{"id":5633,"date":"2019-08-29T10:31:57","date_gmt":"2019-08-29T14:31:57","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=5633"},"modified":"2024-05-28T15:52:45","modified_gmt":"2024-05-28T19:52:45","slug":"isotretinoin-accutane-for-acne","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/isotretinoin-accutane-for-acne\/","title":{"rendered":"Should you take Accutane for your acne?"},"content":{"rendered":"

You\u2019ve tried the drug store creams and the expensive department store lotions to clear pimples. Maybe you\u2019ve even been prescribed a topical drug or an oral tetracycline antibiotic by your dermatologist\u2014yet, your painful acne persists. If this sounds familiar, it might be time to ask your doctor about <\/span>isotretinoin<\/span><\/a>.<\/span><\/p>\n

<\/span><\/p>\n

What is Accutane (isotretinoin)?<\/span><\/h2>\n

Commonly known by its original brand name Accutane, isotretinoin is a generic medication<\/span><\/p>\n

that\u2019s now marketed under various labels, including <\/span>Absorica<\/span><\/a>, <\/span>Claravis<\/span><\/a>, <\/span>Amnesteem<\/span><\/a>, and Zenatane. The brand name Accutane was discontinued in 2009. Although approved by the U.S. Food and Drug Administration (FDA), isotretinoin is often referred to as the acne drug of last resort. It is a powerful Vitamin A derivative prescribed for patients who \u201chave severe, nodular acne or cystic acne, those with acne resistant to traditional treatments, or patients who have physical or emotional scarring,\u201d says <\/span>Joshua Zeichner, MD<\/span><\/a>, director of cosmetic and clinical research in dermatology at <\/span>Mount Sinai Hospital<\/span><\/a> in New York City. \u201cIsotretinoin is the closest we have to a cure for acne. It is the single most effective drug that we have and gives long-lasting results.\u201d<\/span><\/p>\n

RELATED: <\/b>What is Isotretinoin?<\/b><\/a> | <\/b>What is Amnesteem?<\/b><\/a> | <\/b>What is Absorica?<\/b><\/a><\/p>\n

How does Accutane work?<\/span><\/h2>\n

Isotretinoin is a retinoid that works by decreasing the amount of pore-clogging oil your body produces\u2014even after you stop using it. And unlike spot treatments, the drug, which is taken orally, addresses acne all over the body, including back, neck, and chest.\u00a0<\/span><\/p>\n

\u201cWhile we cannot promise a complete cure,\u201d says Dr. Zeichner, \u201cthe overwhelming majority of patients will be clear or almost clear for good.\u201d\u00a0<\/span><\/p>\n

Of course, with a powerful drug comes the risk of serious side effects. Isotretinoin is a closely monitored medication, and though considered safe by most, it requires patients to have monthly check-ins with their physician to monitor their health and well-being.\u00a0<\/span><\/p>\n

Here\u2019s what you need to know about the drug if you (or your teenager) are considering it.<\/span><\/p>\n

What are the requirements for taking Accutane?<\/span><\/h2>\n

A dermatologist will only prescribe isotretinoin after all other methods of <\/span>acne treatment <\/span><\/a>fail. Once your doctor identifies you as a good candidate for the drug, you will have to enroll in the government registry <\/span>iPLEDGE<\/span><\/a>, a program designed to prevent women from getting pregnant while on the medication, as it carries a high risk of severe birth defects. For female patients , the iPLEDGE program requires two negative pregnancy tests (and the promise to use two different forms of birth control). Note: Progestin-only birth control pills may not work while taking isotretinoin. Your prescriber must verify the results of these pregnancy tests before dispensing the drug. Monthly blood tests thereafter will check for pregnancy and monitor liver function (as isotretinoin can affect the liver). For men, iPLEDGE requires the same monthly blood draw to monitor liver function. Once you\u2019re given your monthly prescription, you have a seven-day window in which to fill it. If you miss that window, you will have to wait 30 days for a new prescription.\u00a0<\/span><\/p>\n

What is the right Accutane dosage?<\/span><\/h2>\n

Isotretinoin dosage is determined by the patient\u2019s weight. According to <\/span>Doris Day, MD<\/span><\/a>, a New York City\u2013based dermatologist, many doctors start their patients on a graduated plan to help mitigate side effects and allow the body to adjust. \u201cI [increase] the dose relatively slowly,\u201d she says. \u201cIt\u2019s really the total dose that matters, so I up it to a dose that\u2019s therapeutic in month two or even month three.\u201d (A therapeutic dose is typically around 1 milligram of Accutane per kilogram of weight.) On a graduate dosage schedule, patients should expect to be on the drug for five to seven months. Read your medication guide to learn more about correct isotretinoin use.<\/span><\/p>\n

Do you take Accutane with food?<\/span><\/h3>\n

Doctors also recommend taking isotretinoin with fatty foods to aid absorption. While on the drug, you should limit or avoid alcohol altogether (again, because of your liver) and let your physician know if he or she is going to prescribe any antibiotics, as there can be drug interactions.\u00a0<\/span><\/p>\n

How effective is Accutane?<\/span><\/h2>\n

Some patients (around 20%, according to Dr. Zeichner) will require a second cycle of isotretinoin to clear their acne. There is a lifetime dosage cap for the drug, so Dr. Day recommends consulting with a board-certified dermatologist to make sure you\u2019re staying within the limit.\u00a0<\/span><\/p>\n

According to the American Osteopathic College of Dermatology<\/span><\/a>, after four to five months of treatment with Accutane, most patients\u2019 acne will be cleared, though some will require a second round. In the first five months of treatment, about 1 in 5 patients will experience a slightly worsening of their acne. Only about 1 in 500 will experience acne that worsens dramatically.\u00a0<\/span><\/p>\n

Accutane side effects<\/span><\/h2>\n

The biggest potential side effect is serious birth defects. \u201cEven after taking just one pill, it causes very, very, very severe and horrific birth defects,\u201d Dr. Day says. Women should wait at least one month after getting off of isotretinoin before getting pregnant or breastfeeding to avoid health problems in babies. For this same reason, women cannot donate blood while on isotretinoin and should wait for at least one month after discontinuing the drug to do so. This is to ensure your blood isn\u2019t given to a pregnant woman.<\/span><\/p>\n

The most common side effect of isotretinoin is dryness\u2014dry eyes, dry mouth, and dry skin. Isotretinoin also causes photosensitivity, so you\u2019ll want to make sure to use sun protection when outdoors and avoid direct sunlight and tanning beds. You could also experience:<\/span><\/p>\n