Roaccutane - a revolution under surveillance

In the 1980s, a drug has truly revolutionized the treatment of severe acne: Accutane ®. Often considered the last chance, it is very effective but is not without risks. Therefore, this treatment is always associated with regular monitoring. Doctissimo tells you everything about this relentless killer spots ...

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Active molecule Roaccutane®, isotretinoin is a derivative of vitamin A acid (also called acid all-trans retinoic acid or tretinoin), used for treating certain leukemias. Less toxic than the latter, isotretinoin is highly teratogenic, however, is to tell the origin of fetal malformations, and responsible side effects rather annoying.

A widely demonstrated effectiveness
The comprehensive treatment and monitored by isotretinoin causes the complete disappearance of lesions in more than 85% of cases.

Subsequently, the risk of relapse is between 20 and 40%. But in two of three cases are curable by other means (antibiotics or isotretinoin in local usage).

In women, attention danger!
Isotretinoin is highly teratogenic. It promotes the appearance of congenital malformations including nervous system, ears and cardiovascular system.

The prescription product for women is therefore subject to strict conditions:

Establishment of a effective contraception one month before starting treatment;
Verifying the absence of pregnancy at treatment by a pregnancy test directed by blood;
Accurate and complete explanations of risk by the doctor to the patient;
Written consent of the patient for treatment and contraception;
Continuation of contraception for one month after stopping treatment. The product is slowly eliminated, the risks persist beyond its making;
Verifying the absence of pregnancy by a blood test five weeks after stopping treatment.
Monitoring of treatment is also strict with an audit every two months, monitoring of contraception and the lack of pregnancy by a blood test.

Side effects almost systematic
Isotretinoin this common side effects, probably due to its mode of action. They are characterized by dryness of the skin and mucous membranes.

The most frequent are present in more than 80% of cases:

Chapped lips;
Dry skin;
Itching;
Nosebleeds.
Finally, the drug may have other side effects that require monitoring:

Biological assessments with mix transaminaseOf total cholesterol and triglycerides early treatment and one month after it;
In people at risk (a pathology associated with diabetes, obesity, alcoholism, etc..) And those whose initial assessment showed abnormalities, such monitoring is maintained throughout the duration of treatment.
Roaccutane and suicide: a storm in a teacup
End of 2000, the announcement of adolescent suicides in Roaccutane © aroused heated debates in the United States. It is known that isotretinoin can cause psychiatric disorders that result in a feeling of sadness, high irritability, unusual fatigue, impaired concentration and loss of appetite.

Some patients have been victims of suicidal thoughts and even move to act. Given the concern of the general public, the prestigious Food and Drug Administration recognizes that given the anecdotal evidence, no relationship could be scientifically demonstrated. Thus, without unduly alarmed, we must remain vigilant. If you feel affected by mood disorders and / or if you experience dark thoughts, talk immediately to your doctor.

Given its side effects and precautions, isotretinoin is reserved for only severe acne. For these skin diseases, the effectiveness of this drug makes it an industry leader in anti-acne.

 

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