Roaccutane dosage per 50 kg of weight. Roaccutane for acne. Dosing in special cases

Acne is a chronic relapsing disease sebaceous glands And hair follicles(2). The disease is widespread in adolescence. Less often acne occurs in infants and adults. The main role in the genesis of acne is played by hereditary predisposition, which determines the amount, size and increased sensitivity receptors of sebaceous gland cells for the male sex hormone testosterone and its metabolites (3, 5).

The initial stage of acne development is the formation retention hyperkeratosis at the mouth of the hair follicle. Hyperandrogenemia leads to hyperplasia and hypersecretion of the sebaceous glands. Hyperkeratosis and excessive sebum production lead to obstruction of the excretory duct sebaceous gland and comedonal formation (6, 7).

Under the created anaerobic conditions, Propionibacterium acnes multiplies. Despite the key importance of this microorganism, staphylococci are also involved in the development inflammatory process in the area of the sebaceous glands. The growth of bacteria initiates the development of the inflammatory process, forming inflammatory elements acne- papules, pustules, nodes or cysts. Recurrent ruptures of cysts with their subsequent re-epithelialization lead to the formation of epithelial tracts, which are often accompanied by disfiguring scars.

Severe forms of acne, as well as the tendency of the disease to recur, are usually genetically determined. In this regard traditional therapy antibiotics, topical agents, as well as various cosmetic effects do not allow achieving a lasting therapeutic result. Often the use of topical agents (topically acting retinoids and antibiotics, azelaic acid, combination drugs) turns out to be very effective directly in the treatment of patients. However, frequent relapses of the disease against the background of standard therapy not only contribute to the formation of post-acne, but also have unfavorable psychological impact for patients adolescence, lead to the formation of dysmorphophobia, depression, and in some cases, suicidal thoughts.

Systemic retinoids are effective therapeutic agents at severe forms acne, ineffectiveness antibacterial drugs, during the formation of hypertrophic and keloid scars (4, 8, 9, 15).

IN last years Dermatovenereologists have begun to increasingly use drugs from this group in the treatment of acne patients. This is due to the accumulated experience of their application in real clinical practice in Russia, as well as the emerging confidence of specialists in the high safety of systemic retinoids with long-term use in people with severe forms of acne.

Of no small importance in the popularity of isotretinoin is its universal mechanism of action, which allows it to have a beneficial effect on all four components of acne pathogenesis. Isotretinoin is able to suppress sebum production by 80%; effectively reduce the phenomenon of follicular hyperkeratosis and indirectly inhibit growth anaerobic bacteria, reducing inflammation of the sebaceous glands and hair follicles (10, 11).

Moreover, when using standard doses and dosage regimens, isotretinoin induces long-term remission of the disease or leads to permanent cure of patients (12, 13, 14).

At the same time, in 2010, the expert council Russian society dermatovenerologists considered it appropriate to recommend practitioners new strategy management of patients with moderate to severe forms of the disease using a “low-dose” isotretinoin regimen (1). This strategy is primarily aimed at the management of patients suffering from recurrent acne. medium degree severity, in which a good therapeutic result was observed from the use of topical drugs, but the process resumed again after discontinuation topical therapy.

Table 1.

Dynamics of the main laboratory parameters in patients with acne who used the “small dose” regimen of Roaccutane (M±m)

Laboratory indicator	Donors	Patients with acne before treatment (n=40)	Patients with acne who received Roaccutane for 1 month (n=40)	Patients with acne who received Roaccutane for 2 months (n=40)	Patients with acne who received Roaccutane for 3 months (n=40)
Cholesterol, µmol/l	3.7±0.1	5.0±0.7	5.1±0.7	5.3±1.2	5.2±2.7	>0,05
Triglycerides, µmol/l	1.7±0.01	1.8±0.02	1.9±0.02	1.8±0.4	1.9±0.8	>0,05
AST, U/l	32±0.5	34±0.9	35±0.9	35±0.7	35±0.8	>0,05
ALT, U/l	24±0.8	25±0.7	25±0.8	25±1.7	25±1.9	>0,05

