Isotretinoin (Accutane®) is a retinoid or vitamin A analog, which means that its molecular structure is similar to Vitamin A. It was first approved in the US in 1982. Capsules come in either 10mg or 40mg doses.
How Do Patients Use This Medication?
Your patient should take capsules as directed with fat-containing food for example, with 2% or whole milk. The fat in the food helps the acne medication to be fully absorbed so that enough can be delivered to the skin to make it effective.
Women who are of childbearing age need to use two reliable forms of contraception while taking this medication, and for one month after completing the treatment.
How Well Does It Work?
For severe acne, it cures approximately 35-38 percent of patients after one course of treatment, 70 percent of the people who take Accutane® experience long-term remission. Adult women have higher relapse rates than teenagers. One course of treatment will take on average, 4-6 months.
The daily dose is most often determined at 0.5 – 1mg per kg of your body weight, the total dose, that is, the total amount taken over the whole treatment period should be not less than 120mg per kg of body weight for long lasting benefit.
If your patient has very oily skin and giant blackheads or a younger teenager, or have acne on their chest and back, then they have a greater chance of having a relapse of their acne. Most dermatologists believe it is a remarkable acne medication, some people’s acne clears quickly while in others improvement is gradual, multiple courses can be taken.
How Does It Work?
Isotretinoin basically helps the sebaceous gland to mature, it does so in several ways. Testosterone drives this oil gland to produce a number of different oils that influence the lining of the hair follicle. Accutane® brings the amount of oils to a more normal level and helps to change the composition of the oil so that it does not allow the pores to clog up. It prevents an excess of keratin from being produced, which means that comedones are not so readily formed.
This is the most effective therapy currently available, it can be used to treat your patient’s acne if it is severe and will reduce the risk of scarring. However, only doctors who have experience in its use should prescribe this medication. This is because regular monitoring, including periodic blood testing, is necessary. Women and girls who are using this medication must follow the manufacturer’s Pregnancy Prevention Program.
Frequently Asked Question’s About Isotretinoin:
1. “Can patients take other medications?”
The following drug interactions have been reported:
- Isotretinoin may reduce the level of Carbamazepine
- Avoid isotretinoin if patients are allergic to Parabens (it is a preservative)
2. “Which brands are available?”
- Accutane® (Roche)
3. “What conditions are treated by this medication?”
FDA-approved:
- Acne
- Severe recalcitrant nodular cystic acne that is not responsive to other therapy
