ISOTRETINOIN
Background and Date of Approval
Isotretinoin received approval from the US FDA in 1982 for treatment of severe acne. This medicine is a retinoid, a medication class structurally related to vitamin A.
Uses
Isotretinoinis used to treat severe forms of acne. Acne is a common skin condition that occurs when hair follicles become clogged with oil and dead skin cells.
How is it administered?
Isotretinoin can be consumed orally and is available in the strength of 20mg. Do not crush, chew, or open the medicine. Your physician will decide the correct dosage and duration based on age, body weight, and disease condition. Only stop taking Isotretinoin if your doctor advises you to stop.
Side Effects
Serious side effects such as difficulty in breathing, fever, coughing, dizziness, chest and abdominal pain, severe headache, signs of pancreatitis like severe stomach pain radiating to the back, dark skin markings, leg swelling, double vision, ringing in the ears with headaches, and sudden migraines. Common side effects include hair loss, irregular heartbeat, joint and bone pain, skin rashes, itching, redness, and inflammation, dryness of the skin, mouth, and nose, respiratory problems, excessive sweating, mood swings, numbness or tingling in the hands or feet, constipation, and elevated levels of blood creatinine or blood fats.
Warnings
Do not take this medicine if you are allergic to Isotretinoin or any of the other substances of this medicine if you take other medicine like vitamin A, tetracyclines, or retinoids. f you have liver disease. Do not use this medicine if you have very high levels of blood fats (e.g., high cholesterol or triglycerides), very high levels of vitamin A in your body (hypervitaminosis A) or, if you are receiving treatment with tetracyclines. Avoid taking peanuts and soya, as this medicine contains soya bean oil. Talk to your doctor if you have other health conditions or ever had or have mental health problems like depression, mood change, or aggressive behavior because taking this medicine may affect your mood. Avoid consuming this medicine if you have any liver condition.
Precautions
Before taking this medicine, inform your healthcare professional if you plan to get pregnant or pregnant or breastfeeding as it is unsafe. Should not get pregnant even after stopping the medicine for one month. Use effective contraception. Notify your doctor if you are allergic or intolerant to some sugar, as this medicine contains sorbitol. This medicine should not be used to treat pubertal acne and not in children under 12 years of age Contact your doctor for more information. Report to your doctor immediately if you experience any side effects such as fever, chest or back pain, difficulty breathing, or fever.
Word of Advice
Inform your doctor about any side effects you experience; your doctor may adjust the dosage of Isotretinoin or prescribe additional medicine to manage side effects. Even if you have not noticed changes in your mood or behaviour, inform your friends and family that this medicine may affect your mood and behaviour. Discuss effective contraception methods with your doctor to prevent pregnancy. Women should undergo pregnancy tests every four months during treatment. Notify your doctor immediately if you become pregnant while under treatment; your doctor will provide appropriate management. Do not take other medications unless prescribed by your doctor.
References
Goodman & Gilmanâs, The Pharmacological Basis of Therapeutics, Dermatological pharmacology, 12th edition, 2011, 1812. KD Tripathi, Essentials of Medical Pharmacology, Drugs acting on skin and mucous membranes, 7th edition, 2013, 894. Roche Products Limited, Electronic medicines compendium (emc), [Revised on Fec 2022] [ Accessed on 23rd Sept 2023], Hreferralspctrackeden (medicines.org.uk) Roche Laboratories Inc, US Food and Drug Administration, [Revised on June 2002] [ Accessed on 23rd Sept 2023], https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/18662s051lbl.pdf
Frequently Asked Questions
Why to use effective contraception during the treatment of Isotretinoin?
To avoid unwanted pregnancy, it is advised to use effective contraception. Inform your doctor if you became preganat while under the treatment of Isotretinoin; your doctor may pick the right treatment. Also, it is better to discuss effective contraception with your doctor.
What are the different forms of Isotretinoin available?
Isotretinoin is primarily available in two forms such as topical creams and gels and oral capsules.
Should I double-dose Isotretinoin if I missed the dose?
No, you should not double dose the Isotretinoin even if you missed the regular dose. If you forgot to take the dose, take one as soon as you remember. If you double-dose the medicine, contact your doctor immediately.
Is that okay to take Isotretinoin with kidney disease?
Only limited information is available about the usage of Isotretinoin in kidney patients. So it is advised to inform the patient of the history with your doctor before starting the treatment.