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- What is isotretinoin, and how does it work (mechanism of action)?
- What are the uses for isotretinoin?
- What are the side effects of isotretinoin?
- What is the dosage for isotretinoin?
- Which drugs or supplements interact with isotretinoin?
- Is isotretinoin safe to take if I'm pregnant or breastfeeding?
- What else should I know about isotretinoin?
What is isotretinoin, and how does it work (mechanism of action)?
- Isotretinoin is an oral drug used for the treatment and prevention of severe acne. Acne is caused by inflammation of the skin. It primarily affects teenagers, but it also affects adults. Severe acne causes permanent scarring of the skin. The inflammation is caused in part by an increased secretion of sebum (oily substance) from glands in the skin (sebaceous glands). The sebum provokes inflammation, and the inflammation resolves (heals) with the formation of a scar (keratinization). The exact mechanism of action of isotretinoin is not known; however, it may reduce acne by reducing the secretion of sebum. If less sebum is secreted it is likely that there will be less inflammation and keratinization.
- The Food and Drug Administration approved isotretinoin in May 1982.
What brand names are available for isotretinoin?
Claravis, Amnesteem, Absorica, Myorisan, Zenatane, Sotret
Is isotretinoin available as a generic drug?
Do I need a prescription for isotretinoin?
What are the uses for isotretinoin?
- Isotretinoin is used to treat severe acne that is resistant to more conservative treatments such as creams, drying agents, and topical or oral antibiotics. Complete remission or prolonged improvement is seen in many patients after one course of 15 to 20 weeks of isotretinoin. Because of its serious side effects, isotretinoin should be used only for severe resistant acne.
- Because isotretinoin causes birth defects, isotretinoin is sold only under a special program approved by the Food and Drug Administration called iPLEDGE. Isotretinoin can only be prescribed by healthcare providers and dispensed by pharmacies registered in iPLEDGE.
What are the side effects of isotretinoin?
The most common side effects of isotretinoin are:
- Dry skin,
- Dry nose,
- Nosebleeds (epistaxis),
- Cracks in the corners of the mouth (chilitis),
- Dry mouth,
- Inflammation of the whites of the eyes.
Other side effects include:
- Joint aches
- Increased cholesterol
- Increased triglycerides
- Increased glucose
- Ringing in the ears
- Abnormal periods
Serious side effects include:
Erythema multiforme and severe skin reactions (for example, Stevens-Johnson syndrome, toxic epidermal necrolysis) have been associated with isotretinoin use. These events may be serious and result in life-threatening events or death, hospitalization, or disability. Patients should be monitored closely for severe skin reactions, and isotretinoin discontinued if necessary.
What is the dosage for isotretinoin?
- The recommended dose of isotretinoin is 0.5 to 2 mg per kg of body weight daily.
- The daily dose usually is administered in two divided doses for 15-20 weeks.
- Isotretinoin should be taken with food in order to improve its absorption.
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Which drugs or supplements interact with isotretinoin?
- Isotretinoin is closely related to vitamin A. Therefore, the use of both vitamin A and isotretinoin at the same time may lead to vitamin A side effects.
- Treatment with tetracycline (Achromycin) and isotretinoin should not be given at the same time since the combination has been associated with brain swelling. (See side effects below.)
Is isotretinoin safe to take if I'm pregnant or breastfeeding?
- Isotretinoin is harmful to the fetus and therefore should not be used during pregnancy. Women of childbearing age must have two negative pregnancy test results before therapy is started, and a pregnancy test must be conducted during each month of therapy. Two effective forms of birth control must be used during therapy, and pregnancy should be avoided one month before, during, and at least one month after stopping isotretinoin.
- It is not known whether isotretinoin is secreted in breast milk, but because of its potentially serious side effects, it should not be used by nursing mothers.
What else should I know about isotretinoin?
What preparations of isotretinoin are available?
capsules: 10, 20, 30 and 40 mg
How should I keep isotretinoin stored?
Store at room temperature 15-30 C (59-86 F) and protect from light
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What Are Boils (Skin Abscesses)?
A boil is a skin abscess, a collection of pus localized deep in the skin. There are several different types of boils. Among them are the following: furuncle or carbuncle, cystic acne, hidradenitis suppurativa, and pilonidal cyst.
Rosacea is a skin disease that causes redness of the forehead, chin, and lower half of the nose. In addition to inflammation of the facial skin, symptoms include dilation of the blood vessels and pimples (acne rosacea) in the middle third of the face. Oral and topical antibiotics are treatments for rosacea. If left untreated, rhinophyma (a disfiguring nose condition) may result.
