Calming is a prescription therapy used for stress and relaxation support.

Patients seeking support for stress and relaxation support may qualify after evaluation by a licensed provider.

Yes. Calming is a compounded prescription topical medication containing ivermectin and metronidazole, both of which require a valid prescription from a licensed healthcare provider. A telehealth consultation and skin history review are required before dispensing to confirm the diagnosis, identify the appropriate active combination for your specific skin presentation, and establish a treatment protocol.

Common side effects during the initial 1 to 2 weeks include mild skin irritation, burning, or stinging at application as sensitized skin adjusts: this is typically transient. Mild dryness or tightness may occur, particularly with gel formulations. Some patients experience a brief initial increase in redness during the first week of antiparasitic therapy as Demodex die-off triggers a transient inflammatory response: this typically resolves with continued use. Contact dermatitis may occur in patients with sensitivity to any formula component. Discontinue and contact your provider if irritation is severe, worsening beyond the initial adjustment period, or if a spreading rash or blistering develops.

Patients with known hypersensitivity or documented allergy to ivermectin, metronidazole, other nitroimidazoles (tinidazole), or niacinamide should not use this product. The safety of topical ivermectin and metronidazole during pregnancy has not been fully established. Use is generally not recommended during pregnancy, and breastfeeding patients should consult their provider. Do not apply to skin with active bacterial, viral, or fungal infection at the treatment site. Pediatric use should be discussed with your provider.

Concurrent topical retinoids in the same facial area increase irritation risk in rosacea-prone reactive skin, discuss timing and sequencing with your provider. Multiple topical antimicrobials used concurrently increase the risk of bacterial resistance selection without established additive benefit. Patients on systemic metronidazole or tinidazole should inform their provider of the topical metronidazole component. Patients on long-term topical corticosteroids should discuss this with their prescriber, as corticosteroids are associated with Demodex overpopulation and may counteract ivermectin's antiparasitic activity. Photosensitizing medications require strict daily SPF use.

Patients with significant hepatic impairment should inform their provider, as metronidazole is hepatically metabolized and rare systemic absorption from topical facial use is possible. Those with autoimmune skin conditions such as lupus or significant photosensitivity disorders require individualized evaluation. Patients on systemic immunosuppressive medications should disclose these. Your provider will evaluate your complete skin and medical history before prescribing.