isotretinoin
isotretinoin .JPG

isotretinoin

CLINICAL USE

Treatment of nodulo-cystic and conglobate acne, and severe acne which has failed to respond to an adequate course of systemic antibiotics

DOSE IN NORMAL RENAL FUNCTION

0.5–1 mg/kg daily in 1–2 divided doses initially. Maximum cumulative dose: 150 mg/kg per courseTopically: 1–2 times daily

PHARMACOKINETICS

  • Molecular weight                           :300.4
  • %Protein binding                           :99.9
  • %Excreted unchanged in urine     : As metabolites
  • Volume of distribution (L/kg)       :No data
  • half-life – normal/ESRD (hrs)      :
  • 10 to 20
  • /Unchanged

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50     : Dose as in normal renal function
  • 10 to 20     : Dose as in normal renal function
  • <10           : Initial dose 10 mg daily and slowly increase as tolerated up to 1 mg/kg daily. See ‘Other Information’

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :Not dialysed. Dose as in GFR <10 mL/min
  • HD                     :Not dialysed. Dose as in GFR <10 mL/min
  • HDF/high flux   :Unlikely to be dialysed. Dose as in GFR <10 mL/min
  • CAV/VVHD      :Not dialysed. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs
  • Antibacterials: possible increased risk of benign intracranial hypertension with tetracyclines – avoid concomitant use

    ADMINISTRATION

    Reconstition

    Route

    Oral, topical (0.05% gel)

    Rate of Administration

    Comments

    OTHER INFORMATION

    Since the drug is highly protein bound, it is not expected to be significantly removed by dialysisWatch for signs of vitamin A toxicity .



    See how to identify renal failure stages according to GFR calculation

    See how to diagnose irreversible renal disease

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