Comparative Pharmacology
Head-to-head clinical analysis: ACCUTANE versus ISOTRETINOIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ACCUTANE versus ISOTRETINOIN.
ACCUTANE vs ISOTRETINOIN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Retinoid that reduces sebum production, normalizes follicular keratinization, and decreases Propionibacterium acnes growth by binding to nuclear retinoic acid receptors, altering gene expression.
Reduces sebum production, inhibits sebaceous gland activity, and induces apoptosis in sebocytes. Binds to retinoic acid receptors (RARs) and retinoid X receptors (RXRs) to regulate gene expression.
Isotretinoin 0.5-1 mg/kg/day orally in 2 divided doses for 15-20 weeks.
0.5-1 mg/kg/day orally in two divided doses for 15-20 weeks; cumulative dose 120-150 mg/kg.
None Documented
None Documented
Terminal elimination half-life of isotretinoin is 10-20 hours. The half-life of the major metabolite, 4-oxo-isotretinoin, is 11-50 hours. The long half-life of the metabolite may contribute to sustained clinical effects.
Clinical Note
moderateIsotretinoin + Estrone sulfate
"The therapeutic efficacy of Estrone sulfate can be decreased when used in combination with Isotretinoin."
Clinical Note
moderateIsotretinoin + Estramustine
"The therapeutic efficacy of Estramustine can be decreased when used in combination with Isotretinoin."
Clinical Note
moderateIsotretinoin + Dienogest
"The therapeutic efficacy of Dienogest can be decreased when used in combination with Isotretinoin."
Clinical Note
moderateIsotretinoin + Medroxyprogesterone acetate
Terminal elimination half-life is approximately 20 hours (range 10-30 hours) for the parent drug. Clinical significance: steady-state achieved in ~5 days with repeated dosing; prolongation in renal impairment is minimal.
Renal and biliary: approximately equal amounts of metabolites are excreted in urine and feces. Unchanged drug is not excreted. Major metabolites: 4-oxo-isotretinoin, tretinoin, 4-oxo-tretinoin. Renal excretion of metabolites accounts for ~65-83% of the dose; fecal excretion accounts for the remainder.
Primarily hepatic metabolism; metabolites excreted in urine (65-80%) and feces (15-35%). Less than 1% excreted unchanged in urine.
Category C
Category D/X
Retinoid
Retinoid
"The therapeutic efficacy of Medroxyprogesterone acetate can be decreased when used in combination with Isotretinoin."