Currently, 63 percent of prescriptions are for twice-daily dosing. It is important to evaluate our patients with each visit to the office. If their skin and lips are not dry, they may not be satisfactorily absorbing their medication. Is the patient taking the medication? If so, is the patient absorbing it? Why not? In addition to giving out a prescription, we must educate our patients on how to take the medication. High-fat, high-calorie meals maximize absorption, and twice daily dosing is superior to single dosing regimens, if your patient will be adherent with taking it.
Clinical Focus January On Dosage and Diet: Isotretinoin Isotretinoin is one of the most essential agents in the treatment of acne, but dietary and dosage considerations must be made to maximize efficacy.
J Am Acad Dermatol. Guidelines for optimal use of isotretinoin in acne. Food increases the bioavailability of isotretinoin. J Clin Pharmacol. Breakfast habits, nutritional status, body weight, and academic performance in children and adolescents. J Am Diet Assoc. Regis D. Food: now and then — young people's attitudes to healthy eating.
Education and Health. Young People's Food Choices: Attitudes to healthy eating and weight control, Isotretinoin for the treatment of acne vulgaris: which factors may predict the need for more than one course? Isotretinoin causes severe birth defects, including malformation of the head and face, mental retardation and severe internal defects of the brain, heart, glands and nervous system.
It can also cause miscarriage, premature birth and death of the fetus. You must use two forms of birth control at the same time for at least one month before you start taking isotretinoin and for all the time you are taking this medicine.
Keep using two kinds of birth control for one month after you stop taking isotretinoin. If you are using Depo-Provera as your form of birth control, you may not need to use two forms of birth control. Check this with your doctor.
Your doctor will make sure you are not pregnant before starting isotretinoin and check again every month while you are taking it.
You will be asked to read and sign a consent form to show that you understand the dangers of birth defects and agree to use birth control. If your period is late, stop taking isotretinoin and call your doctor right away. If you get pregnant while you are taking isotretinoin, talk with your doctor about going on with the pregnancy. Already a member or subscriber?
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Contact afpserv aafp. Want to use this article elsewhere? Get Permissions. Read the Issue. Sign Up Now. Previous: Clinical Briefs. Oct 15, Issue. Am Fam Physician. What is isotretinoin? But how would a low-fat meal, like low-fat cereal and raspberries, affect the absorption, and ultimate efficacy? This question was addressed in an open-label, single-arm study of patients with acne, who were taking the lidose isotretinoin formulation without food, at the standard dose, for no longer than 20 weeks.
Whether they relapsed was evaluated in a 2-year observational phase of the study, Dr. During the 2-year period, most patients did not need to be retreated.
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