Last Updated on July 2, 2018 by Dr.Derek Fhisher
Most popular brand: Accutane
Active ingredient: Isotretinoin
Available dosage forms: 10, 5, 20, 30, 40 mg
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Isotretinoin general information
Accutane is among the favorite brands of Isotretinoin. This pill was endorsed by many dermatologists all around the world to be among the very best and best acne treatments. The product doesn’t have some side results and has a terrific feedback from customers.
In case you are taking isotretinoin tablets, you might have to hesitate for some time after you give up taking it. The principal advantage of Acnevva is the fact that it is very powerful and doesn’t have any one side effect which is thus harmless to your own skin. You have to identify the degree of your acne condition so the appropriate remedy might be resorted.
People afflicted by acne can have distinctive kinds of problems with their skin. Then, finding the top acne solution isn’t an effortless job, entailing much studying to know the top elements for curing acne. Neutrogena is a favourite brand of many in regards to picking natual skin care products for skin issues. To be able to select a proper acne treatment you are required to know the cause of your own acne.
It ought to be noted there are potential side effects linked with accutane, and thus, it should not really be taken without prescription. It’s likewise recommended to stop utilizing the drug if there aren’t any visible skin improvements following a few weeks. Besides the common lesions in acne, other features can also be present.
The chemical is located in kind of gel and also cream. Exfoliate the skin once each week with a rather mild scrub. To help lower the inflammation, it is also possible to use Klaron lotion. Axillary and diaper rash might also present.
The thought that acne might be brought on by an unhealthy diet was debated for many years. Well, beside understanding how to treat acne, you also have to understand what factors that is able to make your acne worse. Skin experts say as long as you follow these few easy rules you cannot only handle your constipation but permanently knock out acne breakouts. It is quite effective in regards to fighting and eliminating acne.
Topical therapy involves the utilization of Nizoral shampoo for around a week. This treatment uses a gel put on the epidermis along with the blue light to take care of stretch marks. Topocal Clindamycin and also Erythromycin have equal effectiveness in regards to eliminating acne and can really be applied one or two times each day.
Grapefruit is a great fruit to use if treating acne. In addition, this medicine can likewise stop the recurrence of acne. Thus the treatment of constipation should really be a very significant part acne treatment.
A lot of people still think that acne results from dirty skin. It works along with the pure acne fighting mechanisms to make sure that acne is wholly eliminated and permanently prevented from reoccurring. Acnezine serves as a very natural remedy for any type of acne. With the proper skincare regime, you can certainly get that acne off your skin.
Tetracycline was prescribed for decades to lessen acne inflammation. They might even be used in instances of acne vulgaris, a mild kind of acne. It’s used for the therapy for nodular acne. It’s been found to be very effective in lessening the redness along with the formation of bumps on the face. Additionally, This is a standard condition for those who have fair skin. Acne prone skin can certainly find more Acne with the usage of oily skin because it will clog all the pores.
Isotretinoin (Isotretinoin): instruction, and the use of a formula
The nosological classification (ICD – 10)
Feature substance Isotretinoin
The yellow – orange or orange crystalline powder. Molecular weight 300,44.
Mode of action – A – vitamin-like, dermatoprotektivnoe, anti-inflammatory, anti-acne, protivoseboreynoe.
It normalizes the terminal differentiation of the cells, inhibits the proliferation of the epithelium of the sebaceous glands, the formation of detritus, facilitates its evacuation. It reduces the production and facilitates the secretion of sebum.
At intake absorption of volatile, low bioavailability and variable; together with food intake increases the bioavailability of 2 times. T max ; 2 – 4 hours Linking plasma proteins (mainly albumin) .; 99.9%. It is metabolized to form three major active metabolites ; 4 – oxo – isotretinoin (major metabolite), tretinoin and 4 – oxo – retinoina and less significant metabolites including glucuronides well. Since the in vivo isotretinoin and tretinoin reversibly transformed into each other, tretinoin metabolism associated with the metabolism of isotretinoin. 20 – 30% of the dose is metabolized by isomerization of isotretinoin. The pharmacokinetics of isotretinoin in man an essential role can play enterohepatic circulation. In studies of in vitro shown that isotretinoin metabolism are involved isozymes CYP2C8. CYP2C9. CYP3A4 and CYP2B6 P450. T 1/2 isotretinoin ; 19 hours, 4 – oxo – izoretinoina ; 29 hours. Excreted by the kidneys and bile in approximately equal quantities.
Application of the substance Isotretinoin
for oral and rectal use: severe acne (nodular – cystic, conglobata, acne scarring with the risk); Acne is not amenable to other forms of therapy.
For local application: acne vulgaris, seborrheic dermatitis, rosacea, perioral dermatitis.
Hypersensitivity, for oral and rectal use: Pregnancy, installed or planned (possible teratogenic and embryotoxic action), the period of breast-feeding, liver failure, hypervitaminosis A, expressed hyperlipidemia, concomitant tetracycline therapy; for rectal administration (optional): rectal diseases; for local use: should not be applied to extensive areas of the skin during pregnancy, breastfeeding and women planning pregnancy.
Restrictions on the use
for systemic use: diabetes, a history of depression, obesity, lipid metabolism, alcoholism.
Application of pregnancy and breastfeeding
is contraindicated during pregnancy (teratogenic and embryotoxic action).
Category effects on the fetus by FDA ; X.
breast-feeding should be discontinued at the time of treatment.
