Accutane is available as oral capsules containing the active ingredient isotretinoin, a derivative of Vitamin A (Retinol). Chemically, isotretinoin is classified as a natural retinoid and is not a hormone.

Isotretinoin also enhances acne treatment by thinning the upper layers of the epidermis, allowing active substances to penetrate the skin more easily. This improves absorption and leads to faster, observable results.

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Isotretinoin is a systemic retinoid and the most effective treatment for acne. However, it must be prescribed by a doctor, with dosage tailored to the individual’s weight, age, and acne severity. Acne often stems from overactive sebaceous glands, which produce excess sebum—a favorable environment for acne-causing bacteria, Propionibacterium acnes. Accutane effectively addresses this by reducing sebum production and shrinking the sebaceous glands. Additionally, it promotes normal cell regeneration and differentiation while providing an anti-inflammatory effect.

Accutane dosage

Accutane is available in 8 mg and 16 mg capsules and is prescribed for severe acne and cases unresponsive to other treatments. The dosage is tailored individually, as the drug's effectiveness and side effects can vary widely among patients. Treatment requires a prolonged course, typically lasting 16-24 weeks.

The daily dose of Accutane is determined by the doctor, with a cumulative dosage that the patient must achieve over the treatment period. According to the guidelines, the initial dose ranges from 0.4-0.8 mg/kg of body weight per day. For severe cases or acne on the trunk, a maximum dose of 2 mg/kg per day may be prescribed.

The target cumulative dose is 100-120 mg/kg. If tolerance issues arise, the dose may be lowered, extending the treatment duration as needed.

In many cases, one course is sufficient for acne to clear. For difficult cases, a second course may be considered, with a minimum 8-week interval after the first. Accutane is taken orally with meals, 1-2 times a day, and should be consumed with fatty foods for optimal absorption.

Contraindications of Accutane

Pregnancy is a strict contraindication for Accutane treatment due to isotretinoin’s strong teratogenic and embryotoxic effects. Effective contraception is required beginning one month before treatment, continuing throughout, and for one month after stopping the medication. Without these precautions, there is a high risk of severe birth defects if pregnancy occurs.

Additional contraindications for Accutane include:

• Breastfeeding
• Hypersensitivity to the drug
• Children under 12 years of age
• Hypervitaminosis A
• Elevated blood lipid levels
• Concurrent treatment with tetracycline antibiotics
• Liver failure

Accutane side effects

Most side effects of Accutane are dose-dependent and generally resolve after stopping the medication or adjusting the dose. An initial acne flare-up is also typical at the beginning of treatment.

Other potential side effects include:

• Dryness of skin and mucous membranes; dry, cracked lips
• Peeling of skin on palms and soles, rash, itching, dermatitis
• Increased sweating, temporary hair loss, hirsutism
• Muscle and joint pain
• Fatigue, headache, vision disturbances
• Gum inflammation and bleeding, nausea, vomiting, diarrhea
• Inflammatory bowel disease (colitis, ileitis), bleeding, pancreatitis
• Blood count changes
• Increased sensitivity to UV radiation
• Risks of birth defects, miscarriage, or fetal death

The instructions for Accutane do not provide specific information on its compatibility with alcohol. However, it is noted that in cases of chronic alcoholism, the medication can only be used under careful monitoring of blood lipid and glucose levels.

Since Accutane can have toxic effects on the liver and pancreas, consuming alcohol may exacerbate these effects. For this reason, doctors generally recommend avoiding alcohol during treatment with Accutane.