Difference between revisions of "Isotretinoin"

(Administration)
 
(One intermediate revision by one other user not shown)
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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===
*Adult:
+
*No adjustment
*Pediatric:
 
  
 
===Hepatic Dosing===
 
===Hepatic Dosing===
*Adult:
+
*No adjustment
*Pediatric:
 
  
 
==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==
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==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

Comments

See Also

References