Side effects of substance Isotretinoin
From the nervous system and sensory organs: excessive fatigue, headache, increased intracranial pressure (cerebral pseudotumor: headache, nausea, vomiting, blurred vision, swelling of the optic nerve), seizures, xerophthalmia, individual cases of violations of visual acuity, photophobia, violation of dark adaptation (decrease in visual twilight vision); rare ; depression, psychosis, suicidal ideation, disturbance of color vision (goes after drug discontinuation), lenticular cataract, keratitis, blepharitis, conjunctivitis, eye irritation, optic neuritis; impaired hearing at certain frequencies of sound.
From the digestive tract: dryness of the oral mucosa, bleeding from the gums, inflammation of the gums, nausea, diarrhea, inflammatory bowel disease (colitis, ileitis), bleeding, pancreatitis (particularly with concomitant hypertriglyceridemia above 800 mg / dl). Described rare cases of pancreatitis with fatal outcome, transient and reversible increases in liver transaminases and isolated cases of hepatitis (in many of these cases, the changes do not go beyond the limit of normal and return to the beginning levels during treatment, but there was a need to reduce the dose or stop the drug in some situations ).
From the hematopoietic system: anemia, decreased hematocrit, leukopenia, neutropenia, increase or decrease the number of platelets, ESR acceleration.
From the respiratory system: rare ; bronchospasm (more frequently in patients with bronchial asthma in the anamnesis).
From the musculo – skeletal system: aching muscles with increased levels of creatine kinase in serum or without it, joint pain, hyperostosis, arthritis, calcification of ligaments and tendons, tendinitis.
For the skin: peeling of the skin of the palms and soles, rash, pruritus, facial erythema / dermatitis, sweating, pyogenic granuloma, paronychia, onychodystrophy, increased proliferation of granulation tissue, persistent hair thinning, reversible loss hair, fulminant form of acne, hirsutism, hyperpigmentation, photosensitivity, mild skin traumatized. Early treatment can occur exacerbation of acne that persists for several weeks.
Effects due to hypervitaminosis A: dry skin, mucous membranes, including lips (cheilitis), the nasal cavity (bleeding), the larynx and the pharynx (hoarseness), eyes (conjunctivitis, reversible corneal opacities and intolerance to contact lenses).
Other: lymphadenopathy, hematuria, proteinuria, vasculitis (Wegener’s granulomatosis, allergic vasculitis), systemic hypersensitivity reactions, glomerulonephritis, local or systemic infections caused by Gram-positive pathogens ( Staphylococcus aureus ), hypertriglyceridemia, hypercholesterolemia, hyperuricemia, decrease in high-density lipoprotein, rare ; hyperglycemia.
When the external application: passing redness, rashes with a new 2 – weeks of treatment, not requiring discontinuation of the drug, allergic reactions; possible (with prolonged use) ; cheilitis, conjunctivitis, dryness and peeling of the skin.
The simultaneous use of isotretinoin with other retinoids (including acitretin, tretinoin, retinol, adapalene) increases the risk of hypervitaminosis A. Because tetracyclines increase the risk of increased intracranial pressure, the simultaneous application of isotretinoin is contraindicated (reported a few cases of brain pseudotumor ). Isotretinoin can weaken the effect of progesterone, so during treatment with isotretinoin should not use contraceptives containing low doses of progesterone. The simultaneous use of drugs. which increase photosensitivity (including sulfonamides, tetracyclines, thiazide diuretics) increases the risk of sunburn.
The action of the ointment is weakened, while the use of antibiotics of the tetracycline group, as well as local application of glucocorticoids.
Dosing and Administration
Inside, topically, rectally. The dosage regimen is selected individually because Therapeutic efficacy and side effects of isotretinoin are dose dependent and vary in different patients. Inside (during the meal), the initial dose of ; 0.4 – 0.5 mg / kg / day. Divided into two parts, is applied for 16 – 24 weeks. In severe disease or lesions of the trunk ; 2 mg / kg / day. In chronic renal failure, severe initial dose should be reduced to 10 mg / day. Dose adjustment is dependent on the response to therapy and / or severity of side effects. If the number of lesions decreased by 70% or more for 16-24 weeks. treatment should be stopped. The second course of treatment is carried out at intervals of not less than 2 months upon confirmation of persistent or recurrent course of the disease.
Rectal: 0,5 – 1 mg / kg, 1 time a day (at night).
External . When acne and rosacea, 2 times a day on previously cleaned skin ointment applied thinly with a cotton swab or a solution. The duration of treatment ; 4 – 12 weeks. Repeated course is possible after consultation with the doctor.
Precautions substance Isotretinoin
In the course of treatment is necessary to monitor the level of lipids, glucose, liver function. Patients with diabetes are recommended more frequent monitoring of blood glucose.
For women of childbearing age you must use reliable contraceptive measures 4 weeks before, during, and for 1 month after treatment. In the event of pregnancy should be interrupted for medical reasons.
In case of colitis, blurred vision and the symptoms of cerebral pseudotumor treatment ceased. If you suspect a brain pseudotumor conduct a neurological examination.
We should not prescribe isotretinoin patients receiving other drugs from the group of retinoids (to avoid hypervitaminosis A).
It is necessary to avoid high insolation, including UV – therapy.
When isotretinoin treatment may be reduced tolerability of contact lenses. Patients wearing contact lenses in case of side effects from the eye glasses should be used.
Do not apply ointment on the skin around the eyes and in severe acute inflammation; can not be applied to mucous membranes.