Isotretinoin: functions, dosage, side effects, how to use it

What drug isotretinoin?

What is isotretinoin for?

Isotretinoin is a drug used to treat very severe types of acne, such as acne nodules and cystic acne. If left untreated, severe acne can cause permanent scarring.

Usually doctors will prescribe this drug if the patient's acne does not improve even though he has been treated with antibiotics or other acne treatments.

Isotretinoin is a retinoid class drug that is a vitamin A derivative. It works by reducing oil production in the skin. Excess oil on the surface of the skin can cause severe acne. This drug also works to reduce inflammation that occurs due to acne.

How do I use isotretinoin?

Isotretinoin is a strong drug. Therefore, this drug should not be consumed carelessly and must be taken as recommended by a doctor.

The rules for using isotretinoin are:

• Take this drug in its entirety. Do not crush, crush, or chew this medication.
• This medicine must be taken after meals. The process of absorption into the bloodstream will be better if this medicine is taken after meals.
• Take this medicine with a glass of mineral water and do not lie down for 10 minutes after drinking it.
• Don't be surprised if your acne looks worse after taking this medicine. This is because this is a common and normal side effect. Usually this drug will show its benefits after 1-2 months of use.
• Before using topical drugs, you should first clean the area to be treated. Then wash your hands with clean water when you are finished using them.
• Avoid applying the medicine to areas of skin that are irritated, injured, or burned.
• Avoid exposure to direct sunlight when you are using the drug in gel form.
• Use a moisturizing cream if your skin is very dry during the use of the medicine.
• This medicine should not be taken continuously in the long term. Do not use this medication for longer than your doctor has prescribed.
• This medicine should not be used interchangeably with other people. Even if the person has the same symptoms as you. Because, the dosage of drugs for each person may vary.
• Do not add or reduce doses of medication without your doctor's knowledge. Taking medication that is not according to the rules can increase the risk of side effects.
• So as not to forget, take this medicine at the same time every day.
• If at any time you forget to take this medicine and the next interval for consumption is still far away, it is advisable to do so as soon as you remember. Meanwhile, if the time lag is near, ignore it and don't try to double the dose.
• You may be asked to have regular blood tests by your doctor. This is done to ensure that the drugs you are taking do not have a negative effect on your body.
• This medicine should not be taken by women who are pregnant, planning to become pregnant, or breastfeeding. The reason is, this drug can be absorbed through the skin and lungs.

How is isotretinoin stored?

Isotretinoin is a drug that should be stored at room temperature, away from direct light and damp places. Don't keep it in the bathroom. Don't freeze it. Other brands of this drug may have different storage rules.

Observe the storage instructions on the product package or ask your pharmacist. Keep all medicines away from children and pets.

Do not flush medicines down the toilet or down the drain unless instructed to do so. Discard this product when it has expired or when it is no longer needed.

Consult your pharmacist or local waste disposal company about how to safely dispose of your product.

Rules for Use of Isotretinoin

The information provided is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist before starting treatment.

What is the isotretinoin dosage for adults?

The dose of isotretnoin for severe nodular acne is 0.5-1 mg / kg orally 2 times a day.

In principle, take this drug exactly as the doctor recommends. Follow all the instructions for using the medicine listed on the prescription label and read all medication guides or instruction sheets carefully.

Don't hesitate to ask a doctor if you don't really understand how to use it.

What is the Isotretinoin dosage for children?

There is no definite dosage requirement for children. This medicine can be dangerous for children. It is important to understand the safety of drugs before use. Consult your doctor or pharmacist for more information.

In what dosage is Isotretinoin available?

Isotretinoin dosage forms are capsules and gels.

Isotretinoin dosage

What are the side effects of isotretinoin?

The most common side effects of the drug isotretinoin are:

• Red rash
• Dry skin until peeling
• Itchy skin and feels hot like burning
• Lips get chapped and bleed easily
• Dry eyes
• Nosebleed
• Swelling of the eyelids or lips
• Hair loss

Stop using the drug and contact your doctor if you experience the following symptoms of serious side effects:

• Sudden numbness or feeling weak, especially on one side of the body.
• Blurred vision, sudden headache or pain behind your eye, sometimes with vomiting.
• Hearing problems, hearing loss, or ringing in your ears.
• Severe pain in the upper abdomen spreading to the back, nausea and vomiting, fast heartbeat.
• Decreased appetite.
• Dark urine, pale stools, jaundice (yellowing of the skin or eyes)
• Diarrhea, severe and bleeding in the rectum.
• Fever, chills, body aches, flu symptoms, purple spots under your skin, easy bruising or bleeding.
• Depression, difficulty concentrating, difficulty sleeping, watery eyes, aggression, behavior changes, hallucinations, thoughts of suicide or hurting yourself.

Not everyone experiences this side effect. There may be some side effects not listed above. If you are concerned about the side effects please consult your doctor or pharmacist.

Isotretinoin side effects

What should be known before using isotretinoin?

