Isotretinoin is an active ingredient used to treat acne. However, it is only approved for the treatment of severe acne. This is because the active ingredient can have significant side effects. These include skin rash and inflammation of the skin, eye and mouth. As it can cause malformations in the fetus, it is not allowed to be taken during pregnancy. Learn more about the effects, side effects, and dosage of isotretinoin here.
Effect of isotretinoin
Isotretinoin belongs to the group of acne medications – more precisely, to the retinoids. These are substances related to vitamin A (retinol). By using the agent, the sebaceous glands become smaller and less sebum is produced. In addition, isotretinoin has an anti-inflammatory effect and normalizes the growth of (mucosal) cells. As a result, acne can be effectively alleviated. The active ingredient can be applied both topically and systemically. In a topical application, the agent acts only locally on the diseased area. In systemic therapy, the active ingredient is taken in tablet form and thus exerts its effect throughout the body. Due to its considerable side effects, isotretinoin is usually only used in severe cases of the disease. In addition, the active ingredient is usually only used if other treatment – for example, local acne or antibiotic therapy – has previously failed.
Side effects of isotretinoin
Whether side effects occur with treatment with isotretinoin, and if so, which ones, depends largely on how the active ingredient is applied. If it is applied locally, there are usually fewer side effects than if the active ingredient is allowed to spread throughout the body. It is in this case that the active ingredient shows a number of side effects. Very often, side effects occur on the skin during application: These include inflammation, skin flaking, rash, increased skin vulnerability and itching. The skin becomes drier and mucosal inflammation and nosebleeds may occur. In addition, the skin is more sensitive to the sun. This should be taken into account especially in summer. In addition, the following side effects also occur very frequently during treatment: Decrease in the number of red blood cells (somewhat less frequently also white blood cells), change in the number of blood platelets, dry mucous membranes and inflammation in the area of the eyes and mouth, back pain, muscle and joint pain and increase in blood lipid levels. Likewise, headaches, hair loss and an increase in blood sugar levels may occur.
Effects on the psyche
Presumably, isotretinoin also has effects on the psyche of some patients. In rare cases, side effects such as mood swings, anxiety, and increased aggressiveness have been observed. In addition, depression may occur or pre-existing depression may be exacerbated. Very rarely, suicidal thoughts and, in the worst case, suicide attempts may also occur in treated patients. For this reason, patients should be closely monitored not only by the treating physician but also by relatives or friends. This is especially important at the beginning of treatment. For a detailed list of all side effects, please refer to the package insert of your medication.
Dosage of isotretinoin
Isotretinoin is a prescription medication that can only be purchased from a pharmacy with a doctor’s prescription. The acne medication not available without a prescription. Basically, the active ingredient is available for topical application in the form of ointment, creams or gels. For internal use, there are tablets. These usually contain 10 or 20 milligrams of the active ingredient. Isotretinoin tablets should be taken once or twice daily with some liquid at mealtimes. Depending on the dose, treatment is usually given for 16 to 24 weeks. At the beginning of therapy, adults and children over 12 years of age should receive 0.5 milligrams of isotretinoin per kilogram of body weight. Later, the dose can be increased up to 1 milligram as needed. If renal function is impaired, the dose must be correspondingly lower.
Overdose of acne medication
If you have taken too high a dose of isotretinoin, contact your doctor immediately or go to the nearest hospital.If you miss a dose, take it as soon as possible. However, do not take it if it is already time for the next dose. So do not take double doses! Do not interrupt or stop treatment with isotretinoin without a valid reason, without consulting your doctor. An exception is the possibility of pregnancy. In this case, you must not continue to use the active substance under any circumstances. In addition, you should also stop taking it immediately if you experience any of the following symptoms:
- Nausea and vomiting coupled with upper abdominal pain.
- Nausea and vomiting paired with headache and/or visual disturbances
- Severe abdominal pain as well as bloody diarrhea
Also, in case of an allergic reaction, the intake must be stopped immediately. This can be manifested by rashes, itching, breathing problems, swelling or circulatory problems.
Contraindications
Products containing isotretinoin must not be used if there is hypersensitivity to the active ingredient. In addition, the active ingredient is also contraindicated in the following conditions:
- Elevated blood lipid levels
- Impaired liver function
- Increased vitamin A concentration in the body
In addition, the active substance may be used only with special caution in certain visual disorders, depression, renal dysfunction, diabetes, obesity, increased intracranial pressure and chronic inflammatory bowel disease. When used topically on the skin, do not treat skin sites affected by acute eczema, perioral dermatitis, or rosacea.
Pregnancy and lactation
Isotretionin should not be used during pregnancy or lactation. Women of childbearing age must use safe contraception and perform a pregnancy test before starting treatment. As a rule, pregnancy tests are also performed at regular intervals during treatment. Contraception must be started four weeks before treatment and continued until four weeks after treatment. Stop treatment immediately if there is a possibility that you are pregnant. Otherwise, severe malformations in the unborn child or miscarriage may occur. Due to the dangerous side effects, women of childbearing age may only receive prescriptions that are sufficient for 30 days in terms of the amount prescribed. The prescription must also be filled by seven days after it is issued – otherwise it expires.
Interactions
If you take other medications in addition to isotretinoin, you may experience drug interactions. Therefore, be sure to inform your doctor about medications you use regularly. Do not take antibiotics that end in -cycline during treatment with the acne medication. Likewise, do not add vitamin A supplements to the body.
