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Accutane is a drug that is used for treating moderate to severe acne. It was first used as chemotherapy medication for treating brain cancer and pancreatic cancer. At present, it is still used to treat cancers because it has the ability to kill rapidly dividing cells. The approach of this drug is systemic and it is not selective. This drug is retinoid that is derived from Vitamin A and it is naturally found in the body in a few amounts. Roche worldwide distributes it. During 1930s, high doses of fat-soluble Vitamin A were used to treat acne. The effects of this reduced production of sebum and dry hair could be noticed. When studies showed that Vitamin A is good for the skin, a retinoic acid derivative was developed. From the time the drug was introduced there were known teratogenic effects and pregnancies were discouraged. There have been reports that 30 % causes congenital malformation. Last February 2002, Roche patent expired and now many other manufacturing company selling cheaper generic versions of this drug however they will continue to sell outside America with the brand name of Roaccutane.
The exact action of this drug is unknown. It is believed that it works similar to a retionoids that alters the DNA transcription. It decreases the sebum output and stabilizes keratinization that makes cells sloughed off and inhibits formation of comedones. This drug is taken orally and it is best absorbed after having a high fat meal. This drug primarily bound to plasma protein and mostly albumin. There have been traces of three metabolites after taking this drug namely: retinoic acid, 4-oxo-isotretinoin, 4-oxo-retinoic acid and oxo-retinoic acid. Accutane is excreted both in urine and feces. The dose of the drug a patient’s receives depends on the weight and the severity of the condition. The high dose treatment is administered at the rate of 0.5 mg/kg/day- 2mg/kg/day usually into two divided doses with the duration of 4-6 months. The high dose treatment is only considered as last resort because it would lead to adverse side effects.
The common side effects of this drugs are the following: mild acne flares, lips and mucous membranes dryness, rosacea, skin peeling, rash, myalgia and arthralgia.