Isotretinoin
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