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Accutane (Isotretinoin)

Accutane is a retinoid used for the treatment of severe acne.

Accutane – your efficient helper on the way to pure face

Accutane belongs to the class of retinoid medicines and is used for curing difficult cases of acne. The pill is mostly recommended when no other methods of therapy, like antibiotics and creams, showed their effectiveness. Sometimes Accutane is prescribed even in moderate cases of acne if the process of scarring is too active. The efficiency of Accutane varies in different people: almost half of all patients cure once and for all, the rest need the therapy to be repeated. Isotretinoin, which is the generic name of Accutane, is also used to treat other diseases, for example, some forms of ichthyosis, fibrodysplasia ossificans progressive and several forms of cancer (including neuroblastoma and squamous-cell carcinoma).

The initial manufacturer and distributor of Accutane was Swiss Roche Pharmaceuticals. They developed this preparation while working on the medicines against cancer. Accutane was authorized by FDA in 1982. Roche's patent for the medicine expired in 2002 and there appeared lots of other generic variants of Accutane. Roche Pharmaceuticals officially stopped the manufacturing and marketing of isotretinoin on the territory of the United States in 2009. The main reason was numerous lawsuits from the patients, who suffered from diseases acquired as a result of Accutane intake. In its defense, the company claims that isotretinoin has cured about 13 million people.

How does it work?

The cause of acne is known to be hidden in excessive production of sebum. Isotretinoin affects sebaceous glands by reducing their size thus lessening the amount of sebum produced by the skin. This helps to cure even the most difficult cases of acne and prevent scarring.

Isotretinoin is the only existing acne medication, which influences all four main pathogenic processes in acne. It explains the effectiveness of Accutane compared to antibiotics even in the most difficult cases of illness.

Peculiarities of the intake

Accutane is mostly prescribed for the period from 4 months to half a year. If the effect wasn't achieved, the therapy should be repeated for another 16 – 20 weeks after 2 months brake. The difference in appearance can be seen in a couple of weeks or in a couple of months, depending on the initial skin condition. Some people may notice the worsening of the condition during the first days or even months of treatment. It's a possible adverse reaction.

The prescribed dosage depends on your weight, medical state and the body reaction to treatment. Remember that only your dermatologist can set the right dosing regimen that will be both safe and effective. Usually the common daily dose is from 0.5 to 2 mg per kg of body weight divided into two intakes. The patients should administer the pills orally with a large amount of liquid. Don't crush or chew them! The tablets should be taken with a substantial meal. It has been proved that fatty food increases the absorption of the preparation, which in its turn promotes the efficiency of isotretinoin. Stay active and don't take horizontal position for at least 10 minutes after the intake.

The pills are available in soft gelatin capsules in three different dosages. Accutane 10mg (light pink), 20mg (maroon) and 40mg (yellow).

What possible reactions of the organism might be expected?

The manifestation of adverse effects depends on several factors. First of all it's the dosage, the second factor is the duration of the preparation intake and the third one – personal sensitivity of the person to the ingredients of the preparation.

There are some side reactions, which necessarily occur to all the patients who take the preparation. Among them are dryness of lips and dry mouth. If these reactions are missing, it means that the regimen is ignored.

Before you begin the treatment of acne with isotretinoin, you'll have to pass several tests including pregnancy test (for women), test for the level of cholesterol in the blood, liver function, white blood count and eye exams. They are important because of high probability of adverse reactions. The medication is metabolized in the liver, so it is vitally important to monitor the state of this organ during the whole period of treatment.

Skin reactions

The list of probable side effects is impressive, but not all people experience them during the intake of Accutane. Among the most frequent are dry mouth, dryness of skin, cracks in the corners of the mouth, nosebleeds, eczema, redness of the skin and rash. The main reason of these adverse reactions is the dryness of mucous membranes. If any of these reactions are too strong, consult your medical care provider. He or she may recommend using moisturizing lip balm and creams for your body. Besides, to prevent dry mouth you can suck caramel candies and increase the amount of water you drink during the day.

Reactions connected with muscles and skeleton

One more kind of side effects is connected with musculoskeletal system. Here belong joint pain, back pain, fragile and brittle bones, tendons and ligaments calcination, premature epiphyseal closure and excessive growth of bone. Taking into consideration all the dangers connected with bone fragility as a consequence of such treatment, it is recommended to limit physical activity and avoid contact sports (football, hockey, soccer, wrestling and so on).

