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Isotretinoin, more popularly recognized through its brand name, Accutane, is a potent oral medication used in the treatment of severe acne that is resistant to conventional methods such as topical or oral antibiotics and creams. An overwhelming number of patients reported dramatic decrease in acne symptoms and a prolonged drug-free improvement in just a single 15 to 20-week isotretinoin course.
Isotretinoin is able to effectively fight acne by attacking it at its very root. It accomplishes this in two ways.
• It greatly decreases the size and sebum output of your oil glands. By doing this, it actually starves the P. acnes bacteria by cutting off its food source.
• Isotretinoin promotes normal shedding off of dead keratinized epidermal cells in your hair follicles. This shedding off unclogs your pores and prevents whiteheads and blackheads from forming.
Oral isotretinoin is known in the United States as Accutane and Roaccutane worldwide. Besides these two name brands, it is also marketed in the US under various generic brands. Isotretinoin is also sold in the UK, Canada, Europe and Australia in both oral and topical acne treatment preparations.
The recommended daily dosage for isotretinoin is 0.5 - 2 mg per kg of body weight, which is normally given in two separate doses for 15 to 20 weeks. It is best to take it with meals to maximize its absorption into the system.
Since isotretinoin is a derivative of vitamin A, it is a retinoid related to both tretinoin and retinol. Simultaneous use of both isotretinoin and vitamin A can possibly cause vitamin A side effects.
In the same vein, treatments involving the simultaneous use of isotretinoin and tetracycline should be avoided because this combination has been linked to brain swelling.
You may experience some of these side effects during treatment. These usually disappear when isotretinoin treatment is stopped.
• Dry skin and mouth, bleeding gums, chapped lips
• Increase in blood cholesterol and triglycerides
• Inflammation of the white of the eye (conjunctiva)
• Epistaxis (nosebleeds)
• Muscle and joint pains
• Vision change such as reduced night vision
• Psychiatric problems, hallucinations, suicidal behavior
• Can cause fetal deformity
Rare side effects include skin rashes, excessive skin peeling, photosensitivity, hearing problems and hepatitis. Brain swelling, accompanied by headache, nausea and vision problems, has also been reported.
Because of some serious risks and side effects involved, isotretinoin should only be chosen for severely stubborn acne. Isotretinoin treatment should be closely supervised because:
• Oral isotretinoin is classified as a teratogen, a drug that can cause fetal deformity in pregnant women. If taken by pregnant women, isotretinoin can very possibly cause severe birth defects. Women should show 2 negative pregnancy tests before starting the therapy and have a pregnancy test every month during therapy.
• Breastfeeding mothers undergoing therapy may transfer isotretinoin to their newborn through their breast milk. Isotretinoin should not be used by nursing mothers.
• Isotretinoin can be associated with hallucinations, depression, and suicidal tendencies in people who use it.
Since isotretinoin causes fetal deformities, it is marketed only through a special program under FDA approval called iPLEDGE. iPLEDGE-registered health workers and pharmacies are the only ones allowed to prescribe and sell isotretinoin.
UPDATE: On July 8, 2009, Acne Drug Accutane No Longer Sold details...