Some things you need to know before taking isotretinoin are:

• Tell your doctor if you have any allergies to Isotretinoin or other acne medications.
• Tell your doctor about all the medicines you are regularly taking recently. Starting from prescription drugs, non-prescription, to herbs.
• This drug is teratogenic, which is very toxic and can cause defects in the fetus if taken carelessly. Therefore, women who are pregnant and planning to become pregnant are not advised to take this drug.
• Tell your doctor if you have a history of chronic diseases such as heart disease, diabetes, asthma, stroke, and so on.
• Tell your doctor if you have liver or kidney damage.
• Tell your doctor if you have bone abnormalities.
• Avoid direct sun exposure and wear protective clothing, sunglasses, and sunscreen. Because, this drug can make your skin sensitive to sunlight.
• This drug can affect psychological conditions and mood. A number of patients taking this drug have found themselves suffering from depression or psychosis (loss of mind), behaving violently, thinking about killing or injuring themselves, and some have even tried or succeeded in doing so. Immediately notify your doctor if while taking this medicine you suffer from constant anxiety, experience extreme mood swings, decreased appetite, and so on.
• This medication may cause dry eyes, making wearing contact lenses uncomfortable.
• Be careful when you drive or operate machinery at night because this drug also affects vision.
• While taking this medication, avoid hair pulling, laser skin treatments, and dermabrasion. Because, this drug makes your skin more sensitive, so these various treatments can have a negative effect on your body.
• Consult a doctor before undergoing strenuous physical activities such as sports. This medicine may cause bones to weaken or thicken and may increase the risk of bone injury in some people.

Is isotretinoin safe for pregnant and lactating women?

There are no adequate studies regarding the risks of using this drug in pregnant or breastfeeding women. Always consult your doctor to weigh the potential benefits and risks before using this medication.

Isotretinoin is included in the pregnancy risk category X according to the US Food and Drug Administration (FDA) in the United States, or the equivalent of the Food and Drug Administration (BPOM) in Indonesia.

The following references the pregnancy risk categories according to the FDA:

• A = Not at risk
• B = No risk in several studies
• C = May be risky
• D = There is positive evidence of risk
• X = Contraindicated
• N = Unknown

There are not sufficient studies in women to find out the risk to the baby when the mother takes this drug during breastfeeding. Consider the potential benefits and potential risks before taking this medication during breastfeeding.

Warnings and Cautions for Isotretinoin Drugs

What drugs may interact with isotretinoin?

Interactions with other drugs can affect how the drug works and increase the risk of dangerous side effects. This article does not list all possible drug interactions.

Record all medicinal products you use (including prescription, non-prescription and herbal medicines) and share them with your doctor and pharmacist. Do not start, stop, or change the dose of any medicine without your doctor's permission.

Some drugs that have the potential to cause interactions with Isotretinoin are:

• Chlortetracycline
• Demeclocycline
• Desogestrel
• Dienogest
• Doxycycline
• Drospirenone
• Estradiol Cypionate
• Estradiol Valerate
• Ethinyl Estradiol
• Ethynodiol Diacetate
• Etonogestrel
• Levonorgestrel
• Lymecycline
• Meclocycline
• Medroxyprogesterone Acetate
• Mestranol
• Methacycline
• Minocycline
• Norelgestromin
• Norethindrone
• Norgestimate
• Norgestrel
• Oxytetracycline
• Rolitetracycline
• Tetracycline

Can food or alcohol interact with isotretinoin?

Certain drugs should not be used with meals or when eating certain foods because drug interactions can occur. Consuming alcohol or tobacco with certain drugs can also cause interactions to occur.

Discuss your use of drugs with food, alcohol, or tobacco with your health care provider.

What health conditions can interact with isotretinoin?

Any other health conditions you have can affect the use of this drug. Some of the conditions that can interact negatively with the drug isotretinoin are:

• Alcohol addiction
• Diabetes or other metabolic disorders
• Obesity or being overweight
• Anorexia (eating disorder)
• Epiphyseal, premature or
• Osteomalacia (softening of the bones)
• Osteoporosis (porous bones)
• Asthma
• Depression and a history of depression
• Vision and hearing problems
• Heart disease
• Hepatitis
• Hypertriglyceridemia (high triglycerides in the blood)
• Indigestion
• Pancreatitis (inflammation of the pancreas)
• Pseudotumor cerebri (swelling in the brain)
• Psychosis or a history of psychosis
• Overdose of vitamin A (too much vitamin A in the body)
• Kidney illness
• Liver disease

Isotretinoin drug interactions

What should I do in an emergency or overdose?

In case of an emergency or overdose, contact the local emergency services provider (119) or immediately to the nearest hospital emergency department.

What should I do if I miss a dose?

If you forget a dose of this medicine, take it as soon as possible. However, when it is nearing the time of the next dose, skip the missed dose and return to the usual dosing schedule. Don't double the dose.