Note: p - significance of differences between the group of people treated with Roaccutane and donors

In such cases, the initial dose of the drug should be calculated in the range of 0.1-0.15-0.3 mg/kg/day. in permanent (daily) or intermittent (every other day) regimens, or prescribed in a standard dose of 10 mg per day, regardless of body weight, followed by a stepwise reduction (after 1 month - up to 5 times a week; after another month - up to 3 times a week a week, after another month - up to 2 times a week; after another month - up to 1 time a week). The duration of treatment with isotretinoin according to the “low-dose” regimen should not on average exceed 3 to 6 months. From a practical point of view, an important advantage of this method of using isotretinoin is that there is no need to calculate the total course dose of the drug.

The purpose of our study was to study the effectiveness and safety of the use of isotretinoin (Roaccutane) in a “low dose” regimen in patients with recurrent acne of moderate severity.

Material and research methods

We observed 40 patients with acne aged 18 to 27 years (women - 25 (62.5%); men - 15 (37.5%). In all study participants, acne manifested itself at puberty.

The inclusion criteria for the study were: the presence of moderate to severe acne; good therapeutic effect from carrying out 2 or more courses of adequate topical therapy for the disease with subsequent relapses of acne; signing informed consent to participate in the study.

Exclusion criteria were: a history of indications for therapy with systemic retinoids, antiandrogen drugs; the fact of use of systemic antibiotics or topical retinoids during the last 3 months; the presence of clinically significant changes in hematological and (or) biochemical analysis blood; presence of mild or severe forms of acne; presence of pregnancy; presence of chronic liver failure or Gilbert's syndrome.

Inflammatory efflorescences were predominantly recorded on the skin in the form of multiple papules and papulopustules of a bright pink color, small in size (up to 0.5 cm in diameter) with uneven outlines, slightly rising above the surface of the skin. In 8 (20%) cases, single nodes (cysts) were also visualized.

Against this background, all patients had severe seborrhea, as well as the presence of non-inflammatory forms of acne - open and closed comedones. Despite a long history of acne, the observed individuals did not have scars or other post-acne lesions on their skin.

In 32 (80%) of the observed patients with acne, skin lesions were limited to the facial area. In 8 (20%) cases, multiple papulopustular elements were also localized in the upper third of the chest and back.

All patients had previously received different kinds therapy. 18 (45%) patients received systemic antibiotics more than 3 months before participating in the study. Topical retinoids had previously been used by 26 (65%) patients; azelaic acid preparations - 11 (27.5%) respectively; topical agents with antibacterial effect - 35 (87,5%); combination drugs- 19 (47.5%). It is noteworthy that, according to the recommendations of specialists, all 40 previously observed used other various topical agents, which, from the point of view evidence-based medicine are ineffective against acne.

Facial skin care in 16 (40%) patients with acne was ineffective and consisted of repeated use throughout the day of various cleansing gels, scrubs, as well as alcohol-containing products that contributed to additional irritation skin. On the contrary, 5 (12.5%) study participants did not carry out any activities at all hygienic care for oily or dry skin in seborrheic areas.

To assess the severity and extent of the disease, the Acne Dermatology Index (ADI) was used, which takes into account the number of comedones, papules, pustules, and nodules in the subject being examined.

All patients were prescribed isotretinoin (Roaccutane), manufactured by F. Hoffmann-La-Roche Ltd., Switzerland, at a standard dose of 10 mg/day for three months.

A study of the content of triglycerides, cholesterol, ALT, AST in the blood serum of observed individuals with acne was carried out before the start of treatment with isotretinoin (Roaccutane), and was also carried out during therapy with “small doses” of the drug once a month for three months. 40 healthy individuals were examined as a control group.

After completing a 3-month course of isotretinoin monotherapy, patients were prospectively monitored for 6 months.

Results and its discussion. In all patients, before treatment, the presence of many miliary and lenticular papules of a conical shape of a bright pink color, pustules with a tense cap, cloudy contents, single nodes of a purplish-bluish color, dense consistency, without signs of fluctuation, associated with an increase in the ADI index to 9, was detected. 7±0.5 (Fig. 1) on the back, chest and face.

