INFORMATION FOR PHARMACISTS
Access the iPLEDGE system via the internet (www.ipledgeprogram.com)or telephone (1-866-495-0654) to obtain an authorization and the "do not dispense to patient after" date.Accutane must only be dispensed in no more than a 30-day supply.
REFILLS REQUIRE A NEW PRESCRIPTIONAND A NEW AUTHORIZATION FROM THE iPLEDGE SYSTEM.
An Accutane Medication Guide must be given to the patienteach time Accutane is dispensed, as required by law. This AccutaneMedication Guide is an important part of the risk management programfor the patient.
Isotretinoin, a retinoid, is available as Accutane in 10-mg, 20-mg and 40-mg soft gelatin capsules for oral administration.
Accutane is indicated for the treatment of severe recalcitrant nodular acne. Nodules are inflammatory lesions with a diameter of 5 mm or greater. The nodules may become suppurative or hemorrhagic. "Severe," by definition,2 means "many" as opposed to "few or several" nodules. Because of significant adverse effects associated with its use, Accutane should be reserved for patients with severe nodular acne who are unresponsive to conventional therapy, including systemic antibiotics. In addition, Accutane is indicated only for those females who are not pregnant, because Accutane can cause severe birth defects (see boxed CONTRAINDICATIONS AND WARNINGS).
A single course of therapy for 15 to 20 weeks has been shown to result in complete and prolonged remission of disease in many patients. 1,3,4 If a second course of therapy is needed, it should not be initiated until at least 8 weeks after completion of the first course, because experience has shown that patients may continue to improve while off Accutane. The optimal interval before retreatment has not been defined for patients who have not completed skeletal growth (see WARNINGS: Skeletal: Bone Mineral Density, Hyperostosis, and Premature Epiphyseal Closure).
Published Studies Related to Accutane (Isotretinoin)
A single blind randomized clinical study: the efficacy of isotretinoin plus narrow band ultraviolet B in the treatment of psoriasis vulgaris. [2011.06]
In this randomized clinical trial, 39 patients with psoriasis vulgaris were randomized in two groups. Intervention group received narrow band ultraviolet B (NBUVB)+isotretinoin (0.5 mg/kg/day), control group received NBUVB+placebo.
A phase I factorial design study of dose-dense temozolomide alone and in combination with thalidomide, isotretinoin, and/or celecoxib as postchemoradiation adjuvant therapy for newly diagnosed glioblastoma. [2010.11]
External beam radiation therapy (XRT) with concomitant temozolomide and 6 cycles of adjuvant temozolomide (5/28-day schedule) improves survival in patients with newly diagnosed glioblastoma compared with XRT alone...
Mortality in the randomized, controlled lung intergroup trial of isotretinoin. [2010.06]
In 2001, we reported that mortality may have been higher with isotretinoin (30 mg/d for 3 years) than with placebo in the subgroup of current smokers among the 1,166 patients with definitively resected early-stage non-small cell lung cancer who participated in the randomized, controlled Lung Intergroup Trial...
A randomized and controlled trial about the use of oral isotretinoin for photoaging. [2010.02]
Topical retinoids are used to treat photoaging; oral isotretinoin is gold standard for acne; "off label" indications, including photoaging, have been reported with insufficient evidence of efficacy. This is a randomized controlled phase II trial with clinical and histological assessment to evaluate efficacy and safety of oral isotretinoin for photoaging...
Dose response of retinol and isotretinoin in the prevention of nonmelanoma skin cancer recurrence. 
Using data from a randomized, double blind, study of the efficacy of retinol or isotretinoin vs. placebo on recurrence of nonmelanoma skin cancer in high-risk subjects, a reanalysis of the original intent to treat analysis was performed in a dose-response format...
Clinical Trials Related to Accutane (Isotretinoin)
Aflac ST1001 Prolonged Isotretinoin [Recruiting]
Neuroblastoma is a cancer of the nervous system and accounts for 15% of cancer related
deaths in children. With the advancement of treatment therapies, the long term survival rate
has progressed to approximately 50%. The therapy used for treatment, however, is very toxic
and associated with serious long-term side effects. Treatment for neuroblastoma typically
includes chemotherapy, surgery, stem cell transplantation, radiation therapy, and
immunotherapy. At the end of this treatment, children with neuroblastoma commonly take the
drug isotretinoin for 6 months. Isotretinoin maintains the response to previous treatments
and helps turn the remaining cancer cells into normal nerve cells.
Most patients often respond to this treatment at first but are at a high-risk for the cancer
coming back. The majority of the children who relapse after treatment or develop recurrent
disease do so in the first two years following the completion of therapy and there are no
current treatments to cure those who relapse. This study will explore whether or not
extending the therapy with isotretinoin from 6 months to 24 months will help prevent the
cancer from coming back without causing severe side effects.
Erlotinib Hydrochloride and Isotretinoin in Treating Patients With Recurrent Malignant Glioma [Recruiting]
RATIONALE: Erlotinib hydrochloride may stop the growth of tumor cells by blocking some of
the enzymes needed for cell growth. Isotretinoin may help cells that are involved in the
body's immune response to work better. Giving erlotinib hydrochloride together with
isotretinoin may kill more tumor cells.
