Medications

Zilxi

Zilxi

Previously Found with Medfinder

Comprehensive medication guide to {drug} including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.

Estimated Insurance Pricing
With insurance, eligible patients using the Zilxi Savings Card may pay as little as $25, though many plans require prior authorization.
Estimated Cash Pricing
Zilxi costs approximately $400–$600 per 60g canister without insurance.
Medfinder Findability Score
45
/100
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Post Author

Peter Daggett

Last Updated

February 18, 2026

Zilxi 2026 Availability, Prices, and Tips to Find

What Is Zilxi?

Zilxi (Minocycline Topical Foam 1.5%) is a prescription topical antibiotic approved for the treatment of inflammatory lesions — specifically papules and pustules — associated with rosacea in adults. It is manufactured by Journey Medical Corporation and was the first topical minocycline foam approved by the FDA. Unlike oral minocycline, Zilxi is applied directly to the skin, which helps reduce systemic side effects while targeting facial inflammation.

How does Zilxi work?

Zilxi contains minocycline, a tetracycline-class antibiotic that works by reducing inflammation and inhibiting bacterial growth on the skin. When applied topically as a foam, it directly targets the inflammatory lesions of rosacea without the systemic exposure associated with oral tetracyclines. Patients apply a thin layer of foam once daily to the affected areas of the face.

What doses are available for Zilxi?

  • Zilxi 1.5% Topical Foam — 30g pressurized canister
  • Zilxi 1.5% Topical Foam — 60g pressurized canister

How hard is it to find Zilxi in stock?

Zilxi scores a 45 out of 100 on our findability scale, meaning it can be difficult to locate in stock. As a branded specialty topical foam with no generic equivalent, many pharmacies do not routinely stock it. While there is no active FDA shortage, patients frequently encounter localized availability issues and may need to call multiple pharmacies or use a specialty pharmacy to obtain it.

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Who Can Prescribe Zilxi?

Zilxi is most commonly prescribed by dermatologists, as rosacea is a skin condition that typically falls within their specialty. However, primary care physicians and internal medicine doctors can also prescribe it. Telehealth consultations are available for patients who may have difficulty seeing a dermatologist in person.

Is Zilxi a controlled substance?

No, Zilxi is not a controlled substance. It is a topical antibiotic and does not have any potential for abuse or dependence. It does not require a DEA number to prescribe and can be called in or electronically sent to any pharmacy.

Common Side Effects of Zilxi

  • Diarrhea (most commonly reported)
  • Headache
  • Skin irritation at the application site
  • Nausea

Serious but rare side effects may include C. difficile-associated diarrhea, hepatotoxicity, autoimmune syndromes, intracranial hypertension, serious skin reactions, photosensitivity, and tissue hyperpigmentation. Contact your healthcare provider immediately if you experience any severe or unusual symptoms.

Alternative Medications to Zilxi

  • Metronidazole (MetroGel, MetroCream) — A topical antibiotic and first-line treatment for rosacea, available as a generic gel and cream at a lower cost.
  • Ivermectin (Soolantra) — A topical anti-parasitic cream approved for rosacea that targets Demodex mites contributing to inflammation.
  • Azelaic Acid (Finacea) — A topical gel or foam that reduces inflammation and kills bacteria, approved for rosacea.
  • Doxycycline (Oracea) — A low-dose oral tetracycline antibiotic often used for moderate-to-severe rosacea.

Drug Interactions with Zilxi

  • Isotretinoin (Accutane) — Concomitant use increases the risk of intracranial hypertension (pseudotumor cerebri). Do not use together.
  • Anticoagulants (e.g., Warfarin) — Tetracyclines may increase the anticoagulant effect, requiring closer monitoring of INR levels.
  • Penicillin — Tetracyclines may interfere with the bactericidal action of penicillin antibiotics.
  • Oral Retinoids — Increased risk of intracranial hypertension when combined with tetracyclines.

Although Zilxi is applied topically and has lower systemic absorption than oral minocycline, patients should inform their doctor of all medications they are taking.

Final Thoughts on Zilxi

Zilxi is a unique treatment option for adults with inflammatory rosacea, offering the benefits of minocycline in a targeted topical foam. However, its high cash price of $400–$600 per canister and limited pharmacy stocking can make it challenging to obtain. Patients should check with specialty pharmacies, use the manufacturer's savings card (eligible commercially insured patients may pay as little as $25), and consider alternatives like Metronidazole or Azelaic Acid if cost or availability is a barrier. Using Medfinder can help you quickly locate pharmacies that have Zilxi in stock near you.

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