By the 7th day from the start of therapy with isotretinoin (Roaccutane), 25 patients (62.5%) registered the development of a peculiar reaction of exacerbation of dermatosis, manifested by the appearance of fresh nodules and miliary pustules on the face and back. However, already on the 14th day of treatment, a clear decrease in the signs of seborrhea was recorded in all patients receiving isotretinoin (Roaccutane). After 3-4 weeks from the start of taking isotretinoin (Roaccutane), pronounced positive dynamics were noted in the skin pathological process(papules flattened, faded, pustules shriveled into crusts, nodes decreased in size), which was accompanied by a statistically significant decrease in the ADI index to 5.1±0.1 (p<0,001). Ко 2-му месяцу терапии изотретиноином (Роаккутаном) данный показатель снизился до 3,1±0,1 (р<0,001), клинически отражая исчезновение комедонов, уменьшение количества папулезных узлов и полное исчезновение пустулезных эффлоресценций. Через 3 месяца от начала лечения изотретиноином (Роаккутана) у подавляющего большинства пациентов полностью разрешились комедоны, папулы, пустулы, а величина индекса ADI достигла 0,6±0,01 (р<0,001) (рис. 1).

Rice. 1. Dynamics of the ADI index in patients with acne who used the “low-dose” isotretinoin (Roaccutane) regimen.

Six months after the start of isotretinoin (Roaccutane) therapy, it was possible to prospectively assess the condition of the skin process in 38 patients (two patients dropped out of the observation group for personal reasons). Thus, in the 36 individuals we observed, there were no signs of seborrhea and acne; the value of the ADI index was zero. Only in two patients were single lenticular pale pink nodular efflorescences recorded on the back against the background of a complete absence of pustules, comedones, nodes and seborrhea (ADI index = 2.4 ± 0.1) (Fig. 1).

It was also found that isotretinoin (Roaccutane) was generally well tolerated by patients, and side effects were minimal in severity and spectrum. Thus, all patients (100%) developed cheilitis on the 7th–14th day of treatment. In 18 patients (45%) the presence of retinoid dermatitis of the face was noted, in 22 patients (55%) - dryness of the nasal mucosa. The above-mentioned side effects did not require discontinuation of isotretinoin (Roaccutane) and were easily and quickly relieved by the prescription of moisturizers, in particular the drug Clobeyz.

Upon re-examination, laboratory parameters in all patients (in particular AST, ALT, triglycerides) at the end of the three-month course of isotretinoin (Roaccutane) therapy were comparable to control values. In 2 patients, an increase in the concentration of cholesterol in the blood was noted, but no significant differences were obtained with the control group (p>0.05) (Table 1).

conclusions

1. The use of a mild dosing regimen of isotretinoin (Roaccutane) in patients with moderate to severe forms of acne is very appropriate.

2. The use of small doses of isotretinoin (Roaccutane) allows for rapid and lasting resolution of skin rashes, prevents relapses, minimizes the risk of side effects, and also does not require any additional therapy for both the main disease and side effects identified during treatment. effects.

A.L. Bakulev, S.S. Kravchenya

Saratov State Medical University named after V.I. Razumovsky

Bakulev Andrey Leonidovich - Doctor of Medical Sciences, Professor of the Department of Skin and Venereal Diseases

