Isotretinoin
Isotretinoin (Isotretinoin) is a vitamin A derivative that belongs to the class of medications called retinoids. Retinoids are typically used to treat skin problems.
Available form
Capsule
Dosage
10mg, 40mg
Manufacturers
Mylan Pharmaceuticals
Branded drugs
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The usual starting daily dose is 0.5 mg per kilogram of body weight taken daily for a period of 2 to 4 weeks. Based on body weight, severity of acne, and your response to the medication, your doctor will then adjust your dose. Isotretinoin (Isotretinoin) should be taken as a single dose or in 2 divided doses during the day.
Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
Your acne may get worse temporarily, before it gets better. Your doctor will adjust your daily dose after the initial treatment to between 0.1 mg and 1 mg per kilogram of body weight depending on your response to the medication.
Food increases the amount of medication available to the body. It also helps to reduce upset stomach. For these reasons, Isotretinoin (Isotretinoin) medication should be taken with food.
The first signs of healing usually occur after 2 to 3 weeks of treatment, however, it may take 1 or 2 months before you see beneficial effects. The complete course of treatment usually lasts 12 to 16 weeks. Most people with severe acne notice a marked improvement after 1 or 2 courses of treatment. You may continue to see even more improvement in your acne condition for several months after you have stopped taking the medication.
If any of your side effects do not clear up in a few weeks after you stop taking your medication, speak to your doctor. Be sure to read the patient information that comes with each package of medication.
It is important that Isotretinoin (Isotretinoin) be taken exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store Isotretinoin (Isotretinoin) at room temperature, in the original package, protect it from light and moisture, and keep it out of the reach of children.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes Isotretinoin (Isotretinoin). If you are concerned about side effects, discuss the risks and benefits of Isotretinoin (Isotretinoin) with your doctor.
The following side effects have been reported by at least 1% of people taking Isotretinoin (Isotretinoin). Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
Stop taking the medication and seek immediate medical attention if any of the following occur:
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Isotretinoin (Isotretinoin).
10 mg
Each oval capsule with a yellow to orange paste fill and a reddish-brown opaque gelatin shell, with an "I" logo printed in black ink on one side, contains 10 mg of Isotretinoin (Isotretinoin). Nonmedicinal ingredients: ammonium hydroxide, beeswax yellow, gelatin, glycerin, hydrogenated vegetable oil, polyethylene glycol, polyvinyl acetate phthalate, propylene glycol, red iron oxide, soybean oil, synthetic black iron oxide, and titanium dioxide.
40 mg
Each oval capsule with a yellow to orange paste fill and an orange-brown opaque gelatin shell, with an "I40" logo printed in black ink on one side, contains 40 mg of Isotretinoin (Isotretinoin). Nonmedicinal ingredients: ammonium hydroxide, beeswax yellow, gelatin, glycerin, hydrogenated vegetable oil, polyethylene glycol, polyvinyl acetate phthalate, propylene glycol, red iron oxide, soybean oil, synthetic black iron oxide, titanium dioxide, and yellow iron oxide.
Do not take Isotretinoin (Isotretinoin) if you:
Isotretinoin (Isotretinoin) should not be taken by women who may become pregnant unless all of the following conditions apply:
There may be an interaction between Isotretinoin (Isotretinoin) and any of the following:
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with Isotretinoin (Isotretinoin). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Isotretinoin (Isotretinoin).
HEALTH CANADA ADVISORY
September 7, 2016
Health Canada has issued new restrictions concerning the use of Isotretinoin (Isotretinoin). To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca.
Behaviour changes and suicidal thoughts: Some people taking Isotretinoin (Isotretinoin) have experienced depression, including thoughts of suicide. If you experience any behaviour change or symptoms such as sad mood, hopelessness, feelings of guilt, loss of pleasure or interest in activities, changes in sleep pattern, irritability, or restlessness while taking Isotretinoin (Isotretinoin), contact your doctor immediately.
If you are at risk for developing depression or have a history of depression, discuss with your doctor how Isotretinoin (Isotretinoin) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Isotretinoin (Isotretinoin), and whether any special monitoring is needed.
Family members or caregivers of people who are taking Isotretinoin (Isotretinoin) should contact the person's doctor immediately if they notice unusual behaviour changes.
Birth Control: Isotretinoin (Isotretinoin) causes birth defects in a large percentage of babies born to women who take Isotretinoin (Isotretinoin) during pregnancy. Isotretinoin (Isotretinoin) interacts with hormonal birth control (i.e., birth control pills), making it very important that women of childbearing age use an additional type of birth control.
Two reliable forms of birth control should be used at the same time during treatment unless abstinence is the chosen method.
Blood donation: You should not give blood during treatment with Isotretinoin (Isotretinoin) and for one month after stopping treatment in case the blood is given to a pregnant woman.
Bones and joints: Isotretinoin (Isotretinoin) may cause some minor bone changes. Talk to your doctor if you notice aches or pains in the bones or joints, or have difficulty moving. Your doctor may monitor you for bone changes while you are taking Isotretinoin (Isotretinoin).
Cholesterol: Isotretinoin (Isotretinoin) can cause increases in cholesterol and other lipids in the blood. If you are already at an increased risk of developing High Cholesterol, for example if you have a family history of high cholesterol, Diabetes, are overweight, or have an increased alcohol intake, you are more likely to experience this.
If you are at any increased risk of developing increased blood lipids, discuss with your doctor how Isotretinoin (Isotretinoin) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Isotretinoin (Isotretinoin), and whether any special monitoring is needed.
