Isotretinoin
 
What is Isotretinoin and why is it prescribed?
Isotretinoin is prescribed for the treatment of severe, disfiguring cystic acne that has not cleared up in response to milder medications such as antibiotics. It works on the oil glands within the skin, shrinking them and diminishing their output. You take Isotretinoin by mouth every day for several months, then stop. The antiacne effect can last even after you have finished your course of medication.

How should you take Isotretinoin?
Follow your doctors directions for taking Isotretinoin. Take Isotretinoin with food or milk. Depending on your reaction to Isotretinoin, your doctor may need to adjust the dosage upward or downward. If you respond quickly and very well, your doctor may take you off Isotretinoin even before the 15 or 20 weeks are up. After you finish taking Isotretinoin, there should be at least a 2-month rest period during which you are off the drug. This is because your acne may continue to get better even though you are no longer taking Isotretinoin. Once the two months are up, if your acne is still severe, your doctor may want to give you a second course of Isotretinoin. Avoid consumption of alcoholic beverages. Do not crush the capsules. Do not share Isotretinoin with anyone because of the risk of birth defects and other serious side effects. If you miss a dose take the forgotten dose as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take two doses at the same time. Store Isotretinoin at room temperature, away from light.

Are there any Isotretinoin side effects?
Isotretinoin side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Isotretinoin side effects may include abnormal hair growth or loss, allergic reaction, bleeding gums, blood in urine, bowel inflammation and pain, bruising, changes in blood sugar or cholesterol levels, changes in skin pigmentation, chest pain, decreased night vision, decreased tolerance to contact lenses, delay in wound healing, depression, difficulty sleeping, dizziness, drowsiness, dry or fragile skin, dry or cracked lips, dry mouth, dry nose, fatigue, flushing, headache, hearing problems, heartbeat irregularities, herpes, inflammation or sores in the esophagus, itching, joint pain, liver disorders, menstrual changes, muscle wasting, nail disorders, nausea, nervousness, nosebleeds, peeling palms or soles, pinkeye, rash, skin infections, stomach and intestinal discomfort, stroke, sudden drop in blood pressure, sunburn-sensitive skin, suppression of growth, sweating, swelling due to fluid retention, tendon and ligament problems, urinary discomfort, vision problems, vomiting, weakness, and weight loss.

What are the possible food and drug interactions when taking Isotretinoin?
If Isotretinoin is taken with certain other drugs, the effects of either could be increased, decreased, or altered. Be sure to inform your doctor of all the prescription and over the counter medications you are taking. While taking Isotretinoin, do not take vitamin supplements containing vitamin A. Isotretinoin and vitamin A are chemically related. Isotretinoin should not be combined with tetracycline antibiotics such as Doryx, Minocin, and Vibramycin.

Are there any special warnings about Isotretinoin?
Stop taking Isotretinoin and notify your doctor immediately at the first sign of a skin rash or any other allergic reaction. Although they are rare, serious and even fatal allergic reactions have been known to occur. When you first start taking Isotretinoin, it is possible that your acne will get worse before it starts to get better. Isotretinoin may cause depression or other mental problems. In rare cases, it has prompted thoughts of suicide. If you begin to feel depressed or become troubled by suicidal thoughts, contact your doctor immediately. Before starting Isotretinoin therapy, all patients must sign a consent form noting that they are aware of the possibility of mental side effects, the danger of birth defects, and the need for certain other precautions. If you are a woman of childbearing age and you are considering taking Isotretinoin, you will be given both spoken and written warnings about the importance of avoiding pregnancy during the treatment. You will also be asked to sign a second consent form. Some people taking Isotretinoin, including some who simultaneously took tetracycline, have experienced headache, nausea, and visual disturbances caused by increased pressure within the skull. Avoid taking tetracycline while using Isotretinoin. See a doctor immediately if you have these symptoms. If the doctor finds swelling of the optic nerve at the back of your eye, you must stop taking Isotretinoin at once and see a neurologist for further care. Be careful driving at night. Some people have experienced a sudden decrease in night vision. Isotretinoin affects the body's processing of fats and sugars. It should be used cautiously by people with diabetes, excess weight, high triglyceride or cholesterol levels, or a tendency to drink too much alcohol. If you have any of these conditions, your doctor will monitor you closely during Isotretinoin therapy. You may not be able to tolerate your contact lenses during and after your therapy with Isotretinoin. You should stop taking Isotretinoin immediately if you have abdominal pain, bleeding from the rectum, or severe diarrhea. You may have an inflammatory disease of the bowel. You should not donate blood during your therapy with Isotretinoin and for a month after you stop taking it. You may become more sensitive to light while taking Isotretinoin. Try to stay out of the sun as much as possible. You should not use wax hair removal treatments or skin resurfacing procedures while taking Isotretinoin or for 6 months after completing therapy. Some people taking Isotretinoin develop vision or hearing problems. If you notice changes in your vision or hearing, stop taking this drug and contact your doctor.
 

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