2. Samtsov A.V. Acne and acneiform dermatoses. - M., 2009. - P. 32-45.
3. Layton A.M., Knaggs H., Taylor J. et al. Isotretinoin for acne vulgaris - 10 years later: a safe and successful treatment. Br J Dermatol., 1993; 129: 292-296.
4. Goodfield M.J., Cox N.H., Bowser A. Advice on the safe introduction and continued use of isotretinoin in acne in the U.K. 2010.Br J Dermatol., 2010 Jun; 162(6):1172-9.
6. Roodsari M.R., Akbari M.R., Sarrafi-rad N. et al. The effect of isotretinoin treatment on plasma homocysteine levels in acne vulgaris. Clin Exp Dermatol. 2010 Aug; 35 (6): 624-6.
7. Li L., Tang L., Baranov E. et al. Selective induction of apoptosis in the hamster flank sebaceous gland organ by a topical liposome 5-alpha-reductase inhibitor: a treatment strategy for acne. J Dermatol., 2010 Feb; 37 (2): 156-62.
8. Sardana K., Garg V.K. Efficacy of low-dose isotretinoin in acne vulgaris. Indian J Dermatol Venereol Leprol., 2010 Jan-Feb; 76 (1): 7-13.
9. Ingram J.R., Grindlay D.J., Williams H.C. Management of acne vulgaris: an evidence-based update. Clin Exp Dermatol., 2010, Jun; 35(4): 351-4.
10. Merritt B., Burkhart C.N., Morrell D.S. Use of isotretinoin for acne vulgaris. Pediatr Ann., 2009, Jun; 38 (6): 311-20.
11. Bener A., Lestringant G.G., Ehlayel M.S. et al. Treatment outcome of acne vulgaris with oral isotretinoin. J Coll Physicians Surg Pak., 2009, Jan; 19 (1): 49-51.
12. Kontaxakis V.P., Skourides D., Ferentinos P. et al. Isotretinoin and psychopathology: a review. Ann Gen Psychiatry., 2009, Jan 20; 8:2.
13. Degitz K., Ochsendorf F. Pharmacotherapy of acne. Expert Opin Pharmacother, 2008, Apr; 9 (6): 955-71.
14. O’Reilly K., Bailey S.J., Lane M.A. Retinoid-mediated regulation of mood: possible cellular mechanisms. Exp Biol Med (Maywood), 2008, Mar; 233(3):251-8.
15. Berbis P. Systemic retinoids (acitretin, isotretinoin). Ann Dermatol Venereol., 2007, Dec; 134 (12): 935-41.

Instructions for use:

Acnekutan – a remedy for acne; inhibits the activity and proliferation of the sebaceous glands and helps reduce their size, suppressing bacterial colonization of the duct, restoring the normal process of cell differentiation, stimulating regeneration, and providing an anti-inflammatory effect on the skin.

Release form and composition

Dosage form - hard gelatin capsules: 8 mg - size No. 3, brown, 16 mg - size No. 1, green cap and white body; capsule contents – orange-yellow waxy paste (10 pcs in a blister, in a cardboard pack of 2, 3, 5, 6, 9 or 10 blisters; 14 pcs in a blister, in a cardboard pack of 1, 2, 4 or 7 blisters).

1 capsule of Acnecutan contains:

Active ingredient: isotretinoin – 8 or 16 mg;
Auxiliary components: purified soybean oil, Gelucir 50/13 (a mixture of stearic acid esters of glycerol and polyethylene oxide), Span 80 (sorbitan oleate - mixed esters of sorbitol and oleic acid);
Capsule body and cap: titanium dioxide (E171), gelatin; No. 3/No. 1 – red iron oxide dye (E172)/indigo carmine (E132), yellow iron oxide dye (E172).

Indications for use

Conglobate, nodular cystic and other severe forms of acne, including those with a risk of scarring;
Acne that does not respond to other treatment methods.

Contraindications

Hypervitaminosis A;
Severe form of hyperlipidemia;
Liver failure;
Concomitant use of tetracyclines;
Breastfeeding period;
Pregnancy is established or planned (high probability of embryotoxic and teratogenic effects);
Age up to 12 years;
Individual intolerance to the components of the drug.

The occurrence of pregnancy during the period of use or during the first month after completion of the course of therapy carries a potential threat of severe malformations in the newborn.

