Isotretinoin by Ray Sahelian, M.D. natural health consultant

Isotretinoin is a medicine used since 1982 for the treatment and prevention of severe acne.  The inflammation in acne is caused in part by an increased secretion of sebum (oily substance) from glands in the skin (sebaceous glands). The sebum provokes inflammation, and the inflammation resolves (heals) with the formation of a scar (keratinization). The exact mechanism of action of isotretinoin is not known; however, it may reduce acne by reducing the secretion of sebum. If less sebum is secreted it is likely that there will be less inflammation and keratinization. Roche Laboratories Inc., is the maker of isotretinoin.

Gastrointestinal Isotretinoin Side effects

People taking the acne drug isotretinoin appear to run an increased risk of developing inflammatory bowel disease.  American Journal of Gastroenterology, July 2006. Inflammatory bowel disease, or IBD, includes Crohn's disease and a similar condition called ulcerative colitis.

Liver and Cardiac Isotretinoin side effects

Isotretinoin seems to raise the risk for potential heart and liver problems more than doctors had expected. The findings came from lab tests on 13,772 patients taking the popular acne drug and underscore the need to closely monitor people taking isotretinoin, which is sold as Accutane and in three generic versions. Abnormal results for cholesterol and liver function were more common than expected in those using isotretinoin. Most dermatologists already knew isotretinoin could increase levels of cholesterol, liver enzymes and blood fats called triglycerides that can raise the risk of heart disease. But the new study found higher than expected percentages of patients developing these abnormal lab results.

Psychiatric Isotretinoin Side Effects

Isotretinoin is a synthetic oral retinoid that has great efficacy against severe, recalcitrant, nodulocystic acne. Since its introduction to the market, isotretinoin has been associated with a variety of adverse psychiatric effects, including depression, psychosis, mood swings, violent behavior, suicide, and suicide attempts.

Isotretinoin Dosage

The recommended dose of isotretinoin is 0.5 mg per kg of body weight daily. The daily dose usually is administered in two divided doses for 14 to 20  weeks. Isotretinoin should be taken with food.

Isotretinoin Drug Interaction

Isotretinoin is closely related to vitamin A. Therefore, the use of both vitamin A and isotretinoin at the same time may lead to vitamin A side effects. Additional drugs that may interact with isotretinoin include alcohol, benzoyl peroxide, salicylic acid, or other drying medicines used for acne; corticosteroids (example: prednisone); medicines for seizures; other drugs that make you more sensitive to the sun such as sulfa drugs; progestin-only birth control hormones (examples: 'Minipills' like Aygestin, Micronor, Nor-QD or injectable / implantable products such as Depo-Provera or Norplant.

Isotretinoin and Pregnancy

Isotretinoin is known to cause birth defects when used during pregnancy. Isotretinoin can cause brain and heart defects in infants if a woman takes it during or immediately before pregnancy. Women who take it must have pregnancy tests and use birth control or abstain from sex.