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Accutane is a powerful medicine used for the treatment of moderate to severe acne.

Cost of accutane uk Accutane for acne is about $3,000 per year to treat acne (the most widely used topical steroid to treat acne) according an article that appeared in Medscape 2007.[7] In a study of 10 patients on Accutane for acne (with one patient discontinued due to adverse effects), each patient was assigned a treatment dose of Accutane at a weekly dose of 4.5 mg twice a day. The patients had been taking Accutane for at least 10 weeks when the baseline study was performed. At that time, the patients' acne was moderate to severe. At the end of study mean improvement in acne severity at week 12 was 10.4% vs. 4.9% for placebo and 6.4% vs. 2% for placebo + Accutane. Improvement all acne lesions was statistically significant with a weighted average mean change of 10.4% for placebo and 6.5% + Accutane. These results demonstrated statistically significant improvements in acne severity with Accutane vs. placebo in this study.[7] Although one study did not have adequate power to detect statistical differences between groups at the two time points, there was a trend for Accutane to be more effective than placebo at the end of study, but difference was not statistically significant. In one study using 3x week of daily dose Accutane for acne, one patient showed moderate improvement at the end of 2-week open label study[8], another patient improved significantly on Accutane (2.5 times more than placebo) at the end of 2-week open label study and had no improvement using Accutane and Tazorac (for moderate acne)[9]. Some studies have reported that Accutane at a dose of 5 mg/kg 3 times a day has similar efficacy to tretinoin with side effects.[10,11,12,13] However, the results need to be extrapolated from single patient studies into general practice given the large number of patients. In a clinical trial by Sato et al, 5 mg/kg 3 times a day was superior to tretinoin at 25 mg/d, but 2.5 times a day was no significantly better than tretinoin at 25 mg/d with similar side effects.[14] A study by Sato et al reported that 4% of patients had an adverse reactions, and of those, tretinoin was associated with fewer side effects than Accutane and Tazorac.[14] In addition to adverse reactions associated with tretinoin topical product (which has similar side effects when used in a higher dose than 4 mg twice a day), Accutane should be prescribed with caution when used in patients with a history of psoriasis or with other systemic acne medications such as clindamycin or sulfate since Accutane can cause side effects (such as acne lesions) similar to these medications.[15] Accutane can be prescribed at doses of 0.25, 3.75 mg twice a day, or 6 mg once daily. It is usually prescribed as an extended-release formula. Accutane dosing regimens Acne treatment can be given in the hospital with or without surgery. Acute therapy can begin with a regimen of topical corticosteroids with oral isotretinoins and antibiotics (see Medscape article, Accutane for Acne: A Brief History). In the outpatient setting, Accutane needs to be prescribed with a patient-specific regimen based on the severity of acne. Oxygen Therapy Acne treatments may worsen and lead to decreased oxygenation of the skin. Acne patients and those with other skin conditions require more frequent oxygen therapy or continuous therapy, as the oxygen supply of skin may begin to decrease with the use of systemic anti-inflammatory steroids.[16] Patients that suffer from chronic bronchiectasis (which reduces lung capacity) may require more frequent airway ventilation and may need additional oxygen therapy or continuous therapy.[17] Long-Term Oral Medication Acne patients should not be prescribed topical steroids with high levels of salicylic acid or other topical acne medications unless they are prescribed with a specific medical reason. Salicylic acid may worsen acne lesions in patients that have experienced previous episodes of acne in addition to causing a risk of hyperkeratosis. Patients should not be prescribed high concentrations of topical steroids until they have had a full course of oral antibiotics including sulfonamide or clindamycin. These oral anti-infective agents have been reported to decrease the levels of skin enzyme known as PGE2. The lower levels of PGE2 in the body, better skin will heal from acne. Accutane is the most well-tolerated anti-acne topical drug. It is safe for all patients.

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