For women of childbearing age, Acnecutane therapy is allowed only in severe forms of acne that are not amenable to conventional treatment methods. In this case, the woman must:

Understand and unconditionally follow all the doctor’s instructions;
Obtain information from the doctor about the danger of pregnancy during therapy, for 1 month after it and the need for urgent consultation in case of suspected pregnancy;
Confirm understanding of the need for precautions and the degree of responsibility;
Receive information about possible ineffectiveness of contraceptives;
Understand the need and constantly use the most effective methods of contraception for 1 month before Acnecutane therapy, during treatment and for 1 month after its completion;
Use (if possible) two different methods of contraception at the same time, including barrier;
Receive a negative result from a reliable pregnancy test 11 days before taking the drug;
Conduct a pregnancy test monthly during treatment and 5 weeks after completion of therapy;
Start therapy only 2-3 days after the start of the normal menstrual cycle;
Recognize the need to visit a doctor every month;
Use the same effective methods of contraception when treating a relapse of the disease, for 1 month before therapy, during treatment and for 1 month after its completion, and undergo the same reliable pregnancy test;
Understand the need for precautions and confirm your understanding and desire to use reliable methods of protection recommended by your doctor.

Use of contraception according to the above recommendations during isotretinoin therapy is necessary even for women who do not usually use contraception due to amenorrhea, infertility (with the exception of patients who have undergone a hysterectomy), or who report that they are not sexually active.

Directions for use and dosage

Capsules are taken orally 1-2 times a day, preferably with meals.

The doctor prescribes the dose of the drug individually, taking into account the therapeutic effectiveness and the presence of side effects in the patient.

Recommended dosage: initial dose - at the rate of 0.4 mg per 1 kg of patient weight per day, if necessary, it is possible to prescribe 0.8 mg per 1 kg per day. For the treatment of acne of the trunk or severe forms of the disease, the dose may be 2 mg per 1 kg per day.

The optimal cumulative dose for a course of therapy is 100-120 mg per 1 kg of weight. It usually takes 4-6 months to achieve complete remission.

For patients with poor tolerance to Acnecutane, the recommended daily dose can be reduced by extending the period of therapy.

Acne usually disappears completely after one course of treatment.

In case of relapse, a second course can be prescribed no earlier than 2 months after the end of treatment, since symptoms of improvement may be somewhat delayed. The second course is carried out in the initial daily and cumulative dose.

In patients with severe chronic renal failure, the initial dose should be reduced to 8 mg per day.

Side effects

Digestive system: nausea, diarrhea, dry mouth, inflammation of the gums, bleeding from the gums, intestinal bleeding, inflammatory bowel pathologies (ileitis, colitis), pancreatitis, including fatal outcomes (more often with hypertriglyceridemia above 800 mg/dl); in some cases - hepatitis, a reversible transient increase in the activity of liver enzymes;
Dermatological reactions: during the first few weeks of use, acne may worsen; peeling of the skin of the soles and palms, itching, rash, dermatitis or erythema of the face, sweating, paronychia, pyogenic granuloma, onychodystrophy, persistent thinning of hair, increased proliferation of granulation tissue, reversible hair loss, hirsutism, fulminant forms of acne, photosensitivity, hyperpigmentation, easy skin trauma ;
Nervous system: headache, fatigue, increased intracranial pressure (pseudotumor cerebri: nausea, vomiting, headache, papilledema, blurred vision), seizures; rarely – psychosis, depression, suicidal thoughts;
Musculoskeletal system: joint pain, muscle pain (with or without increased serum creatine phosphokinase activity), arthritis, hyperostosis, tendinitis, calcification of tendons and ligaments;
Sense organs: photophobia, impaired visual acuity (isolated cases), xerophthalmia, impaired dark adaptation (decreased twilight visual acuity); rarely - transient disturbance of color vision (recovers on its own after withdrawal), optic neuritis, keratitis, lenticular cataract, conjunctivitis, blepharitis, eye irritation, papilledema (as a manifestation of intracranial hypertension), in patients with contact lenses - difficulty wearing, impaired hearing perception of certain sound frequencies;
Hematopoietic system: decreased hematocrit, anemia, leukopenia, neutropenia, changes in platelet count, acceleration of erythrocyte sedimentation rate;
Respiratory system: rarely - bronchospasm (more often with a history of bronchial asthma);
Laboratory indicators: hypercholesterolemia, hypertriglyceridemia, decreased levels of high-density lipoproteins, hyperuricemia; rarely – hyperglycemia; cases of newly diagnosed diabetes mellitus; more often during intense physical activity – increased activity of creatine phosphokinase in the serum; systemic or local infections caused by Staphylococcus aureus (gram-positive pathogens);
Other: proteinuria, hematuria, lymphadenopathy, vasculitis (including allergic etiology, Wegener's granulomatosis), glomerulonephritis, systemic hypersensitivity reactions.

