Accutane is a medication that is used to treat severe recalcitrant nodular or cystic Acne.

It is also known as Isotretinoin.

Typically other medications such as antibiotics, creams, or other medications have already been used and failed in patients looking to use Accutane.

The primary concern with this medication is the increased risk for serious birth defects (Teratogenicity)  for those who take this medication while pregnant.

More than 30% risk is seen for birth defects.

Concern for absorption through skin is seen and therefore even handling the medication should be limited by women intending to become pregnant.

Those providers who prescribe of this medication must be apart of program iPLEDGE program

Women intending to take this medication must attempt at all possible not to become pregnant while taking this medication.

Patients taking this medication should not donate blood for at least one month after stopping the medication.

Treatment Options

Other than acne – this medication can also be used in treatment of some cancers.

Brain cancer, Pancreatic cancer and other cancers.

It can be used to treat Harlequin-type ichthyosis.

This drug is not intended for the everyday or bad acne.

Mechanism of Action

  • This medication is a retinoid and is a derivative of Vitamin A.
  • Mostly unknown
  • Drug may amplify certain proteins in skin that reduces sebum production
  • It may cause cell death in many cells – especially those that are at the base of causing acne.

Side Effects

  • Severe teratogen – abnormal physiological development of fetus. [Causes Birth Defects]
  • Dryness of skin, lips, and mucous membranes
  • Itching
  • Hair loss
  • Skin peeling
  • Nose Bleeds
  • Eye irritation
  • Change and/or loss of vision
  • Elevated Liver enzymes
  • Muscle and Joint pains
  • Elevated glucose in blood
  • Stomach pains
  • Depression
  • other

accutane-pills1Pharmoacokinetics

When given orally – it is best absorbed after a high-fat meal.

It binds to Albumin inside the blood stream.

The metabolites of Isotretinoin are excreted through feces and urine.

Half-life is 21 hours.

History

The Retinoic acid derivative of this medication was first developed in the early 1980’s by Hoffmann-La Roche.

Dr. Gary Peck is who first discovered its use in treatment of acne.

February 2002-  Roche’s patents for Isotretinoin expired.

There are many companies that now sell Accutane.

It can even be found over the internet without a prescription.

This is a very concerning development due to that lack of knowledge about the major side effects.

 

 

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