Isotretinoin (Accutane)

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Pharmachologic effect

Pharmacology: Pharmacological action – dermatoprotective. Normalizes terminal differentiation of cells, inhibits the proliferation of the epithelium of the ducts of the sebaceous glands, the formation of detritus, facilitates its evacuation. Reduces production and facilitates the release of sebum. When ingestion is quickly and fairly fully absorbed. The average time to reach C_max is 2.9 hours. Most of it binds in blood plasma with albumin. T_1 / 2 – 10-20 h. The main metabolite is 4-oxo-isoretinoin, its T_1 / 2 is 25 h (17-50 h). It is allocated mainly by the kidneys.

Indications for use

Application: Acne rash.


Isotretinoin (Accutane)Contraindications: Hypersensitivity, violations of liver and kidney function, hyperlipidemia, rectum diseases, pregnancy (teratogenic and embryotoxic manifestations are possible), breast-feeding (breastfeeding should be stopped for the duration of treatment).

Restrictions on the use: Diseases of the liver, kidneys, chronic pancreatitis, circulatory insufficiency.

Side effects

Side effects: Arthralgia, myalgia, pain in the chest, rash (erythema, seborrhea, eczema), thinning of hair – rarely, intracranial hypertension, mental disorders (depression, suicidal tendencies), vasculitis (including Wegener’s granulomatosis) , dry eyes, decreased night vision, cataracts, conjunctivitis, keratitis, enteritis.

Interaction: Incompatible with retinoids, which exert keratolytic and exfoliative action.

Dosage and route of administration

Dosing and Administration: Inside, the recommended dose is 0.5-2 mg / kg, divided into two parts; applied within 15-20 weeks. For most patients, a sufficient initial dose is 0.5 mg / kg / day, with severe disease or torso 2 mg / kg / day. Correction of the dose is carried out depending on the response to therapy and / or the severity of side effects. If the amount of rashes decreased by 70% or more in 15-20 weeks, the treatment is stopped. The second course of therapy is carried out with an interval of at least 2 months with confirmation of the persistent or recurrent course of the disease.

Special instructions: During the therapy, it is necessary to control the level of lipids, glucose, liver function; insolation should be avoided.