Oral Isotretinoin ( Accutane )

Isotretinoin is used to try very severe acne that is not responding to other various kinds of medications. It belongs to a type of drugs known as retinoids. It is commonly known in United States as it original brand name Accutane. Other generic brand names in United States are Ammesteem, Claravis and Sotret. It is a very powerful oral medication that can help you be free of pimples long term without ever using pimples medication at all. You might be asking if it is so effective, why every doctor didn’t just prescribe it for all acne sufferers. Although it is very effective, it has many side effects too and it is not suitable for many people. It is often used as a last resort. However with careful guidance from doctors, Isotretinoin’s ( Accutane ) benefits will far out weight the risks involved.

Isotretinoin’s effectiveness is due to the fact that it attacks the root of the problem. It reduces the sebaceous glands activity causing a huge reduction of sebum (oil) production. With lesser sebum there is less food for P. acnes bacteria result in P. acnes bacteria to die quickly. Isotretinoin also helps to stabilize shedding of dead cells in the skin. This action prevents dead cells from clogging the pores preventing the formation of comedones ( whiteheads and blackheads ).

Severe side effects

Isotretinoin has a very high probability of causing severe birth defects during when taken during pregnancy. Some of the birth defects are skull deformities, heart defects, deafness, central nervous systems defects and many more.

Isotretinoin can also cause mild side effects such dry lips, dry eyes, mild nosebleeds and dry skin due to the reduction of sebum (oil) productions. However all of these can be solved by using by moisturizer or eyedrops. isotretinoin can also cause you to have pain joint stiffness or pain. Mild hair loss during treatment has been documented in studies, but it is rarely permanent. Once the treatment therapy is over, hair will grow back.

The most recent case of side effect is inflammatory bowel disease. A man had successfully sued Accutance maker Hoffman-La Roche for 7 millions after he had to remove his colon after getting inflammatory bowel disease. Although labels on Accutane packages have warn about inflammatory bowel disease, there are not enough scientific evidence to show that.

However there are other serious problems associated with Isotretinoin.

Mood swings, depression and suicidal behaviors have been reported in studies while patients were on Isotretinoin. However up till now there is no conclusive evidence to proof if Isotretinoin contributes directly to these behaviors.

Isotretinoin might cause allergic reactions in some peoples. Some of the allergic reactions can be red rashes, difficulty breathing or fever. If you have any allergic reactions, stop the medication and get medical help immediately.

It can cause slight night blindness. Your vision at night could be impaired, so be careful driving or operating heavy machinery at night.

Persistent headaches could happen while on medication. It rarely happened but sees your doctor once you have continual headaches.

You might suffer some hearing loss but it is usually temporary.

iPLEDGE

Due to past efforts to reduce pregnancy by Isotretinoin’s ( Accutane ) users had been unsuccessful, FDA in United States started a federal registry program called iPLEDGE. The main purposes of iPLEDGE program are to reduce the numbers of unwanted birth defects, miscarriages and abortions that are cause by Isotretinoin. The iPLEDGE program is applicable in the United States, however all Isotretinoin’s users should follow the same precautionary steps listed in iPLEDGE strictly to prevent unwanted side effects.

Everyone associated with the prescription and productions of Isotretinoin are linked together in the iPLEDGE. iPLEDGE program make it mandatory for anyone prescribing Accutane such as doctors and dermatologists to be linked to this registry. However iPLEDGE causes some doctors to rather not prescribe Accutane than to take the time-consuming effect to adhere to the iPLEDGE registry.

Steps for all isotretinoin users to strictly follow

It is mandatory for every one in the United States who want to be prescribed Isotretinoin to be registered into the iPLEDGE program regardless whether you are male or female, able to get pregnant or not. The registrations of everyone prevent the sharing of prescription of Isotretinoin. This help to discourage guys from sharing their Isotretinoin with their female friends, wife, sisters and so on.

All prescriptions are only allowed a one month supply.

Steps for female who want to be prescribed Isotretinoin

What you need to do before your first prescription of Isotretinoin?

You must learn information about Isotretinoin and iPLEDGE program. More informations about iPLEDGE program can be found in www.ipledgeprogram.com or through your doctors.

Visit your doctors or dermatologists to get advice on Isotretinoin.
Get information on two approved iPLEDGE approved birth controls. You need to get started on 2 approved birth controls at least one month before u start using Isotretinoin.

