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Roaccutane is a synthetic vitamin A product available in capsule
form. It is used for severe acne as well as in moderate acne not
responding to antibiotics and / or Diane for three to six months.
It is manufactured by Roche Pharmaceuticals who offer a help line on the
subject.
Roaccutane shrinks the oil glands (sebaceous glands) in the skin,
thereby reducing oil secretion by the skin. If there is no oil
around the hair follicles, there is no chance of infection of the hair
follicles. Absence of infection means no acne.
Roaccutane gets rid of acne permanently in 70% of individuals taking
it for 4 to 6 months. In 30%, the acne could recur, requiring
further treatment with Roaccutane or another acne medicine.
0.5mg per kg to 1mg per kg. ie a 60 kg individual takes 30 -
60mg daily. A 40kg person takes 20 -40mg daily etc.
An alternate dosage of Roaccutane is the
low dose pulsed treatment. This form of treatment is administered
at a dose of 0,5mg per kg for one week in a month for three months.
In view of the risks involved in pregnant women, this dose is used only
in selected cases, after careful consideration.
Until a total dose of 120-150mg/kg is reached. This usually
means 4 to 6 months of treatment. In terms of the number of boxes
of capsules, a 60kg person takes 6 boxes in total, a 40kg person, 4
boxes etc. Each box contains 60 x 20mg capsules). At a dose
of one 20mg capsule twice a day, a 40kg individual will take treatment
for 4 months, a 50kg individual for 5 months and a 70 kg person for 7
months. Dose adjustments can be made if the medicine is well
tolerated
Yes, it often does worsen about 2 weeks to a month after starting the
medication. The worsening usually lasts about two weeks, after
which the acne begins improving.
Roaccutane affects pregnancy very seriously and can result in major
birth defects if the baby if pregnancy occurs whilst a pregnant female
is on Roaccutane. Strict contraception needs to be adhered to by
every female of child bearing potential. Taking an oral
contraceptive is the preferred method of preventing pregnancy. The
contraceptive needs to be taken one month before, during treatment and
one month after the end of treatment. There is no danger to the
baby if pregnancy occurs one month after stopping Roaccutane.
No, there is no risk to males even if they father a child whilst
taking Roaccutane.
No
A blood test for liver function (LFT) and Triglyceride level is taken
before starting treatment. This is repeated one month later during
a follow up visit. If the test is normal, it is repeated only at
the end of treatment. If abnormal, tests will need to be done at
intervals or the dosage may need to be reduced.
Yes, there is no problem with normal routine exercise, going to the
gym, playing rugby or cricket etc. However, running a marathon may
sometimes pose a problem as Roaccutane may cause joint pains.
What about the use of
muscle building proteins?
It is best to avoid any form of muscle building
proteins during your treatment as these have been found to aggravate the
acne and to make the condition more difficult to treat.
This is not necessary. Roaccutane may make one a little more
sensitive to the sun than usual. Normal and sensible sun exposure
is not a problem. Excessive sunlight may lead to early wrinkling
and skin cancer even in those who are not taking Roaccutane. It is
best to stay out of direct sunlight between 10am and 2 pm whether you
are taking Roaccutane or not. You are not prohibited
from going to the beach or swimming. Just be sensible about the
amount of sunlight reaching your skin and use a sunblock with a minimum
factor of 15.
Yes, a course of Roaccutane can certainly be taken more than once, if
necessary.
Roaccutane is not interfered with by food. It may consequently
be taken before, with or after meals. Although most people prefer
taking the capsules two or three times a day, they may be taken all at
once in the morning or the evening.
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If an oral contraceptive is taken with the Roaccutane, it may be
taken at the same time as the Roaccutane.
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Rarely, Roaccutane may cause hair loss. In this instance, the
dosage may be reduced but the medication seldom needs to be stopped as a
result.
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If you have to take a
second course of treatment of Roaccutane, is there a chance that
Roaccutane may not work the second time around, thus necesitating
further courses?
If Roaccutane worked the first time, it is unusual for it not to work
the second time round. However, recurrences may occur even after a
second course (in 30% of individuals). Further courses may then be
necessary.
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Generics are produced when the patent of the originator has expired.
They are produced using the same chemical formula as the original
medication. Roaccutane has been available for the past 20 years.
Dermatologists therefore have extensive experience with Roaccutane.
Time will tell whether the generics work in exactly the same way as
Roaccutane. However, as the chemical formula is the same, there is
no reason to suspect otherwise.
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If you have any questions relating to Roaccutane, please discuss them
during your consultation.
Please note that e-mail replies to patients are not sent
from site.
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