Accutane (Isotretinoin)

Accutane Description

Accutane is an active drug substance used in the treatment of acne. It is a retinoid (a derivative of vitamin A occuring naturally in the body, produced by the liver in small quantities). The active ingredient, isotretinoin, is known to possess immunomodulatory properties. This substance is considered the most effective in the treatment of acne. It is generally reserved to treat severe acne that has been resistant to antibiotic treatment for 3 months.

Isotretinoin, the main component of Accutane, is a cis-isomer of tretinoin and one of the first-generation retinoids (non-aromatic retinoids). Isotretinoin was in developed first in 1982 by Roche and brought to the market under the name of Accutane. Isotretinoin is the active ingredient of various other medicines such as Curacne and Roaccutane.

The drug was originally developed for cancer patients who were undergoing chemotherapy. During the 1970s, in the laboratory of Hoffmann-La Roche a program of synthesis of retinoids was initiated in order to reduce the side effects of chemotherapy. But W. Bollag first had the idea to use the 13-cis isomer of retinoic acid and discovered that it had therapeutic efficacy in cases of rash acne. It had reduced side effects compared to retinoic acid.

Accutane is 99.9% bound to proteins. The plasma half-life is 17-50 hours. It metabolism is caused by topical application in the keratinocytes, resulting in its systemic uptake in the liver. It is excreted by the liver and kidney through feces and urine.

Conditions Treated by Accutane

A systemic Accutane therapy reduces the size of the sebaceous glands. The quantity and composition of lipids of the sebaceous glands become normal. A healing effect prevails over the acne spots. Nevertheless, relapses are possible. A study in 1998 estimated the rate of relapse three years after the first treatment being up to 61% of treated cases.

An immunomodulatory effect occurs by inhibition of granulocyte and stimulation of Langerhans cells. Accutane has a direct effect on lymphocytes. Accutane causes an enhanced maturation of the keratinocytes. This also applies to cells which exhibit signs of malignant transformation. These tumor-protective effects are generally observed after UV irradiation.

In addition to acne, Accutane is also employed in the treatment of gram-negative folliculitis, rosacea, psoriasis, seborrheic dermatitis, eczema and actinic keratosis.

Accutane works as a hormone replacement therapy (HRT), both topically and systemically applied. Because of the significant risks and side effects, this drug is usually prescribed only in severe cases that require refractory systemic treatment. The drug has to be approved by an authorized doctor for usage and is never sold over the counter without a prescription.

For better effect on moderate, inflammatory forms of acne, a topically applied gel formulation in combination with the antibiotic erythromycin was developed in the late 90s.

Accutane Dosage Information

a.) Typical Dosage Recommendations

The standard daily dosage of Accutane is 1 mg/kg of the patient’s body weight. So in case of a 160 pound person the dosage should be around 80 mg each day. Accutane must not be administered systemically in persons with metabolism disorders like hyperlipidemia or hypervitaminosis.

Childbearing women should not use Accutane. Serious threatening malformation in fetus is possible. For this reason, many users undergo a new pregnancy test carried out by the doctor each month. The safety of topical application during lactation has not been studied sufficiently, so that is also not recommended.

b.) Missing a Dose

Take the missed dose as soon as possible. But if it’s too late, just go ahead with the next scheduled dose.

c.) Overdosing

The common symptoms of an Accutane overdose are headaches, dizziness and pain in the stomach. Seek medical attention right away if you feel you’ve been overdosed.

Accutane Warnings

With systemic therapy, patients have often complained of headaches. Very rarely, there have been cases of intracranial pressure, convulsions and drowsiness as well. An influence of brain metabolism could be detected if there is overdosing. Increased application of Accutane can also cause the formation of serotonin, which resultantly decreases the formation of proteins and cell metabolites. Psychological adverse effects such as depression and suicidal behavior have also been reported.

There are reported cases of reversible muscle and joint pain. Rare cases of arthritis, premature closure of the bone growth plates, excessive bone formation (hyperostosis), and calcification of ligaments and tendons (calcinosis) have also been noticed. One of the serious side effects of Accutane is blood excretion in the urine. There is also a risk of glomerulonephritis (the kidney’s failure to filter waste material and other fluids from the blood).

Accutane Side effects

The adverse effects of topical application are limited to the treated skin area. However, if there is systemic absorption of Accutane, sometimes various body locations can be undesirably affected.

• Parched skin
• skin flaking
• nosebleeds

These are some of the regular side effects observed after the application of Accutane. Accutane is not stable when you are out in the open sun and hence it can cause phototoxic reactions on the part of the skin where it is topically applied. In cases of systemic application, patients have sometimes complained of hair loss.

In systemic absorption of Accutane, there is a risk of liver inflammation other disorders, which necessitates a regular check on the daily secretion of liver enzymes. Increased blood sedimentation rate and anemia are very common side effects observed in systemic Accutane therapy. Similarly, thrombocytopenia and thrombocytosis can also occur. Accutane treatment can also lead to neutropenia (lack of white blood cells) and lymphadenopathy (very rare disease of lymph nodes).

Accutane treatments have known to cause

• inflammation of the eyelids
• conjunctivitis
• irritated eyes

There are also cases of:

• blurred vision
• cataracts
• color blindness
• corneal opacity
• night blindness
• corneal inflammation
• alteration of the fundus oculi with swelling (papilledema) as a sign of pseudotumor cerebri and light shyness (photophobia).

Possible Drug Interactions with Accutane

To prevent a vitamin A overdose, Accutane must not be used at the same time with high doses of vitamin A-containing medicines and dietary supplements. Liver products may contain high vitamin A doses; therefore the consumption rate of these products should be monitored if you are also using Accutane at the same time.

• Tetracycline Antibiotic:
  • demeclocycline (Declomycin)
  • doxycycline (Doryx, Vibramycin)
  • doxycycline (Adoxa)
  • minocycline (Minocin)
  • Achromycin (tetracycline)
• Seizure medications such as:
  • carbamazepine (Tegretol)
  • carbamazepine (Carbatrol)
  • phenytoin (Dilantin)
  • valproic acid (Depakene)

This list is not complete and other drugs may interact with Accutane. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

If you have any questions about buying discount Accutane online or any other prescription products you can contact our team of professional Patient Service Representatives or one of our pharmacists 24-7 by calling 1-800-226-3784.