Roaccutane and its side effects are dose dependent and vary among different patients. This requires individual selection of doses in the course of treatment.
Roaccutane Treatment should begin with the dose of 0.5 mg / kg body weight / Maintenance dose for most patients ranges from 0.5 do1.0 mg / kg body weight / In severe forms of disease or body acne daily dose may be increased to 2 mg / kg body weight .
It is proved that the frequency of remission and relapse prevention are optimal when using a cumulative dose of 120 mg / kg (for treatment). Therefore, the duration of therapy in specific patients varies depending on the daily dose. Complete remission of acne is often elusive for 16-24 weeks of treatment. When poor tolerability of the drug dose can be reduced, but the duration of treatment with the need to increase.
In most cases, for a course of therapy is sufficient for the complete disappearance of acne. When relapse is shown a second course of treatment Roaccutane in the same daily and cumulative dose, as the first. Since improvement may continue for up to 8 weeks after drug withdrawal, re-course should be appointed not earlier than after the end of this period. Capsules taken with food 1 or 2 In renal insufficiency, severe treatment should be started with lower doses (eg, 10 mg) and individually to select it, depending on tolerability.
Most side effects are dose dependent Roaccutane. As a rule, the appointment of the recommended dose ratio of benefit and risk, given the severity of the disease, it is acceptable to the patient. Symptoms associated with hypervitaminosis A: dryness of the skin, mucous membranes of the lips, nasal cavity (bleeding), larynx (hoarseness), eyes (conjunctivitis, reversible corneal opacity and intolerance of contact lenses).
Dermatological reactions: rash, itching, erythema face, sweating, pyogenic granuloma, paronychia, onihodistrofii, increased proliferation of granulation tissue, persistent hair thinning, reversible alopecia, fulminant form of acne, hirsutism, hyperpigmentation, photosensitivity, photoallergy travmiruemost light skin. At the beginning of treatment may be exacerbation of acne that persists for several weeks.
On the part of the musculoskeletal system: pain in muscles with increased levels of CK in serum or without it, joint pain, hyperostosis, arthritis, calcification of ligaments and tendons, and other changes in the bones, tendinitis. From the side of the central nervous system: behavioral disorders, depression, headache, increased intracranial pressure, seizures. From the senses: individual cases of violations of visual acuity, photophobia, violation of dark adaptation (mitigation twilight vision), rarely – breach of color vision (passing drug discontinuation), lenticular cataract, keratitis, hearing loss at certain frequencies of sound.
On the part of the digestive system: nausea, inflammatory bowel disease (colitis, ileitis), bleeding, pancreatitis (especially with concomitant hypertriglyceridemia above 800 mg / dL), transient and reversible elevation of hepatic transaminases, some cases of hepatitis. In many cases, these changes did not go beyond the limits of normal and returned to the original parameters in the treatment process, but in some situations it was necessary to reduce the dose or cancel Roaccutane.
Described rare cases of pancreatitis with a fatal outcome. On the part of the respiratory system: rarely – bronchospasm (more frequently in patients with bronchial asthma in history). On the part of the hemopoietic system: reducing the number of leukocytes and erythrocytes, reduced hematocrit, increase or decrease in the number of platelets, the acceleration of ESR. From the laboratory parameters: hypertriglyceridemia, hypercholesterolemia, hyperuricaemia, lower HDL, seldom – hyperglycemia, during the reception Roaccutane were reported for the first time identified diabetes.
In some patients, especially during intensive physical activity, described isolated cases of increased activity of CK in serum. On the part of the immune system: local or systemic infections caused by gram-positive pathogens (Staphylococcus aureus). Other: lymphadenopathy, hematuria, proteinuria, vasculitis (Wegener’s granulomatosis), allergic vasculitis, systemic hypersensitivity reactions, glomerulonephritis.
Contraindications to the use of the drug Roaccutane
- Hepatic insufficiency;
- Hypervitaminosis A;
- Pronounced hyperlipidemia;
- Hypersensitivity to the drug or its components.