Diabetes: Isotretinoin (Isotretinoin) may cause a loss of control of blood sugar levels for people with diabetes. If you have diabetes, or anyone in your family has diabetes, discuss with your doctor how Isotretinoin (Isotretinoin) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Isotretinoin (Isotretinoin), and whether any special monitoring is needed. You may need to check your blood glucose levels more often.
Inflammatory Bowel Disease: Isotretinoin (Isotretinoin) may cause irritation in the digestive system. If you experience stomach pain, rectal bleeding or diarrhea, contact your doctor immediately.
Liver disease: Several cases of hepatitis (inflammation of the liver) have been reported that are considered to be possibly or probably related to Isotretinoin (Isotretinoin) therapy.
If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.
Neurologic: Isotretinoin (Isotretinoin) has been linked to causing intracranial hypertension, also known as pseudotumor cerebri. Early symptoms of this condition include headache, nausea, vomiting, and visual disturbances. If you have these symptoms call your doctor immediately.
Night vision: Decreased night vision has been reported during Isotretinoin (Isotretinoin) therapy. Because some patients experience sudden onset of vision problems, use caution when driving or operating any vehicle at night. Report any vision changes to your doctor.
Pancreatitis: Isotretinoin (Isotretinoin) can cause the pancreas to become inflamed. If you have a history of pancreatitis, discuss with your doctor how Isotretinoin (Isotretinoin) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Isotretinoin (Isotretinoin), and whether any special monitoring is needed.
Report signs of pancreatitis such as abdominal pain on the upper left side, back pain, nausea, fever, chills, rapid heartbeat, or swollen abdomen to your doctor immediately.
If you have a history of pancreatitis, gallstones, Alcoholism, or high triglycerides, you may be more at risk of experiencing this.
Skin care: Isotretinoin (Isotretinoin) causes irritated, dry skin and lips. Ask your doctor or pharmacist for appropriate moisturizers and lip balms to use to prevent severe dryness. While you are taking Isotretinoin (Isotretinoin), avoid exfoliators, waxing and dermabrasion, or laser procedures.
Skin rash: Isotretinoin (Isotretinoin) may cause skin rash or itchiness. Rarely, people taking Isotretinoin (Isotretinoin) experience a severe skin reaction that can be life threatening. If you experience a rash that gets worse, or develops into blisters, sores on the lips or eyes, or covers a large area of the body, contact your doctor immediately.
Sun sensitivity: Isotretinoin (Isotretinoin) may make you more likely to burn in the sun. Use appropriate measures to prevent excessive exposure to the sun. These include wearing a hat and sunglasses when out in the sun, using a sunscreen that provides an SPF of 15 or more, and avoiding going out in the sun between 10 am and 2 pm when the sun is at its strongest.
Vitamin supplements: You should not take vitamin supplements containing vitamin A if you also take Isotretinoin (Isotretinoin) as this may increase the side effects of vitamin A. Talk to your doctor or pharmacist if you are not sure which of your supplements might contain vitamin A.
Pregnancy: Isotretinoin (Isotretinoin) causes severe birth defects in an extremely high percentage of infants born to women who take Isotretinoin (Isotretinoin) even for a short period of time during pregnancy.
Isotretinoin (Isotretinoin) must not be used during pregnancy. Women must not become pregnant while taking Isotretinoin (Isotretinoin) or for at least one month after stopping the medication. Your doctor will perform monthly pregnancy tests while you are taking Isotretinoin (Isotretinoin) to confirm the safety of continuing to take Isotretinoin (Isotretinoin).
Women who may become pregnant must not be given Isotretinoin (Isotretinoin) until pregnancy is excluded. A pregnancy test should be performed when you first see your doctor. A second pregnancy test must be performed within 11 days of starting treatment. Isotretinoin (Isotretinoin) treatment should start on the second or third day of the next normal menstrual period following this negative pregnancy test. Effective birth control must be used for at least one month before starting Isotretinoin (Isotretinoin) treatment, during the treatment, and for at least one month following the discontinuation of treatment.
Breast-feeding: It is not known if Isotretinoin (Isotretinoin) passes into breast milk. If you are a breast-feeding mother and are taking Isotretinoin (Isotretinoin), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding. Because of the potential for side effects, women should consider not breast-feeding if they take Isotretinoin (Isotretinoin).
Children: The long-term safety of using Isotretinoin (Isotretinoin) have not been established for children less than 12 years of age.
Seniors: The use of Isotretinoin (Isotretinoin) by seniors has not been well studied. It is likely that seniors would be at an increased risk for side effects from Isotretinoin (Isotretinoin).
Isotretinoin (Isotretinoin) is a vitamin A derivative that belongs to the class of medications called retinoids. Retinoids are typically used to treat skin problems. Isotretinoin (Isotretinoin) is used to treat severe types of Acne, such as nodular or inflammatory acne, where other medications with less potential for severe side effects have failed to help. It may also be used to treat acne conglobata and recalcitrant acne.
Isotretinoin (Isotretinoin) helps to reduce sebum production, which is often associated with bacteria that contributes to acne. In many cases, it can produce remission of the acne condition.
Your doctor may have suggested Isotretinoin (Isotretinoin) for conditions other than those listed in these drug information articles. As well, some forms of Isotretinoin (Isotretinoin) may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking Isotretinoin (Isotretinoin), speak to your doctor. Do not stop taking Isotretinoin (Isotretinoin) without consulting your doctor.
Do not give Isotretinoin (Isotretinoin) to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take Isotretinoin (Isotretinoin) if their doctor has not prescribed it.
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