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Indication & Dosage |
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| Oral |
| ACNE |
| Adult:
Initially, 0.5-1 mg/kg daily in 2 divided doses. Usual duration of treatment: 15-20 wk; may be discontinued if number of cysts is reduced by >70% (whichever is sooner). Patients intolerant to initial dose: Continue treatment at a lower dose. Patients with very severe acne or acne evident on the body instead of face: Up to 2 mg/kg daily. There should be a 2-mth drug-free interval if a 2nd course is necessary. |
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| Topical/Cutaneous |
| ACNE |
| Adult:
As 0.05% gel: Apply sparingly once or twice daily. Effect may not be evident for 6-8 wk. |
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| Administration |
Should be taken with food. |
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| Precautions |
Preexisting or predisposition to hypertriglyceridaemia (e.g. DM, obesity or increased alcohol intake). Monitor triglyceride levels. Monitor blood lipids and LFTs at wkly or bi-wkly intervals. Monitor blood glucose in known or suspected DM patients. Genetic predisposition for age-related osteoporosis, history of childhood osteoporosis, osteomalacia or other bone metabolism disorders. Anorexia nervosa. History of psychiatric disorder. May impair night vision. Avoid wax epilation and skin resurfacing procedures for at least 6 mth. Avoid prolonged exposure to UV light or sunlight. Discontinue if hearing impairment, abdominal pain, rectal bleeding, severe diarrhoea or adverse ocular effects occur. Patient should not donate blood during therapy and for at least 1 mth following drug discontinuation. |
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Potentially Life-threatening
Adverse Drug Reactions |
Dryness of mucous membranes, dryness of skin with scaling, fragility, erythema, cheilitis, pruritus, epistaxis, conjunctivitis, dry sore mouth and palmo-plantar exfoliation. Corneal opacities, dry eyes, visual disturbances, skeletal hyperostosis and musculoskeletal symptoms. Elevation of serum triglycerides, LFTs, ESR and blood glucose. Hair thinning, photosensitivity, changes in skin pigmentation, paronychia. GI disturbances, hepatitis. Headache, drowsiness, sweating, mood changes, psychotic symptoms, depression, suicidal tendencies, benign intracranial hypertension, seizures. Vasculitis, hypersensitivity reactions, IBS. |
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| Adverse Drug Reactions |
Anaphylaxis. Haemorrhagic pancreatitis. |
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| Interactions |
Additive toxicity with vitamin A or its derivatives. Decreased efficacy of microdosed progesterone (use 2 forms of contraception). May increase risk of bone loss with phenytoin. May increase risk of osteoporosis with systemic corticosteroids. Reduces plasma levels of carbamazepine. |
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