Symptoms associated with hypervitaminosis A: dryness of the mucous membranes of the pharynx and larynx (hoarseness), lips (cheilitis), eyes (reversible clouding of the cornea, conjunctivitis, intolerance to contact lenses), nasal cavity (bleeding), skin.

Embryotoxic and teratogenic effects of Acnecutan: congenital deformities - hydrocephalus, microcephaly, microphthalmia, underdevelopment of cranial nerves, malformations of the parathyroid glands and cardiovascular system, disorders of skeletal formation (underdevelopment of the skull, digital phalanges, cervical vertebrae, ankles, femur, bones forearm, cleft palate, facial skull), underdevelopment and/or low location of the ears, complete absence or underdevelopment of the external auditory canal, hernia of the spinal cord and brain, fusion of the toes and hands, bone fusions, developmental disorders of the thymus gland, fetal death in perinatal period, miscarriage, premature birth, early closure of epiphyseal growth zones, in animal experiments - pheochromocytoma.

special instructions

Prescription of the drug to each patient should be carried out after a thorough preliminary assessment of the ratio of expected benefits and potential risks.

The drug is not indicated for the treatment of acne during puberty.

The use of Acnecutane requires regular monitoring of liver function and liver enzymes before treatment, after one month of therapy, and then every 3 months. If the level of liver transaminases exceeds the normal level, the dose of the drug should be reduced or discontinued.

In addition, before starting treatment, the patient should determine the level of lipids in the blood serum, then, after one month of use, and every 3 months or as indicated. Typically, lipid levels are normalized by reducing the dose, following a diet, or discontinuing the drug.

Since an increase in triglyceride levels above 9 mmol/l or 800 mg/dl can cause the development of acute pancreatitis, including death, the patient needs to monitor their content. In case of persistent hypertriglyceridemia or symptoms of pancreatitis, the drug should be discontinued.

Due to the risk of psychotic symptoms, depression, and suicide attempts, it is recommended to prescribe the drug with extreme caution if there is a history of depression and to monitor the appearance of symptoms of depression in all patients.

Acne exacerbation that occurs at the beginning of therapy goes away within 7-10 days without dose adjustment.

At the beginning of therapy, it is recommended to use moisturizing body cream or ointment and lip balm to reduce dry skin.

Since the effect of the drug can cause a decrease in the acuity of night vision (sometimes persisting even after the end of treatment), the doctor should inform the patient about the possibility of this condition and recommend that he be careful when driving a car at night. Dryness of the conjunctiva can cause the development of keratitis, therefore, to moisturize the mucous membrane of the eyes, it is recommended to use artificial tears, moisturizing eye ointments. If your visual acuity worsens, you should consult an ophthalmologist.

Ultraviolet therapy and exposure to direct sunlight should be avoided; it is recommended to use a cream with a high sun protection factor (15 SPF or more).

If inflammatory bowel disease occurs, you should consult a doctor. In case of severe hemorrhagic diarrhea, the drug should be stopped immediately.

Due to the risk of increased scarring, hypo- and hyperpigmentation, patients are contraindicated for laser treatment and deep chemical dermoabrasion both during the period of taking Acnecutane and for 5-6 months after the end of therapy.

There is a risk of epidermal detachment, dermatitis and scars when performing hair removal using wax applications. Procedures cannot be performed during therapy and for six months after discontinuation of the drug.

Severe allergic reactions are grounds for immediate discontinuation of the capsules.

Patients with obesity, diabetes mellitus, chronic alcoholism, and lipid metabolism disorders require more frequent laboratory monitoring of lipid and glucose levels.

