Roaccutane (Isotretinoin) is a form of vitamin A. It reduces the amount of oil
released by oil glands in your skin, and helps your skin renew itself
more quickly.
Roaccutane (Isotretinoin) is used to treat severe nodular acne that has not responded to other treatments, including antibiotics.
Roaccutane (Isotretinoin) may also be used for other purposes not listed in this medication guide.
Isotretinoin, a retinoid, is available as
Roaccutane
(Isotretinoin) in 10-mg and 20-mg soft gelatin capsules for oral
administration. Each capsule contains beeswax, butylated
hydroxyanisole, edetate disodium, hydrogenated soybean oil flakes,
hydrogenated vegetable oil, and soybean oil. Gelatin capsules contain
glycerin and parabens (methyl and propyl), with the following dye
systems: 10 mg - iron oxide (red) and titanium dioxide; 20 mg -
FD&C Red No. 3, FD&C Blue No. 1, and titanium dioxide.
Chemically, isotretinoin is 13-cis-retinoic acid and is related to both retinoic acid and retinol (
vitamin A).
DRUG INTERACTIONS
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Vitamin A: Because of the relationship of
Roaccutane
(Isotretinoin) to vitamin A, patients should be advised against taking
vitamin supplements containing vitamin A to avoid additive toxic
effects.
-
Tetracyclines: Concomitant treatment with
Roaccutane (Isotretinoin) and tetracyclines should be avoided because
Roaccutane
(Isotretinoin) use has been associated with a number of cases of
pseudotumor cerebri (benign intracranial hypertension), some of which
involved concomitant use of tetracyclines.
-
Micro-dosed Progesterone Preparations:
Micro-dosed progesterone preparations ("minipills" that do not contain
an estrogen) may be an inadequate method of contraception during
Roaccutane
(Isotretinoin) therapy. Although other hormonal contraceptives are
highly effective, there have been reports of pregnancy from female
patients who have used combined oral contraceptives, as well as
transdermal patch/injectable/implantable/vaginal ring hormonal birth
control products. These reports are more frequent for female patients
who use only a single method of contraception. It is not known if
hormonal contraceptives differ in their effectiveness when used with
Roaccutane
(Isotretinoin). Therefore, it is critically important for female
patients of childbearing potential to select and commit to use 2 forms
of effective contraception simultaneously, at least 1 of which must be
a primary form.
-
Norethindrone/ethinyl estradiol:
In a study of 31 premenopausal female patients with severe recalcitrant
nodular acne receiving OrthoNovum 7/7/7 Tablets as an oral
contraceptive agent,
Roaccutane
(Isotretinoin) at the recommended dose of 1 mg/kg/day, did not induce
clinically relevant changes in the pharmacokinetics of ethinyl
estradiol and norethindrone and in the serum levels of progesterone,
follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
Prescribers are advised to consult the package insert of medication
administered concomitantly with hormonal contraceptives, since some
medications may decrease the effectiveness of these birth control
products.
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Phenytoin: Roaccutane
(Isotretinoin) has not been shown to alter the pharmacokinetics of
phenytoin in a study in seven healthy volunteers. These results are
consistent with the in vitro finding that neither isotretinoin nor its
metabolites induce or inhibit the activity of the CYP 2C9 human hepatic
P450 enzyme. Phenytoin is known to cause osteomalacia. No formal
clinical studies have been conducted to assess if there is an
interactive effect on bone loss between phenytoin and
Roaccutane (Isotretinoin). Therefore, caution should be exercised when using these drugs together.
-
Systemic Corticosteroids:
Systemic corticosteroids are known to cause osteoporosis. No formal
clinical studies have been conducted to assess if there is an
interactive effect on bone loss between systemic corticosteroids and
Roaccutane (Isotretinoin). Therefore, caution should be exercised when using these drugs together.