused by susceptible anaerobic bacteria. Clindamycin is also indicated in the treatment of serious infections due to susceptible strains of streptococci, pneumococci, and staphylococci. Its use should be reserved for penicillin-allergic patients or other patients for whom, in the judgment of the physician, a penicillin is inappropriate. […]
On the market
- Earliest approval on file
- February 22, 1970
- Generic labelers
- 60 labelers
- Pharmacy cost
- $0.137 per gram
Supply and safety
- Shortage
- In shortage
- Recalls
- 24
Source: FDA drug labels via openFDA (Azelaic acid label of November 11, 2021, Clindamycin label of March 10, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do azelaic acid and clindamycin differ on the record?
Only the clindamycin label carries a boxed warning.
Generics: azelaic acid since 2018; clindamycin since 1982 (Drugs@FDA).
| Azelaic acid | Clindamycin | |
|---|---|---|
| Labeled for | Acne | Bacterial infections, Acne |
| Pharmacologic class | n/a | Lincosamide Antibacterial |
| How it works (label) | The mechanism(s) by which azelaic acid interferes with the pathogenic events in rosacea are unknown. | n/a |
| Half-life (label) | n/a | Excretion The average biological half-life is 2.4 hours. |
| Earliest approval on file (Drugs@FDA) | September 13, 1995 | February 22, 1970 |
| First generic approved | November 19, 2018 | February 8, 1982 |
| Generic labelers (NDC) | 5 labelers | 60 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.441 per gram (Azelaic acid 15% gel) | $0.137 per gram (Clindamycin ph 1% gel) |
| 12-month price change | -32% | -10% |
| Boxed warning | No | Yes |
| Shortage now | No current entry | In shortage |
| Recalls recorded | 3 | 24 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 939 | 8,968 |
| DEA schedule | none | none |
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?
- Alternatives to azelaic acid
- every medicine labeled for the same conditions