Isotretinoin

Also known as 13-cis-retinoic acid is a medication primarily used to treat severe acne. Rarely, it is also used to prevent certain skin cancers (squamous-cell carcinoma), and in the treatment of other cancers.

Isotretinoin

Isotretinoin; 13-cis-Retinoic acid; Accutane; Roaccutane; Claravis

Acneone, Acnestar, Acnex-20, Acno, Across, Acutret, Adclin, Cutret, Elvac, Iret, Isac, Isinin, Iso-Aret, Isobest, Isoderma, Isofact, Isofect, Isoin, Isonik, Isonion, Isoret, Isotane, Isotin, Isotriz, Isotroin, Neutin-20, Nextin, Nidtroin, Reto, Sotret, Tretiva, Tufacne, Yerdon, Zidoin, Zitan

(2Z,4E,6E,8E)-3,7-dimethyl-9-(2,6,6-trimethylcyclohex-1-en-1-yl)nona-2,4,6,8-tetraenoic acid

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The recommended dose range is 0.5 to 1.0 mg/kg/day given in two divided doses with food for 15 to 20 weeks per oral.

For the treatment of severe recalcitrant nodular acne

Dryness of mucous membranes, dryness of skin with scaling, fragility, erythema, cheilitis, pruritus, epistaxis, conjunctivitis, dry sore mouth and palmo-plantar exfoliation. Hair thinning, dry eyes, visual disturbances, changes in skin pigmentation, skeletal hyperostosis and musculoskeletal symptoms. Elevation of serum triglycerides, LFTs, ESR and blood glucose. Corneal opacities, photosensitivity, paronychia. GI disturbances, hepatitis. Headache, drowsiness, sweating, mood changes, psychotic symptoms, depression, suicidal tendencies, benign intracranial hypertension, seizures. Vasculitis, hypersensitivity reactions, IBS.

• Avoid or limit ethanol intake.
• Increased risk of pseudotumor cerebri with tetracyclines.
• Additive toxicity with vitamin A or its derivatives.
•  Decreased efficacy of microdosed progesterone (use 2 forms of contraception).
• May increase risk of bone loss with phenytoin.
• May increase risk of osteoporosis with systemic corticosteroids.
• Reduces plasma levels of carbamazepine.
• Avoid dong quai, St John's wort.

Pregnancy, lactation

Store at 15-30°C

Molecular weight

300.4351

Molecular formula

C20H28O2

CAS number

4759-48-2

Precautions

• Preexisting or predisposition to hypertriglyceridaemia (e.g. DM, obesity or increased alcohol intake).
• Monitor triglyceride levels.
• Blood glucose levels will be monitor in suspected or known DM patients.
• Monitor LFTs and blood lipids at weakly or bi-weekly intervals.
• Genetic predisposition for age-related osteoporosis, history of childhood osteoporosis, osteomalacia or other bone metabolism disorders.
• Anorexia nervosa.
• History of psychiatric disorder.
• May impair night vision.
• Discontinue the medication if abdominal pain, hearing impairment, rectal bleeding, severe diarrhoea or adverse ocular effects occur.
• Avoid wax epilation and skin resurfacing procedures for at least 6 months.
• Prolonged exposure to sunlight or UV light should be avoided.
• Patient should not donate blood during therapy and for at least 1 month following drug discontinuation.