Accutane

Isotretinoin is an oral drug used for the treatment and prevention of severe acne. Acne is caused by inflammation of the skin. It primarily affects teenagers, but it also affects adults. Severe acne causes permanent scarring of the skin. The inflammation is caused in part by an increased secretion of sebum (oily substance) from glands in the skin (sebaceous glands). The sebum provokes inflammation, and the inflammation resolves (heals) with the formation of a scar (keratinization). The exact mechanism of action of isotretinoin is not known; however, it may reduce acne by reducing the secretion of sebum. If less sebum is secreted it is likely that there will be less inflammation and keratinization. The Food and Drug Administration approved isotretinoin in 1982.

The recommended dose of isotretinoin is 0.5 to 2 mg per kg of body weight daily. The daily dose usually is administered in two divided doses for 15-20 weeks. Isotretinoin should be taken with food.

The most common side effects of isotretinoin are dry skin, itching, dry nose, nosebleeds (epistaxis), cracks in the corners of the mouth (chilitis), dry mouth, and inflammation of the whites of the eyes. Joint aches also are common. Patients may develop an increase in blood cholesterol and triglycerides. Psychiatric problems such as depression, hallucinations and suicidal behavior have been reported. Rare side effects include skin infections, peeling, sun sensitivity, hearing impairment and hepatitis. Rarely, isotretinoin can cause brain swelling (pseudotumor cerebri or intracranial hypertension), which produces nausea, vomiting, headache, and changes in vision.

Isotretinoin is closely related to vitamin A. Therefore, the use of both vitamin A and isotretinoin at the same time may lead to vitamin A side effects.

Isotretinoin is used to treat severe acne that is resistant to more conservative treatments such as creams, drying agents, and topical or oral antibiotics. Complete remission or prolonged improvement is seen in many patients after one course of 15 to 20 weeks of isotretinoin. Because of its serious side effects, isotretinoin should be used only for severe, resistant acne

Store at room temperature 15-30°C (59-86°F) and protect from light

Before taking isotretinoin,

tell your doctor and pharmacist if you are allergic to isotretinoin, parabens, or any other drugs.
tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially carbamazepine (Tegretol), demeclocycline (Declomycin), doxycyline (Monodox, Vibramycin, and others), minocycline (Minocin), oxytetracycline (Uri-Tet), tetracycline (Achromycin V), vitamin A, and other vitamins and herbal products. Do not take any vitamin supplements that contain vitamin A to avoid possible harmful reactions.
tell your doctor if you have or have ever had diabetes, liver disease, pancreatitis, a high amount of triglycerides (fats) in your blood, a family history of high triglycerides in the blood, or depression.
plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. Isotretinoin may make your skin sensitive to sunlight.
isotretinoin may cause intracranial hypertension, especially when it is taken with tetracycline. Intracranial hypertension is a condition caused when the pressure in the blood vessels of the brain increases or when the brain swells. Symptoms of intracranial hypertenstion include severe headache, upset stomach and vomiting, and changes in vision. If you have any of these symptoms, call your doctor immediately.
be aware that this medicine may affect your night vision. Be cautious when driving or operating any machinery after dark.
hair removal by waxing and laser procedures to the skin should be avoided while taking isotretinoin and for 6 months after stopping isotretinoin. These procedures may cause scarring.