What is isotretinoin ?
Isotretinoin is a drug that is prescribed for severe acne that has not been addressed by previous medication. It can be obtained under the brand name Accutane (Roche). The structure is derived from vitamin A:
Action
The drug is highly effective in people with acne, thanks to a multi-operation;
-It inhibits the excessive sebum production
-It prevents the increase of the sebaceous gland
-It stops the formation of new pimples or blackheads
-It inhibits the inflammatory response (redness) that causes the bacterium.
Possible Side Effects Of Isotretinoin
Most side effects are dose-dependent and reversible.
-Dry lips, skin and mucous membranes. Cracking of the lips can be prevented by rubbing the lips several times a day (lips) ointment;
-Decreased tear production (causing irritation to the eye). Lenses can be replaced by a pair of glasses or one can use artificial tears;
-Zonovergevoeligheid. As long as this medicine should be avoided direct sunlight;
-Increase of the fat and cholesterol;
-Impaired liver function (liver function should be checked every few weeks);
-Temporary hair loss (in some cases, long-term);
-Joint and muscle pain;
-Psychological problems, depression, suicidal tendencies.
Very common (> 10%): symptoms of hypervitaminosis A, such as dry and / or flaky skin (especially on the palms and soles), dry mucous membranes (lips, nasal cavity, pharynx, conjunctiva) and conjunctivitis. Further: eye irritation, thin skin, itching, rash, dermatitis, cheilitis, blepharitis, muscle and joint pain, back pain, thrombosis, increased liver enzymes and, especially in predisposed patients (family history of lipid disorders, diabetes mellitus, obesity or alcohol abuse ), anemia, elevated erythrocyte sedimentation rate, thrombocytopenia, thrombocytosis, increase the triglyceridenspiegels- and lowering of the serum-HDL.
Common (1-10%): headache, nasopharyngitis, epistaxis, increased cholesterol levels, hyperglycemia, neutropenia, hematuria, proteinuria.
Rare (0.1-1%): allergic skin reactions, anaphylactic reactions, (worsening) depression, aggression, anxiety, mood swings, (reversible) alopecia.
Very rare (0.01-0.1%): acne fulminans, increased acne, malaise, nausea, gastroenteritis, gastrointestinal bleeding, hepatitis, pancreatitis, glomerulonephritis, hyperuricemia, increased creatine kinase, diabetes mellitus, lymphadenopathy, benign intracranial hypertension (with symptoms pupil edema, headache, nausea, vomiting, visual disturbances, seizures, drowsiness, dizziness, (reversible), clouding of the cornea, cataracts, disturbances in dark adaptation, photophobia, keratitis, decreased hearing, vasculitis, bronchospasm, hoarseness, thinning hair, hirsutism, hyperpigmentation, hyperhidrosis, nail dystrophy, paronychia, Pyogenic granulomas, arthritis, calcinosis, exostosis, premature epiphyseal closure, decreased bone density, tendonitis, psychotic reactions, (attempted) suicide, suicidal thoughts, menstrual disorders.
In men, gynecomastia and impotence described.
Isotretinoin dosage
The treatment with isotretinoin can vary from 0.5 to 1.0 mg / kg body weight. It is available in tablets of 10 or 20 mg. Doses up to 40 mg per day may be taken at one time, higher doses should be spread throughout the day.
Fertility
The treatment is harmless for men in this field.
For women: Isotretinoin must not be used just before, during and after pregnancy. Also should not breastfeed during treatment. The substance may cause a malformation in babies.
Fertility in both sexes is ultimately unaffected.