Folliculitis is a skin condition that causes small red bumps to form around the hair follicles. Skin bacteria such as Staphylococcus and Pseudomonas may infect the follicles. Treatment involves over-the-counter bacterial washes, topical antibiotics, and/or topical steroids.
Acne is a localized skin inflammation as a result of overactivity of oil glands at the base of hair follicles. This inflammation, depending on its location, can take the form of a superficial pustule (contains pus), a pimple, a deeper cyst, congested pores, whiteheads, or blackheads. Treatments vary depending on the severity of the acne.
Keratosis Pilaris (KP)
Keratosis pilaris (KP) is a common skin disorder in which small white or red bumps appear around hair follicles on the upper arms, thighs, buttocks, and cheeks. The cause of KP is unknown. There is no cure for keratosis pilaris, and the condition may resolve on its own. Gentle exfoliation, professional manual extraction, chemical peels, and microdermabrasion, along with topical products, are the best treatments for this condition.
Cystic acne is distinguised by painful nodules on the chest, face, neck, and back. This form of acne is known to scar. Treatment may incorporate the use of hormonal therapies, oral antibiotics, and prescription medications.
Pregnancy Planning (Tips)
Pregnancy planning is an important step in preparation for starting or expanding a family. Planning for a pregnancy includes taking prenatal vitamins, eating healthy for you and your baby, disease prevention (for both parents and baby) to prevent birth defects and infections, avoiding certain medications that may be harmful to your baby, how much weight gain is healthy exercise safety and pregnancy, travel during pregnancy.
Sun-Sensitive Drugs (Photosensitivity to Drugs)
Sun sensitivity (photosensitivity) is an inflammation of the skin induced by the combination of medications or substances and sunlight. The effect on the skin is redness, which looks similar to a sunburn. Generally, these reactions are either phototoxic or photoallergic. Phototoxic drugs are more common than photoallergic drugs. Symptoms of phototoxic reactions are a burning and stinging sensation and then redness. Symptoms of photoallergic reactions are itching, redness, swelling, and blisters of the affected area. Treatment generally is discontinuation of the medication and topical application of creams.Treatment generally is discontinuation of the medication and topical application of creams.
Dry eyes are caused by an imbalance in the tear-flow system of the eye, but also can be caused by the drying out of the tear film. This can be due to dry air created by air conditioning, heat, or other environmental conditions. Treatment may involve self-care measures, medications, or rarely, surgery.
Head and Neck Cancer
Head and neck cancer is cancer of the oral cavity, salivary glands, paranasal sinuses and nasal cavity, pharynx, larynx, or lymph nodes in the upper part of the neck. These cancers account for 3% to 5% of cancers in the U.S. Tobacco and alcohol use are important risk factors. Treatment may involve surgery, radiation therapy, and/or chemotherapy.
Hailey-Hailey Disease (Familial Benign Pemphigus)
Hailey-Hailey disease (familial benign pemphigus) is a hereditary skin disease that causes painful blistering the skin folds. There is no specific treatment for this disease, and treatment focuses on alleviating symptoms and signs.
Disease Prevention for Teens
Teenagers recognize that they are developmentally between child and adult. Teen health prevention includes maintaining a healthy diet, exercising regularly, preventing injuries and screening annually for potential health conditions that could adversely affect teenage health.
Heart Attack Prevention
Heart disease and heart attacks can be prevented by leading a healthy lifestyle with diet, exercise, and stress management. Symptoms of heart attack in men and women include chest discomfort and pain in the shoulder, neck, jaw, stomach, or back.
Pregnancy and Drugs (Prescription and OTC)
Taking prescription medications or over-the-counter drugs or supplements should be discussed with your doctor. There are some medications that have been found to cause no problems in pregnancy, however, medications such as Accutane for acne, should never be taken during pregnancy.
Cleft Palate and Cleft Lip
Cleft palate and cleft lip are facial and oral defects that occur early in pregnancy. A cleft lip is a split of the two sides of the upper lip, and a cleft palate is a split in the roof of the mouth. Cleft lip the fourth most common birth defect in the U.S. Repair of a cleft palate or cleft lip may require multiple surgeries.
How Do I Take Care of My Skin?
Common skin concerns include uneven skin tone and texture, acne, skin pigmentation, and aging. Home remedies to improve your skin's overall appearance include exfoliation and using alpha and beta hydroxy acids, applying over-the-counter serums, lotions, creams, topical retinoids, masks, and toners. Wearing broad-spectrum sunscreen with a minimum SPF of 30, maintaining proper hydration, and eating a well-balanced diet will also go a long way toward achieving a youthful radiance.
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