| Indication |
For the treatment of severe recalcitrant nodular acne |
| Pharmacodynamics |
Isotretinoin, a retinoid, is indicated in the treatment of
severe recalcitrant nodular acne. Nodules are inflammatory lesions with a
diameter of 5 mm or greater. The nodules may become suppurative or
hemorrhagic. "Severe," by definition, means "many" as opposed to "few or
several" nodules. Clinical improvement in nodular acne patients occurs
in association with a reduction in sebum secretion. The decrease in
sebum secretion is temporary and is related to the dose and duration of
treatment with Accutane, and reflects a reduction in sebaceous gland
size and an inhibition of sebaceous gland differentiation. |
| Mechanism of action |
Isotretinoin noticeably reduces the production of sebum and
shrinks the sebaceous glands. It stabilises keratinization and prevents
comedones from forming. It also reduces inflammation in moderate-severe
inflammatory acne. The exact mechanism of action is unknown, however it
is known that it alters DNA transcription. |
| Absorption |
Not Available |
| Volume of distribution |
Not Available |
| Protein binding |
99.9% |
| Metabolism |
Not Available |
| Route of elimination |
Isotretinoin and its metabolites are further metabolized into
conjugates, which are then excreted in urine and feces. The metabolites
of isotretinoin and any conjugates are ultimately excreted in the feces
and urine in relatively equal amounts (total of 65% to 83%). |
| Half life |
17-50 hours |
| Clearance |
- 96 +/- 6.27 L/hr [severe recalcitrant nodular acne pediatric Patients, 12 to 15 Years]
|
| Toxicity |
Isotretinoin is teratogenic. It also causes mucocutaneous side effects suck as cheilitis, dry skin, and dry eyes. |
