Manufacturer: Zenlabs Category: Skin Substance: Isotretinoin (Accutane) Package: 10mg (10 capsules)
Isotretinoin for the treatment of acne. Promotes the normalization of terminal differentiation of cells, inhibits the hyperproliferation of the epithelium of the excretory ducts of the sebaceous glands. Due to this, the production of sebum decreases, its isolation is facilitated, the composition is normalized, the inflammatory reaction around the glands is reduced. With external and systemic application it has antiseboric, sebostatic, anti-inflammatory, kerato-and immunomodulatory effects; enhances the processes of skin regeneration.
Acnecutan, Dermoretinum, Retasol, Unguentum retinoid, Roaccutan.
Isotretinoin. Capsules (6 mg, 8 mg, 10 mg, 20 mg). 13-cis retinoic acid. Candles rectal (20 mg, 50 mg); ointment (in 1 g – 100 mcg, 500 mcg, 1 mg).
After ingestion, absorption is variable, may increase with admission to food. Bioavailability is low. Binding to blood plasma proteins – 99.9%. The concentration in the epidermis is 2 times lower than in the serum. Penetrates through the placenta, enters the breast milk. Vd – 5 l / kg. T1 / 2 – 19 hours, metabolite – 29 hours. An important role is played by enterohepatic circulation.Metabolized with the participation of several CYP isoenzymes. It is excreted in the urine and with bile.
When taking the drug inside it is necessary to regularly monitor liver function and lipid levels in the blood plasma before treatment, 1 month critical bench after the start of therapy, and then every 3 months. With diabetes, obesity, alcoholism or violations of lipid metabolism, more frequent monitoring is recommended. With diabetes or suspicion of it, you must strictly monitor the level of glucose in the blood plasma. During the treatment period or for some time after its termination, it is impossible to be donors for women of childbearing age. Patients should avoid sunlight and do not receive UFO-therapy. In the process of treatment, contact lens intolerance may occur. Isotretinoin has a teratogenic and embryotoxic effect.
Ingestion: dry mucosa, skin rash, dermatitis, sweating, purulent isotretinoin granulomas, paronychia, nail dystrophy, increased proliferation of granulation tissue in the affected area, rarely – alopecia and vasculitis (Wegener’s granulomatosis). Conjunctivitis, photophobia, decreased night vision, cataract development, hearing loss, headache; rarely – depression, convulsive seizures. The cases of development of intracranial hypertension are described. Nausea, less often – colitis, bleeding from the gastrointestinal tract, a transient increase in the activity of hepatic transaminases. Cases of hepatitis are described.Possible – anemia, neurosy, the change in the number of platelets. An increase in ESR, an increase in the concentration of TG, Xc, uric acid, a decrease in the level of HDL in the blood plasma. Pain in muscles and joints;less often – hyperostosis. When rectal and external application for 1-2 nd week of treatment, there may be a reaction of exacerbation – the appearance of isotretinoin new rashes, itching, swelling and redness of the skin. With a pronounced reaction, it is recommended to cancel the treatment for a few days before it subsides, then resume taking the drug at the same dose. With prolonged use, it is possible to develop symptoms of chronic hypervitaminosis A. When escaping the suppository mass, a locally irritating effect is possible. To prevent it, patients should be kept lying for 30 minutes after the candle is inserted. With the application of the ointment in some cases, the development of intolerance, which is manifested on the 1-2-day treatment with itching, swelling, spotted-populous eruptions; the drug should be discontinued and an anti-inflammatory therapy should be performed.
Tetracyclines reduce the effect of the drug, increase the risk of increased intracranial pressure. Sulfonilamides, tetracyclines, thiazide diuretics increase the risk of sunburn. When used with other retinoids, the risk of hypervitaminosis A increases. The drug weakens the effect of progesterone (contraceptives).