You need to get 2 negative pregnancy tests before you are allowed Isotretinoin.
The first test can be done in the doctor office. The second confirmation test must be done during the first five days of your menstruation before u actually gets started on Isotretinoin. Without getting negative results for the two tests will render you ineligible for Isotretinoin prescription.

Your doctor will enter your information into the iPLEDGE register and give you your prescription of 30 days supply of Isotretinoin. You must collect your Isotretinoin from the pharmacy within 7 days as the prescription is only valid for 7 days.

What you need to do within the month during treatment?

You be on two approved birth controls all the times during treatment.

You need to get a negative pregnancy test result in an iPLEDGE approved lab before you are allowed to get your monthly prescription.

You will need to answer some questions about iPledge and birth preventions.

After you are done, you will get one month supply prescription of Isotretinoin which needs to be collected in 7 days.

What happen after your last dose?

You need to have a pregnancy test right after your last dose.

You need to answer some question about iPLEDGE and birth preventions.

You must continue to two approved birth controls at least thirty days after your last dose.

You will be required to get another pregnancy test in an iPLEDGE approved lab one month after your last dose of Isotretinoin.

What should you tell the doctor before you start on Isotretinoin?

Talk to your doctor if you or your family members have any of the following medical conditions:

• Asthma
• Liver disease
• Diabetes
• Osteoporosis (bone loss) or weak bones
• Heart disease
• Mental problems
• Food or drug allergies
• Anorexia nervosa

Tell your doctor if you are pregnant or breastfeeding. Isotretinoin must be avoided.

Tell your doctor on all the medications, vitamins or herbal supplements that you are taking. Isotretinoin can cause serious side effects if it interacts with other drugs.

Some of the stuffs you should avoid when you are on Isotretinoin

• Tetracycline antibiotics -Tetracycline taken with Isotretinoin might increase pressure in the brain.
• Vitamin A supplements - High doses of Vitamin A will result in the same side effects as Isotretinoin. If they are taken together, there is a higher chance of getting side effects.
• Dilantin (phenytoin) – This medication taken together with Isotretinoin will cause weak bones.
• Corticosteroid medicines – They causes weak bones if taken together with Isotretinoin.
• St. John’s Wort –This herbal supplement will make birth control pills less effective.

What should you avoid doing if you are on Isotretinoin treatment?

• For all females, you should avoid getting pregnant. Having unprotected sex is a big NO.
• Do not breastfeed during treatment and within one month after stopping treatment. It is not certain if Isotretinoin can be passed through breast milk but it is better to play safe than to be sorry.
• Do not donate blood during treatment and within one month after treatment. You might cause serious birth defects on the unborn baby of any pregnant female receiving your blood.
• Do not drive at night if Isotretinoin affects your vision in the dark.
• Do not take other medications or herbal supplements unless your doctor approves them. Isotretinoin might cause serious side effects it interacts with other drugs.
• Do not have cosmetic procedures to smooth your skin such as waxing, demabrasion or laser procedures for at least six months after you stop your Isotretinoin treatment. Isotretinoin might cause scarring from these procedures.
• Avoid sunlight and ultraviolet light as Isotretinoin make your skin more sensitive to light.
• Do not share your Isotretinoin medications with other people. You are causing them more harm than help.

How Isotretinoin is to be taken?

You are only allowed to have 30 days supply of Isotretinoin prescribed by doctor per visit per month.

The dosage of Isotretinoin prescribed by doctor for you is dependent on your weight. Your doctor might change the strength of Isotretinoin as treatment continues. Some of the strength of Isotretinoin includes 20, 30, 40 milligrams.  Take one capsule of Isotretinoin with a full glass of water twice daily during meal. Swallow the capsule in whole as Isotretinoin is harmful to the tube that connects your mouth to the stomach.

If you miss a dose, do not take two doses at one time. Just skip that dose. Too much Isotretinoin is poisonous to your body. If you have an overdose, contact your doctor immediately.

When you first started on Isotretinoin treatment, your acne might get worse initially. This is only temporary, once your body get used to Isotretinoin you will see the clearing effect.

You must visit your doctor at each appointed time. Your doctor might take some blood sample to test for side effects. Female patient will get a monthly pregnancy test during each visit. If you suffered from any side effects notify your doctor immediately.

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