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Nervensystem und Psyche [ Bearbeiten ]

Bei systemischer Therapie treten häufig Kopfschmerzen auf. Sehr selten kommt es zur Erhöhung des Schädelinnendrucks (intrakranieller Hirndruck ), zu Krämpfen und Schläfrigkeit. Eine Beeinflussung des Hirnstoffwechsels konnte nachgewiesen werden. [9] In vitro erhöhte Isotretinoin die Bildung von Proteinen und Zellmetaboliten, von denen bekannt ist, dass sie die Bildung von Serotonin herabsetzen. [10] Depressionen und erhöhte Suizidalität sind in der Diskussion.

Blut und Lymphsystem [ Bearbeiten ]

Augen [ Bearbeiten ]

Sehr häufig kommt es zu Entzündungen der Lidränder und der Bindehaut. trockenen und gereizten Augen. Sehr selten treten Verschwommensehen, grauer Star. Farbenblindheit. Hornhauttrübung. Nachtblindheit. Hornhautentzündung, Veränderung des Augenhintergrundes mit Schwellung (Papillenödem ) als Zeichen eines Pseudotumor cerebri und Lichtscheuheit (Photophobie ) auf.

Stütz- und Bewegungsapparat [ Bearbeiten ]

Sehr häufig kommt es zu reversiblen Muskel- und Gelenkschmerzen. Es gibt Einzelberichte von Rhabdomyolysen mit Beteiligung der Herzmuskulatur unter der Therapie, insbesondere bei zeitgleicher starker körperlicher Belastung, sodass Sport im Therapiezeitraum kritisch zu betrachten ist. Im Rahmen der routinemäßigen Labordiagnostik im Verlauf sollte auch die Kreatinkinase (CK) mitbestimmt werden. [11] Sehr selten treten Gelenkentzündungen, vorzeitiger Schluss der Knochenwachstumsfugen, überschießende Knochensubstanzbildung (Hyperostose und Exostose ) sowie die Verkalkung von Bändern und Sehnen (Kalzinose ) auf.

Niere und Harnwege [ Bearbeiten ]

Eine häufigere Nebenwirkung ist Blut- und/oder Eiweißausscheidung im Urin, was aber meist reversibel ist. Sehr selten kommt es zu einer Glomerulonephritis .

Magen-Darm-Trakt [ Bearbeiten ]

Seit der Zulassung von Isotretinoin wurde bei einzelnen damit behandelten Patienten die Entwicklung chronisch-entzündlicher Darmerkrankungen beschrieben. Neuerlichen Untersuchungen zufolge besteht eine Assoziation zwischen dem Auftreten von Colitis ulcerosa und einer vorherigen Therapie mit Isotretinoin. Das absolute Risiko, durch eine Isotretinoin-Therapie an einer Colitis ulcerosa zu erkranken, ist dennoch sehr gering. Eine Assoziation mit dem Auftreten von Morbus Crohn konnte nicht bestätigt werden. [12]

Wechselwirkungen [ Bearbeiten ]

How does this medication work? What will it do for me?

Isotretinoin is a vitamin A derivative that belongs to the class of medications called retinoids. Retinoids are usually used to treat skin problems. Isotretinoin is used to treat severe types of acne, such as nodular or inflammatory acne, where other medications with less potential for severe side effects have failed to help. It may also be used to treat acne conglobata and recalcitrant acne.

Isotretinoin helps to reduce sebum production, which is often associated with bacteria that contributes to acne. In many cases, it can produce remission of the acne condition.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

How should I use this medication?

The usual starting daily dose is 0.5 mg per kilogram of body weight taken daily for a period of 2 to 4 weeks. Based on body weight, severity of acne, and your response to the medication, your doctor will then adjust your dose. Isotretinoin should be taken as a single dose or in 2 divided doses during the day.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

There may be temporary worsening of acne before it gets better. Your doctor will adjust your daily dose after the initial treatment to between 0.1 mg and 1 mg per kilogram of body weight depending on your response to the medication.

Food increases the amount of medication available to the body. It also helps to reduce upset stomach. For these reasons, isotretinoin medication should be taken with food

The first signs of healing usually occur after 2 to 3 weeks of treatment, however, it may take 1 or 2 months before you see beneficial effects. The complete course of treatment usually lasts 12 to 16 weeks. Most people with severe acne notice a marked improvement after 1 or 2 courses of treatment. You may continue to see even more improvement in your acne condition for several months after you have stopped taking the medication.

If any of your side effects do not clear up in a few weeks after you stop taking your medication, speak to your doctor. Be sure to read the patient information that comes with each package of medication.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, in the original package, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

What form(s) does this medication come in?

10 mg

Each brown-red, opaque, oval-shaped, soft gelatin capsule, imprinted "ROA 10" contains isotretinoin 10 mg. Nonmedicinal ingredients: beeswax, black iron oxide, hydrogenated hydrolyzed starch, gelatin, glycerol, hydrogenated soybean oil, propylene glycol, red iron oxide, mannitol, partially hydrogenated soybean oil, shellac, sorbitol, soybean oil, and titanium dioxide.

40 mg

Each yellow, opaque, oval-shaped, soft gelatin capsule, imprinted "ROA 40" contains isotretinoin 40 mg. Nonmedicinal ingredients: beeswax, black iron oxide, gelatin, glycerol, hydrogenated soybean oil, methylparaben, partially hydrogenated soybean oil, propylene glycol, propylparaben, quinoline yellow WS, shellac, soybean oil, sunset yellow FCF, and titanium dioxide.

Who should NOT take this medication?