| name | Isotretinoin (Accutane) |
| classification | Retinoid, Vitamin A derivative |
| pharmacokinetics | Isotretinoin is readily absorbed from the gastrointestinal tract. Peak plasma concentrations are typically reached within 2-4 hours. The drug is extensively metabolized in the liver, primarily by oxidation and conjugation. The major metabolites are inactive and are excreted in the urine and bile. The half-life is variable, ranging from 3 to 20 hours. |
| suggested dosage | | description | Dosage is highly individualized based on the patient's condition and response. It is crucial to adhere to the prescribed regimen. The typical starting dose for moderate acne is 0.5 mg/kg daily, and this may be adjusted upward or downward as needed and tolerated by the patient. | | note | Always consult with a dermatologist or physician for appropriate dosage recommendations and to monitor your treatment response. | | male patient 70kg | For a 70 kg male patient, initial dosage guidance would usually fall between 20-40 mg per day, but must be determined individually per clinical guidance. |
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| indications | Isotretinoin is primarily indicated for the treatment of severe nodular and cystic acne that does not respond to other treatments. It can also be used for other skin conditions like severe acne rosacea. |
| safety in pregnancy | ABSOLUTELY CONTRAINDICATED in pregnancy. Isotretinoin is a potent teratogen, meaning it can cause severe birth defects. Women of childbearing potential must use effective contraception during treatment and for at least one month after the treatment stops. High-risk patients require specialized contraception measures like intrauterine devices (IUDs), and regular monitoring. |
| safety in breastfeeding | Isotretinoin is not recommended for use during breastfeeding. It is excreted in breast milk, so it could potentially have adverse effects on the infant. |
| side effects | | 1 | Dry skin, lips, eyes, and nose | | 2 | Mouth sores | | 3 | Headaches | | 4 | Elevated liver enzymes (requiring regular monitoring) | | 5 | Depression, mood changes, psychosis | | 6 | Eye irritation | | 7 | Fatigue | | 8 | Joint pain | | 9 | Increased risk of pancreatitis | | 10 | Rare cases of serious neurological adverse reactions | | 11 | Elevated triglycerides and cholesterol | | 12 | Psoriasis |
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| alternatives | |
| contraindications | | 1 | Pregnancy | | 2 | Known hypersensitivity to isotretinoin or related retinoids | | 3 | Severe liver disease | | 4 | Known or suspected depression | | 5 | Existing pancreatic disorders |
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| interactions | | 1 | Alcohol consumption may increase side effects | | 2 | Certain medications may enhance or decrease the effects of isotretinoin, and require careful monitoring and consideration. Consult the pharmacist. |
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| warnings and precautions | | 1 | Regular blood tests (liver function, lipid profile, etc.) are required during treatment | | 2 | Patient education on potential side effects and lifestyle modifications (e.g., moisturizing for dry skin) is essential. | | 3 | Close monitoring for any signs of depression or suicidal ideation | | 4 | Carefully evaluate patients for pre-existing depression or risk factors for this condition. |
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| additional information | Isotretinoin is a powerful medication and should only be used under the strict supervision of a dermatologist. It can have significant side effects, and treatment response can be variable. Close monitoring by a healthcare provider is essential throughout treatment. |
| patient profile | |
