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Accutane (Isotretinoin) - Summary

 
 



BOX WARNING

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.

 

ACCUTANE SUMMARY

ACCUTANE®
(isotretinoin capsules)

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).


See all Accutane indications & dosage >>

NEWS HIGHLIGHTS

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. [2010]
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...

more studies >>

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 glioma.

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]
Objectives:

Phase I

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.

Phase II

Primary objective:

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.

Secondary objectives:

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

more trials >>

Reports of Suspected Accutane (Isotretinoin) Side Effects

Inflammatory Bowel Disease (2158)Colitis Ulcerative (1486)Depression (1167)Crohn's Disease (1107)Irritable Bowel Syndrome (1049)Injury (666)Anxiety (592)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

  Rating
Overall rating:  
Effectiveness:   Highly Effective
Side effects:   Mild Side Effects
  
Treatment Info
Condition / reason:   acne
Dosage & duration:   40mg daily taken 20 mg 2xday for the period of 4 months
Other conditions:   none
Other drugs taken:   none
  
Reported Results
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

  Rating
Overall rating:  
Effectiveness:   Considerably Effective
Side effects:   Moderate Side Effects
  
Treatment Info
Condition / reason:   Acne
Dosage & duration:   40mg/day taken daily for the period of 8 months
Other conditions:   None
Other drugs taken:   None
  
Reported Results
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. Dry lips. 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

  Rating
Overall rating:  
Effectiveness:   Moderately Effective
Side effects:   Severe Side Effects
  
Treatment Info
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
  
Reported Results
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

See all Accutane reviews / ratings >>

Page last updated: 2011-12-09

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