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Isotretinoin

Isotretinoin is a generic medication used for the treatment of severe acne and most commonly known under the brands Accutane and Roaccutane. It is a retinoid, meaning it is derived from vitamin A and is found naturally in the body, produced by the liver in small quantities. more...

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History

Prior to the development of isotretinoin, the mainstay treatment of severe acne was oral antibiotics such as the tetracyclines and erythromycin. While these drugs have proven efficacy, they worked against only one contributing factor of acne, Propionibacterium acnes bacteria. The antibiotics gradually became less effective over time as more resistant strains of the bacterium became prominent.

An early, effective treatment of acne was high doses of the fat soluble vitamin A. At these dose levels (sometimes 500,000 IU per day) effects such as reduced production of sebum and dry hair could be noticed. However the vitamin also had many other prominent side effects which inhibited its widespread use.

The development of the derivative of retinoic acid, isotretinoin (13-cis-retinoic acid), and its release in 1982 by Hoffmann-La Roche was a great step forward in the treatment of acne. The synthetic compound provided better therapeutic benefit than vitamin A, while also producing fewer side effects. In February 2002 Roche's patents for isotretinoin expired, there are now many other companies selling cheaper generic versions of the drug.

Today isotretinoin is usually prescribed after other acne treatments have failed to produce results. The treatment of acne usually begins with topicals, moves onto oral antibiotics (or a combination) and finally isotretinoin therapy. This is because other treatments, while less effective than isotretinoin, produce far fewer side effects.

Brand names

Isotretinoin is produced under many brand names by many manufacturers. It is available typically as 5 mg, 10 mg, 20 mg and (in the USA) 40 mg capsules.

Some brands of isotretinoin include:

  • Accure® by Alphapharm
  • Accutane® and Roaccutane® by Roche
  • Aknenormin® by Hermal
  • Amnesteem® by Mylan
  • Ciscutan® by Pelpharma
  • Claravis® by Barr
  • Isohexal® by Hexal Australia
  • Isotroin® by Cipla
  • Oratane® by Douglas Pharmaceuticals
  • Sotret® by Ranbaxy

Indications

Isotretinoin is indicated for treatment for a number of dermatological conditions, most commonly acne. It is generally not used as a first-line treatment due to the potential side effects. Antibiotics (such as the tetracyclines) are usually prescribed before isotretinoin.

Severe forms of acne (conglobata, fulminans and nodulocystic) as well as acne that scars can be successfully treated with isotretinoin.

Acne that has not responded to other treatment will usually respond to isotretinoin. Dysmorphophobic patients may also be prescribed isotretinoin.

Read more at Wikipedia.org


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Isotretinoin can alleviate severe acne scarring.(Dermatologic Therapy)(Antiacne agents) : An article from: Skin & Allergy News $5.95 21st Century Complete Medical Guide to Acne, Accutane (Isotretinoin), Blackheads, Whiteheads, Pimples, Authoritative CDC, NIH, and FDA Documents, Clinical ... for Patients and Physicians (CD-ROM) $16.50
Link between isotretinoin use and onset of depression refuted. (Study of 215 Patients). : An article from: Clinical Psychiatry News $5.95

FDA to create isotretinoin registry for prescribers and patients
The U.S. Food and Drug Administration (FDA) will be strengthening the risk minimization action plan for isotretinoin (Accutane), a potent teratogenic ...
Both topical isotretinoin and adapalene are efficacious in the treatment of acne - Washington Whispers - Brief Article
This study compares the efficacy and tolerability of adapalene gel 0.1% and isotretinoin gel 0.05% in the treatment of acne vulgaris of the face. This ...
Tinea versicolor clearance with oral isotretinoin therapy
Abstract We describe the incidental clearance of preexisting tinea versicolor skin infection with the treatment of oral isotretinoin therapy for acne ...
FDA approves iPLEDGE for isotretinoin
The FDA recently approved iPLEDGE, the new risk management program developed to decrease pregnancy and subsequent fetal exposure in women taking isotretinoin ...
Isotretinoin in acne vulgaris: a prospective analysis of 160 cases from Kuwait
Abstract A total of 160 patients (59 male and 101 female) ages varying from 13 to 28 years (mean age 20 years) with moderate to severe acne were treated ...
Oral isotretinoin in the treatment and prevention of cutaneous squamous cell carcinoma
Abstract The clinical uses of oral isotretinoin (13-cis-retinoic acid) are many. They include treatment of acneiform eruptions, diseases of cornification, ...
Using Isotretinoin the Right Way for Acne - Brief Article
What is isotretinoin? Isotretinoin (brand name: Accutane) is a medicine for very bad acne that did not get better after you tried other medicines.
Disseminate and recurrent infundibulofolliculitis: response to isotretinoin
Abstract Disseminate and recurrent infundibulofolliculitis (DRIF) is a rarely-reported disorder. Here, the authors describe a case in which isotretinoin ...

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