Accutane is a brand-name prescription drug containing isotretinoin, which is derived from Vitamin A. It's prescribed for patients who have acne that's otherwise difficult to treat, and helps to reduce the amount of oil released by glands in the skin. Accutane has potentially severe side effects and must only be used under the careful supervision of a doctor. Additional precautions should also be taken.
Considerations
French doctors first began prescribing Accutane during the 1970s, but soon noticed that babies born to close to 90 percent of women taking the drug were seriously deformed. After December 31, 2005, only patients who enroll in a program called iPLEDGE can be prescribed Accutane or its generic form of isotretinoin, and only physicians and pharmacies enrolled in iPLEDGE may prescribe and dispense it. That's why dermatologists recommend isotretinoin only to certain patients, and many doctors won't prescribe isotretinoin at all. Because there are other potential side effects, you'll need to check with your doctor to see if the pros outweigh the cons in taking this drug. Accutane costs about $1,200 a month, and many consumers choose the generics, which can cost 25 to 50 percent less.
History
As of July 2009, drug manufacturer Hoffman-La Roche Inc. announced it will no longer be selling Accutane, although other companies will continue to provide their own brands and the generic form. Roche announced that the decision was for "business reasons," which include declining sales and lawsuits. "Roche stands behind the safety of Accutane and the rigorous risk management program Roche developed over decades of cooperation with the FDA and the American Academy of Dermatology," the company said in its news release.
Usage
It's important that you go over the patient information materials with your doctor when prescribed Accutane, its equivalent in other brands or its generic form, isotretinoin, and that you follow the directions exactly. Women of reproductive age will be required to sign the iPLEDGE form first and to undergo pregnancy tests, as well as use two forms of birth control during treatment and for one month afterward.
The dosing levels for adults and teenagers over 12 years of age are based on body weight and must be determined by your doctor; they generally run 0.5 to 1 milligram per kilogram of body weight a day, according to Drugs.com. It's best to divide the dose so that you don't take it all at one time, swallowing each pill with food and a full glass of liquid. You may be required to have blood tests on a regular basis to measure liver function and side effects. Duration of treatment can vary, but usually lasts 16 weeks. If your doctor prescribes a second treatment, a rest period of eight weeks is required beforehand. In many cases, acne continues to improve even after the course of treatment is completed.
Benefits
Isotretinoin begins to work rapidly, with an efficacy rate of more than 90 percent with the most severe acne lesions, according to the "Journal of the American Academy of Dermatology." The FDA, in a 2001 issue of "FDA Consumer Magazine," added that the drug is the biggest breakthrough in acne drug treatment over the last 20 years and is the only drug with the potential to clear severe acne after one course of treatment, meaning that for many patients, they are essentially cured. Unlike other topical acne treatments, Accutane and isotretinoin unclog pores by slowing the production of oils that cause acne, effectively curing it from the inside out.
Side Effects
In addition to the possibility of birth defects, Hoffman-La Roche Inc. warns patients that the drug may raise cholesterol, triglyceride and liver enzyme levels. However, blood tests do return to normal levels when patients stop the treatment. A study published in the April 2000 edition of "Journal of Cutaneous Medical Surgery" reported that 40 percent of users developed dry eyes, 30 percent had lower back pain, 16 percent had joint pain and 10 percent had headaches. Another risk that has become associated with Accutane is suicidal depression in teens. However, a study published in 2005 in the "Archives of Dermatology" reported that most teenagers who take the drug show less depression after treatment than before.
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