Blood should not be collected from potential donors during isotretinoin therapy, or for 1 month after completion of treatment.

During the period of use of Acnecutane, patients must be careful when driving vehicles and working with complex mechanisms.

Drug interactions

Before simultaneous use of Acnecutane with other medications, you should consult your doctor to avoid the development of side effects.

Analogs

Analogs of Acnecutane are: Verocutan, Isotretinoin, Retasol, Roaccutane, Retin ointment, Sotret.

Terms and conditions of storage

Store in a dry place, protected from light, at temperatures up to 25 °C. Keep away from children.

Shelf life – 2 years.

Roaccutane is a potent internal acne treatment for severe acne only. It can be drunk only as prescribed by a dermatologist, strictly according to the indicated doses. Roaccutane for acne may be prescribed initially if other types of treatment have not helped, and the form of acne is extremely severe. The drug has a lot of side effects and only 50% are completely cured of acne when taking Roaccutane.

How Roaccutane treats acne

The principle of operation of Roaccutane has not been fully established, but doctors attribute this to the suppression of sebum production and a reduction in the size of comedones with the help of the main active substance isotretinoin. Isotretinoin has been proven to have antiseptic effects.

Isotretinoin also thins the stratum corneum of the epidermis to make it easier to penetrate deep into the affected area. Due to the fact that Roaccutane suppresses the secretion of sebum by reducing the sebaceous glands themselves, this reduces the migration of bacteria in the ducts. And due to the fact that the stratum corneum is thinned, sebum has a way out, which does not cause blockage of the pore and, as a result, a pimple.

Roaccutane for acne, we repeat once again, is prescribed only by a doctor and, preferably, a dermatologist. For mild and moderate forms of acne, you should not immediately start with Roaccutane. Its effectiveness is not always justified: the number of side effects exceeds the possibility of having a clean face. Only half of those treated for acne with Roaccutane completely got rid of them. The rest did not get relief at all or suffered an aggressive relapse after stopping the drug.

We will not prescribe doses here, because... Only a doctor can prescribe them specifically for your condition. But it is sold in pharmacies in dosages of 10 mg and 20 mg. On average, acne treatment with Roaccutane lasts from 4 to 6 months. Long-term use of the drug is not recommended. Your doctor should monitor you at all times during treatment. Often in the first days of treatment there is a sharp exacerbation of acne, and after stopping treatment the skin condition may not improve. Roaccutane is taken in capsule form with food. You must undergo a complete blood count and other tests prescribed by your doctor every month. If you notice any side effects, immediately tell your doctor.

Interaction of Roaccutane with other drugs and procedures

Roaccutane should not be combined with vitamin A; hypervitaminosis A may occur. It should not be used with tetracyclines and contraceptives containing progesterone.

Due to the thinning of the stratum corneum of the skin, you should not stay in the sun or use sunscreens with a high SPF level. During treatment and for 1 year after treatment, hair removal, surgical and cosmetic interventions, laser interventions, and dermabrasion are prohibited. This is associated with a high risk of scarring and age spots.

Pregnant and breastfeeding women should never treat acne with Roaccutane, because this directly affects the fetus. Before prescribing treatment, the doctor forces you to take a pregnancy test twice. During treatment with Roaccutane, you must strictly adhere to contraceptives, otherwise the child may not be born.

Side effects of Roaccutane

Roaccutane for acne has many terrifying side effects that have a chance of occurring when using the drug. They are described in detail in the instructions for the drug, and here we will describe the most common ones.

Bone pain, dry skin, mucous membranes, headache, fever, nausea, rash, itching, nosebleeds, intolerance to contact lenses - observed in most patients, because this is due to hypervitaminosis A.
swelling, numbness of the extremities, abdominal pain, insomnia and, conversely, excessive drowsiness, sensitivity to light, facial dermatitis, rash, sweating - in about 10%
aggressive or withdrawn behavior, depression, suicidal state, convulsions, intracranial pressure, internal bleeding, intestinal diseases and more.

