Isotretinoin (Accutane) is a retinoid or vitamin A analog, which means that its molecular structure is similar to Vitamin A. Doctors prescribe it to treat severe acne only after other treatments have failed. Isotretinoin can cause some rare but serious side effects. Just one dose of isotretinoin can cause severe birth defects if a woman is pregnant when taking this medicine.
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Treatment with isotretinoin cures acne in 80 out of 100 people who get it. That means acne is not cured in 20 out of 100 people who take isotretinoin. About 3 to 6 months of treatment is needed for isotretinoin to work.
Most people have minor Isotretinoin (AccutaneŽ) side-effects that disappear within 2 weeks after stopping the medication. Acute pancreatitis has been reported in patients with either elevated or normal serum triglyceride levels. If Accutane gives you an allergic reaction, you will not be able to use it. Stop taking isotretinoin and seek emergency medical attention or contact your doctor immediately if you experience any of the following serious side effects: an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); changes in vision, blurred vision, or decreased vision (especially at night); painful or constant dryness of the eyes; depression including feelings of sadness, crying spells, irritability, changes in sleep patterns, unusual tiredness, trouble concentrating, loss of appetite, and/ or suicidal thoughts or other mental problems; stomach, chest, or bowel pain; rectal bleeding, or severe or bloody diarrhea; difficulty or pain when swallowing; new or worsening heartburn; yellowing of the skin or eyes or persistently dark urine; severe headache or dizziness; seizures; nausea and vomiting; joint or muscle pain or bone problems; hearing problems or hearing loss; trouble breathing; fainting; increased thirst or urination; slurred speech or problems moving; leg swelling; increased levels of cholesterol or triglyceride (types of fat) in your blood (detected by blood tests).
Isotretinoin, when administered orally, is best absorbed when taken after a high fat meal, as it has a high level of lipophilicity. In a crossover study, it was found that the peak plasma concentration more than doubled when taken after a high fat meal versus a fasted condition. Isotretinoin is primarily (99.9%) bound to plasma proteins, mostly albumin. At least three metabolites have been detected in human plasma after oral administration of isotretinoin.