Isotretinoin (Accutane)
Uses, Side Effects, Interactions and Dosage
Description
Isotretinoin belongs to a class of drugs called retinoids, which are synthetic derivatives of vitamin A. These drugs are used to treat severe acne and other skin conditions. Topical isotretinoin has been shown to be effective as a treatment in combination with other medications for oral lichen planus. Because isotretinoin is derived from vitamin A, users of this drug should be careful to avoid vitamin A supplements, as this can cause dangerous side effects.
Original uses (on-label)
Severe acne unresponsive to conventional therapy.
Newly discovered uses (off-label)
Also, patients can order isotretinoin online to treat leukoplakia, oral lichen planus, prevention of recurrence of oral cancer.
Potential side effects
Increased heart rate, headache, visual disturbances, malaise, nervousness, dry lips, dry skin, hair abnormalities, skin peeling, increased susceptibility of sunburn, itching, nausea, fatigue, suicidal ideation.
Cautions
- Notify your doctor if you are pregnant, are allergic to parabens, vitamin A, or other retinoids, have diabetes mellitus, increased triglyceride levels, or pancreatitis.
- Not for use during pregnancy. Requires two negative pregnancy tests; effective contraceptive used at least one month prior to starting therapy, during therapy, and for at least one month after discontinuing therapy, and prescriptions can only be written for one month supply at a time.
- Not to be used if you are a woman in childbearing age unless complying with effective contraceptive methods, and patients must commit to using two forms of birth control.
- Patients must be enrolled in the manufacturer sponsored and FDA approved monitoring programs.
- Depression, psychosis, aggressive or violent behavior, and rarely suicidal thoughts and actions have been reported during use.
- Patients who order Accutane need to understand that it use only for severe cystic acne that have not responded to less toxic drugs.
- Avoid excessive exposure to the wind, sun or cold temperatures. Retinoids may increase your skin's vulnerability to these conditions and may cause dryness and burning.
- Using this medication may make it difficult to wear contact lens because of the drying effect on the eyes.
Drug interactions
Corticosteroids, phenytoin, tetracycline, carbamazepine.
Food interactions
Take with food
Herbal interactions
Dong quai, St. John's wort, and additional vitamin A supplements.
Pregnancy and breast-feeding cautions
FDA Pregnancy Risk Category X. Excretion in breast milk is unknown. Use during breast-feeding is not recommended.
Do not buy Accutane if you are pregnant or may become pregnant while undergoing therapy. The chances are extremely high that the infant will be deformed if Accutane is used during pregnancy, or if pregnancy occurs while taking generic Accutane, in any amount, even for short periods of time.
Do not buy Accutane if you are pregnant or may become pregnant while undergoing therapy. The chances are extremely high that the infant will be deformed if Accutane is used during pregnancy, or if pregnancy occurs while taking generic Accutane, in any amount, even for short periods of time.
Special information
This drug has a black box warning describing the known teratogenic effects when taken during pregnancy. In addition, it describes the restricted dispensing program that requires signed patient consent and counseling along with negative pregnancy tests prior to the initiation of therapy. Additional information is also provided regarding the risk of suicidal ideation. Read the complete patient brochure and discuss these risks with your doctor.
What is Accutane?
This drug reduces the size of fatty glands and reduces fat production. It also regulates cell proliferation and differentiation.
Brands & Classes
Brand name
Claravis, Accutane
Generic name
Isotretinoin
Chemical class
Retinoid
Therapeutic class
Acne product (vitamin A derivative)
Claravis, Accutane
Generic name
Isotretinoin
Chemical class
Retinoid
Therapeutic class
Acne product (vitamin A derivative)
Avail forms
Tablets - Oral 5 mg, 10 mg, 20 mg, 30 mg.
Dosage
ADULT
PO 0.5-2 mg/kg/day divided bid for 15-20 wk or until total cyst count decreases by 70%; a 2nd course may be initiated after ≥2 mo off therapy if warranted by persistent or recurring severe cystic acne.
PO 0.5-2 mg/kg/day divided bid for 15-20 wk or until total cyst count decreases by 70%; a 2nd course may be initiated after ≥2 mo off therapy if warranted by persistent or recurring severe cystic acne.