There is another similar drug, Acnecutan. It appeared on the Russian market quite recently since 2010 and has fewer side effects, although it is also based on isotretinoin, but a smaller amount of isotretinoin passes through the blood, and the amount of active ingredients is the same as with Roaccutane. But we have a separate article about this drug.

How much does Roaccutane cost?

Roaccutane, in addition to all its dangerous side effects, also has a high price, depending on the dosage, from 1300 to 2900 rubles per pack of 30 capsules.

10 mg each - about 1500 rubles
20 mg each - about 2600 rubles

Roaccutane Reviews

I was in a very dangerous condition - my whole face was full of potholes and inflammations, nothing was helping: neither a cosmetologist, nor a dermatologist, nor vitamins, injections, blood transfusions, etc. The dermatologist prescribed Roaccutane and, lo and behold, a week later my face became even worse than before. I came to her in a rage, but she reassured me that many people react this way, first with aggravation, then easier. Dear capsules, 1 package was enough for me for a month. I was treated for half a year. My face has become noticeably better, it’s not as scary as before, but the acne hasn’t gone away completely, there are potholes, spots and inflammation too. Now I have a break in treatment, the dermatologist wants me to take the course again in 2 months and says that after the end of treatment there will either be a new relapse or it will improve.

The dermatologist suggested that I immediately start with Roaccutane. I studied the instructions and was shocked. After it, you can’t give birth for at least another 2 years and, sorry, but I’m not ready to sacrifice my health and my child for the sake of some illusory improvements. I refused treatment with Roaccutane, I’d rather just take vitamin A. By the way, when I became pregnant, my acne went away on its own and my acne wasn’t very bad, like in the photos.

Having struggled with decisions for a long time, I finally decided to take Roaccutane. There were a lot of abscesses all over the face, 2-3 popped up every day, a lot of them subcutaneous. External medications and antibiotics did not help. I started taking Roaccutane, in the first 2 weeks it got even worse, but then it calmed down and my face slowly began to clear up, BUT a terrible depression came almost to the end, my liver hurt badly and I constantly wanted to sleep. But I completed the entire course, persevered and now I walk around with a clean face and happy. Thank you everyone, Roaccutane saved me, although it made me feel its terrible power.

33 comments on Roaccutane for acne:

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Calculation of the dose of the drug Acnecutan®

Acnecutane is a systemic retinoid (active ingredient isotretinoin) used to treat acne. This drug is recommended for severe acne and for the treatment of moderate acne when other types of therapy are ineffective (resistant forms of acne).

Dosing of the drug

Treatment with the drug Acnecutan® can lead to clinical recovery of the patient and long-term remission of the disease, but the maximum therapeutic effect from treatment can be expected if the recommended daily and course doses of Acnecutan are observed.

Acnekutan® is produced using the patented Belgian Lidose technology, which allows you to reduce the daily and course doses of the drug, while fully maintaining therapeutic effectiveness, and potentially reducing the severity of side effects. Lidose technology also helps reduce the dependence of isotretinoin absorption on food intake.

It is not recommended to take breaks in treatment with the drug for more than a day due to the increased risk of relapse of the disease with an intermittent course of treatment with this drug. If for some reason the daily dose of Acnecutane cannot be prescribed in the recommended range, the duration of treatment should be proportionally increased to the course dose of the drug.

Acnecutane is used orally, preferably with meals, 1 or 2 times a day.

In most patients, acne symptoms completely disappear after a single course of treatment.

In case of relapse, it is possible to carry out a second course of treatment at the same daily and course dose. A second course is prescribed no earlier than 8 weeks after the first, since the improvement may be delayed.

The number of packages of Acnekutan corresponds to the course dose of isotretinoin 115–120 mg/kg.

This website contains information for patients and specialists in the field of medicine and pharmaceuticals in Russia, and may contain information on YADRAN products that, for one reason or another, are not available or are not officially approved in your country. The information on this website should not be used for self-diagnosis and treatment and cannot be a substitute for an in-person consultation with a doctor.

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Prescription and treatment of prescription drugs should be carried out by specialists.

Aknekutan