Gastrointestinal effects

Besides, some patients may experience adverse reactions connected with gastrointestinal tract. These are diarrhea, intestinal pain, vomiting, nausea, rectal bleeding and pancreatitis. Among the most dangerous diseases that may manifest themselves when on Accutane are ulcerative colitis and inflammatory bowel disease. The latter became the reason of numerous lawsuits from the people, who acquired this illness as a result of using Accutane. In case of strong manifestations of side effects stop the intake promptly and turn for medical help.

Effects on the eyes

Being a derivative of vitamin A,Accutane has a strong influence on eyes. The excess of this substance leads to such diseases as blepharitis (inflammation of the eyelid), conjunctivitis, dry eyes, and irritation of the eye. To the most dangerous side effects belong blurred vision, color blindness, lowered night vision, light sensitivity, keratitis and several other serious illnesses. One more important issue is that because of the dryness of the eyeball the patient may feel discomfort with wearing eye lens. In this case, one should consult his or her doctor. You may need to give up wearing contact lens during the whole period of treatment.

Psychological influence of Accutane

Some patients claim that the intake of Accutane affected their nervous system. A number of researches have been carried out and some of them confirmed the influence of isotretinoin on the psychological state of the patients. It was proved that the intake of Accutane might provoke depression, sleeping problems, aggression, thoughts of suicide and even suicidal attempts. There is a statistics, which says that there are 56 reported cases of suicide connected with the intake of isotretinoin. It is the only non-psychiatric preparation, which is FDA-regulated, on the top-10 list of suicide danger drugs.

Unfortunately, there is a possibility that some side effects produced by these drugs may become permanent. These are dry eyes; dysfunction of salivary gland, which leads to dry mouth; lowered night vision. Any changes in bones (premature epiphyseal closure, hyperostosis) are also irreversible. Though you can buy Accutane online, it is a prescription drug. So think twice before you buy it without doctor's advice.

In case you feel any strong side effects contact your dermatologist and turn for medical help immediately. You should stop the intake of preparation and get a professional consultation concerning its further usage. The list of adverse reactions is not completed. For more information consult your health care provider.

Precautions one should follow

Before you start curing acne with Accutane, make sure that your doctor knows everything about the pills you take and about your health state. The interaction of Isotretinoin with other retinoids might be dangerous. The excessive level of vitamin A may lead to stronger and more dangerous adverse reactions.

Inform your doctor if you administer any retinoid-based medicines or if you are allergic to vitamin A related drugs. Besides, it is vitally important to inform your medical provider about any other type of allergy you may have experienced. In some cases allergic reactions may be provoked by the inactive components of the preparation (soy, parabens). If you experience any reactions of hypersensitivity (hives, swelling of the face, lips, tongue or throat, difficulty breathing) get an emergency medical aid.

Moreover, people suffering from some chronic illnesses and conditions may be in a group of risk. Those, who suffer from diabetes, obesity, liver problems, pancreatitis, excessive alcohol consumption, eating disorders or have a personal or family history of psychiatric disorders or high cholesterol level, must be cautious. Talk to your physician to find out if you belong to any of these categories.

Patients taking Accutane are susceptible to sunburn. It is recommended to avoid both natural and artificial sunbathing. Use protective creams with high SPF level when you go out in the street.

Due to the probability of decreased night vision, it is not advisable to operate any vehicles or machinery in the nighttime until you make sure that you are not affected by this adverse reaction.

In addition, people who are on Accutane are not allowed to be the donors of blood for the whole period of treatment and during a month after the therapy.

The medicine must be used with caution in elderly people and children because of the influence on the musculoskeletal system. In elderly patients, Accutane may provoke osteoporosis. Speaking about the children, it may become the cause of muscle and joint pain. In some cases, Accutane may stop the normal process of growth in children. It happens because of epiphyseal plate closure.

Besides, cosmetic procedures aimed at smoothing your skin are contraindicated during the period of treatment and for six months following the therapy. The reason is the scarring process, which may activate after the procedures.

As the skin becomes more fragile during the treatment, the skin healing process slows down. That's why it is not advisable to make a piercing, a tattoo, hair waxing and a number of other cosmetic procedures, which may break the integrity of the skin. All these manipulations should be postponed for at least half a year after the end of treatment.