Accufine 20 - Isotretinoin

Isotretinoin is indicated for the treatment of severe forms of acne (such as nodular acne or acne conglobata or acne at risk of permanent scarring) that are refractory to appropriate standard courses of treatment with systemic antibiotics and local treatment.

Isotretinoin (13-cis-retinoic acid), a vitamin A derivative, activates nuclear (retinoid) receptors and regulates transcription. This first generation retinoid reduces the proliferation, differentiation and activity of basal sebocytes (cell cycle arrest). At the same time, isotretinoin induces apoptosis through a retinoic acid receptor-independent mechanism while normalizing follicular keratinization and inhibiting comedogenesis. In addition to inhibiting sebum fat synthesis, the sebum excretion rate is significantly reduced after a few weeks of use.

Although isotretinoin is not an antimicrobial agent, it effectively reduces the total Propionibacterium acnes population (including antibiotic-resistant species) by altering the follicular microenvironment. Isotretinoin also has direct and indirect anti-inflammatory properties through inhibition of motility and migration of neutrophils into the skin and other indirect mechanisms, including a reduction in matrix metalloproteinases and a reduction in the P-acnes population.
The recommended initial dose for oral treatment with isotretinoin is 0.5 mg/kg body weight daily. Since the therapeutic response and some side effects are dose-dependent and vary from patient to patient, individual dosage adjustment is required during treatment. For most patients the dose is in the range of 0.5-1.0 mg/kg body weight/day.

Attention Pregnancy

Women taking isotretinoin should not become pregnant during and for one month after stopping isotretinoin therapy. During this time, sexual abstinence or effective contraception is advised. Barrier methods alone (e.g. condoms) are not considered sufficient due to unacceptable failure rates of around 3%.