ABSTRACT
This chapter presents classification & mode of action, indications & dermatological uses, formulations/presentation, dosages & suggested regimens, baseline investigations, considerations & monitoring, contraindications, cautions, important drug interactions, adverse effects & their management, use in special situations, and essential patient information of Isotretinoin. Oral isotretinoin is a vitamin A derivative, first approved by the USA Food and Drug Administration in 1982 for the treatment of severe, recalcitrant acne. Oral isotretinoin monotherapy targets all the major pathogenic processes in acne. Isotretinoin is the only oral retinoid drug which has a profound effect on sebaceous gland activity, causing sebocyte apoptosis by inducing the expression of neutrophil gelatinase associated lipocalin. Isotretinoin also impairs metabolism of androgens within the sebaceous gland, leading to involution and reduced sebum production. Oral isotretinoin has unparalleled efficacy in the treatment of acne with the majority of sufferers achieving disease clearance. Isotretinoin is fat soluble and should be taken with food or a glass of milk to maximize bioavailability.