PURPOSE: This phase I trial is studying the side effects and best dose of erlotinib
hydrochloride when given with isotretinoin in treating patients with recurrent malignant
Vorinostat and Isotretinoin in Treating Patients With High-Risk Refractory or Recurrent Neuroblastoma [Recruiting]
This phase I trial is studying the side effects and the best dose of vorinostat when given
together with isotretinoin to see how well it works in treating patients with high-risk
refractory or recurrent neuroblastoma. Vorinostat may stop the growth of tumor cells by
blocking some of the enzymes needed for cell growth. Isotretinoin may help vorinostat work
better by making tumor cells more sensitive to the drug. Giving vorinostat together with
isotretinoin may be an effective treatment for neuroblastoma
Vorinostat, Isotretinoin and Temozolomide in Adults With Recurrent Glioblastoma Multiforme (GBM) [Recruiting]
1. To determine the maximum tolerated dose (MTD) of vorinostat/isotretinoin (cRA),
temozolomide (TMZ)/cRA and vorinostat/cRA/TMZ combinations in adult patients with recurrent
glioblastoma multiforme (GBM) and anaplastic gliomas.
1. To determine the efficacy of vorinostat/cRA versus TMZ/cRA versus vorinostat/cRA/TMZ in
patients with recurrent GBM as determined by Progression Free Survival (PFS) using an
adaptive randomization phase II trial design.
2. To determine the radiological response, progression free survival at 6 months, overall
survival and unexpected toxicity in the three treatment arms.
3. To obtain exploratory data regarding histone 3 and 4 acetylation and p21 levels in
tumor tissue and peripheral monocytes in a subset of surgical patients and in
non-surgical patients with available tissue from previous surgical procedures.
4. To evaluate the occurrence of symptoms and correlate to disease progression and
tolerance to treatment using the MD Anderson Symptom Inventory-Brain Tumor Module
(MDASI-BT) self-reporting tool.
A Feasibility Study of SAHA Combined With Isotretinoin and Chemotherapy in Infants With Embryonal Tumors of the Central Nervous System [Recruiting]
Drugs used in chemotherapy work in different ways to stop the growth of tumor cells, either
by killing the cells or by stopping them from dividing. Giving more than one drug
(combination chemotherapy) may kill more tumor cells. A peripheral blood stem cell
transplant may be able to replace blood-forming cells that were destroyed by chemotherapy.
This may allow more chemotherapy to be given so that more tumor cells are killed. This
clinical trial is studying the side effects of giving vorinostat and isotretinoin together
with combination chemotherapy and to see how well it works in treating young patients who
have undergone surgery for embryonal tumors of the central nervous system
Reports of Suspected Accutane (Isotretinoin) Side Effects
Inflammatory Bowel Disease (2158),
Colitis Ulcerative (1486),
Crohn's Disease (1107),
Irritable Bowel Syndrome (1049),
Emotional Distress (437),
Intestinal Obstruction (403),
Suicidal Ideation (328), more >>
PATIENT REVIEWS / RATINGS / COMMENTS
Based on a total of 44 ratings/reviews, Accutane has an overall score of 7.73. The effectiveness score is 9.05 and the side effect score is 6.27. The scores are on ten point scale: 10 - best, 1 - worst. Below are selected reviews: the highest, the median and the lowest rated.
Accutane review by 43 year old female patient
|Overall rating:|| || |
|Effectiveness:|| || Highly Effective|
|Side effects:|| || Mild Side Effects|
|Condition / reason:|| || acne|
|Dosage & duration:|| || 40mg daily taken 20 mg 2xday for the period of 4 months|
|Other conditions:|| || none|
|Other drugs taken:|| || none|
|Benefits:|| || Permanently: cured of cystic acne. Temporarily: eliminated blackheads, smoothed skin texture, skin appeared "poreless".|
|Side effects:|| || Dry skin and lips, increased susceptibility to developing blisters on feet if walking long distances without careful attention to socks and shoes. Stupidly used "Biore" skin strips early in the treatment to speed up removal of the blackheads and pulled all the skin off my nose. |
|Comments:|| || I am 43 now but took Accutane back in my early 20's for moderate cyctic acne. I took a second course in my 30's for mild/moderate non-cystic acne which was probably hormone related. I absolutely loved taking Accutane and wished that I could take it again at a milder dosage to treat blackheads and have that smooth "poreless" skin again. It seems to speed up skin cell sloughing and I didn't need to exfoliate, just use a good cream. After years of taking antibiotics and using awful creams that made my skin dry and red, Accutane was a godsend. My older brother and sister have terrible deep scars from cystic acne (my sister had dermabrasion many years ago before the age of laser) but I do not have one scar from my cyctic acne.|
Accutane review by 18 year old male patient
|Overall rating:|| || |
|Effectiveness:|| || Considerably Effective|
|Side effects:|| || Moderate Side Effects|
|Condition / reason:|| || Acne|
|Dosage & duration:|| || 40mg/day taken daily for the period of 8 months|
|Other conditions:|| || None|
|Other drugs taken:|| || None|
|Benefits:|| || Completely eliminated my acne while I was on the drug, however acne did return once I stopped, though not as bad.|
|Side effects:|| || Dry skin, which was easily taken care of with a moisturizer.
I didn't experience any of the other side effects often mentioned such as depression.|
|Comments:|| || I would take 2x20mg pills daily. I needed to moisturize my face once a day also.
When i began I weaned myself onto the drug -- take 20mg for the first week before stepping upto the 40mg dose.|
Accutane review by 34 year old female patient
|Overall rating:|| || |
|Effectiveness:|| || Moderately Effective|
|Side effects:|| || Severe Side Effects|
|Condition / reason:|| || ACNE|
|Dosage & duration:|| || NOT SURE (dosage frequency: 1 pill/day) for the period of 5 MONTHS|
|Other conditions:|| || NONE|
|Other drugs taken:|| || NONE|
|Benefits:|| || REDUCED AMOUNT OF CYSTIC ACNE|
|Side effects:|| || BALDNESS, SENSITIVITY TO SUNLIGHT, NIGHT VISION BLURRINESS|
|Comments:|| || TAKE 1 PILL A DAY, BLOOD TOXICITY TESTS EVERY TWO WEEKS|
Page last updated: 2011-12-09