isotretinoin

Question 1

What are indications?

Answer 1

severe acne
0.5-1mg/kg 1-2 divided doses
continue until total accumaltion dose of 120-150mg is achieved

max 150mg/kg per course

Question 2

What are important MHRA warnings

Answer 2

rare reports of erectile dysfunction

Pregnancy prevention programme

Neuropsychiatric reactions

sexual dysfunction

Caution in younger than 18yrs

Question 3

What are contraindications?

Answer 3

hyperlipidaemia

Hypervitaminosis A

Question 4

what are cautions?

Answer 4

Avoid blood donation for 4 weeks after treatment

diabetes (risk of keratitis)

History of depression

Question 5

What are common side effects ?

Answer 5

anaemia
skin reactions
dry skin
haemorrhage
thrombocytopenia
thrombocytosis

Risk of pancreatitis if high triglycerides

visual disturbances

skin peel severe or haemorrhage diarrhoea

Question 6

How long should PPP be used for?

Answer 6

Must use effective contraceptions for at least 1 before starting and month after stopping

Use at least one form of effective contraception

Question 7

What are patient and carer advice?

Answer 7

avoid wax epilation
dermabrasion
laser skin treatment during treatment and for at least 6 months after stopping

avoid UV exposure

use sunscreen and emollient

monitor signs of changes in behaviour.