Isotretinoin, derived from vitamin A, is used to treat severe acne but can cause serious birth defects. The iPLEDGE program controls its prescription in the US, and patients must get a new prescription every 30 days. It can also cause dry skin, sensitivity to the sun, elevated glucose levels, mood changes, cataracts, difficulty with night vision, and extreme depression. Women who are sexually active and do not use birth control should not take this drug.
Isotretinoin is a drug more commonly known by the trade name Accutane when taken by mouth, or Isotrex when used as an ointment. Isotretinoin is derived from vitamin A and is most commonly used in the treatment of very severe acne. It tends not to be the recommended first-line drug for acne treatment because it can have serious side effects, including serious birth defects or fetal death among pregnant women.
Isotretinoin was developed and first released as a prescription drug after it was noticed that some patients taking high levels of vitamin A seemed to have reduced problems with acne. This was especially true when the vitamin A was derived from animal livers, instead of plant sources.
Treatment high in vitamin A had no side effects, and isotretinoin was thought to provide better results with fewer side effects. Unfortunately the first patients taking isotretinoin had no idea that serious birth defects could result from taking the drug. It is now known that both high doses of fat-soluble vitamin A and isotretinoin are indicated for severe birth defects.
Acne is often associated with teenagers and adolescents with unplanned pregnancies. So, to reduce the risk of pregnancy while taking isotretinoin, the prescription of the drug is controlled through the program called iPLEDGE in the United States, according to the recommendations of the FDA.
Under iPLEDGE, prescribing physicians must be registered to prescribe the drug. Also, isotretinoin is not given refills. Patients must get a new prescription for isotretinoin every 30 days to take the drug continuously. This system is still imperfect and has proved uncomfortable for some patients.
Isotretinoin has been shown to be an effective drug to combat significant acne, but it has side effects other than tetragenic. Some may notice more acne in the beginning, dry skin and sensitivity to the sun. Infrequently, isotretinoin has been linked to elevated glucose levels and mood changes. Rarely, isotretinoin can cause cataracts, difficulty with night vision, and extreme depression.
Because this drug is associated with numerous adverse effects, it’s important to weigh the risk against the benefits and thoroughly discuss all your options with a knowledgeable dermatologist. Also, women who are sexually active and do not use birth control should not take this drug. Sexually active women are advised to practice at least two methods of contraception to prevent pregnancy, such as condoms and the birth control pill.
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