Isotretinoin: Difference between revisions
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*Type: | *Type: | ||
*Dosage Forms: | *Dosage Forms: | ||
*Routes of Administration: | *Routes of Administration: IV, PO | ||
*Common Trade Names: Accutane | *Common Trade Names: Accutane | ||
==Adult Dosing== | ==Adult Dosing== | ||
*Acne: 0.25 mg/kg twice daily x 1 month, then 0.5 mg/kg twice daily as tolerated; continue until a total cumulative dose of 120 to 150 mg/kg is reached | |||
*Cutaneous T cell lymphoma/other cancers IV doses vary | |||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
*Used for acne, neuroblastoma | |||
==Special Populations== | ==Special Populations== | ||
===[[Drug pregnancy categories|Pregnancy Rating]]=== | ===[[Drug pregnancy categories|Pregnancy Rating]]=== | ||
* | *X | ||
===Lactation risk=== | ===Lactation risk=== | ||
* | *unknown | ||
===Renal Dosing=== | ===Renal Dosing=== | ||
* | *No adjustment | ||
===Hepatic Dosing=== | ===Hepatic Dosing=== | ||
* | *No adjustment | ||
==Contraindications== | ==Contraindications== | ||
*Allergy to class/drug | *Allergy to class/drug | ||
*Pregnancy | |||
==Adverse Reactions== | ==Adverse Reactions== | ||
===Serious=== | ===Serious=== | ||
*Hearing impairment | |||
*Bone mineral density loss leading to fractures/delayed fracture healing, skeletal hyperostosis/premature epiphyseal closure | |||
*Erythema multiforme, SJS, TEN | |||
*Agranulocytosis, neutropenia | |||
*Hepatitis | |||
*Hypersensitivity reactions (anaphylaxis, allergic vasculitis) | |||
*IBD, ileitis | |||
*Rhabdomyolysis | |||
*Visual impairment, corneal opacities | |||
*Pancreatitis | |||
*Pseudotumor cerebri | |||
*Psychiatric effects (depressed mood/suicidal ideation, psychosis) | |||
*[[ATRA syndrome]] | |||
===Common=== | ===Common=== | ||
*Increased triglycerides, decreased HDL, increased CPK | |||
*Increased LFTs | |||
*Arthralgia, back pain | |||
*Decreased bone mineral density | |||
*Photosensitivity | |||
==Pharmacology== | ==Pharmacology== | ||
*Half-life: | *Half-life: 5-38h | ||
*Metabolism: | *Metabolism: Hepatic via CYP2B6, 2C8, 2C9, 3A4 | ||
*Excretion: | *Excretion: Urine and feces | ||
==Mechanism of Action== | ==Mechanism of Action== | ||
*Induces apoptosis in certain cells, including those of the sebaceous glands | |||
==Comments== | ==Comments== | ||
| Line 48: | Line 64: | ||
==See Also== | ==See Also== | ||
*[[Acne]] | |||
*[[Vitamin A toxicity]] | |||
==References== | ==References== | ||
Latest revision as of 05:31, 21 April 2021
Administration
- Type:
- Dosage Forms:
- Routes of Administration: IV, PO
- Common Trade Names: Accutane
Adult Dosing
- Acne: 0.25 mg/kg twice daily x 1 month, then 0.5 mg/kg twice daily as tolerated; continue until a total cumulative dose of 120 to 150 mg/kg is reached
- Cutaneous T cell lymphoma/other cancers IV doses vary
Pediatric Dosing
- Used for acne, neuroblastoma
Special Populations
Pregnancy Rating
- X
Lactation risk
- unknown
Renal Dosing
- No adjustment
Hepatic Dosing
- No adjustment
Contraindications
- Allergy to class/drug
- Pregnancy
Adverse Reactions
Serious
- Hearing impairment
- Bone mineral density loss leading to fractures/delayed fracture healing, skeletal hyperostosis/premature epiphyseal closure
- Erythema multiforme, SJS, TEN
- Agranulocytosis, neutropenia
- Hepatitis
- Hypersensitivity reactions (anaphylaxis, allergic vasculitis)
- IBD, ileitis
- Rhabdomyolysis
- Visual impairment, corneal opacities
- Pancreatitis
- Pseudotumor cerebri
- Psychiatric effects (depressed mood/suicidal ideation, psychosis)
- ATRA syndrome
Common
- Increased triglycerides, decreased HDL, increased CPK
- Increased LFTs
- Arthralgia, back pain
- Decreased bone mineral density
- Photosensitivity
Pharmacology
- Half-life: 5-38h
- Metabolism: Hepatic via CYP2B6, 2C8, 2C9, 3A4
- Excretion: Urine and feces
Mechanism of Action
- Induces apoptosis in certain cells, including those of the sebaceous glands