sotretinoin is a medication that has been used in the treatment of cancers and severe skin conditions. Its popular name in the US is accutane prior to July 2009. For acne treatments, when all other options have failed, it is used as the “last resort”. Apart from its main use as a chemotherapy medication, it has also been tested as a treatment for harlequin-type itchyosis. This is a sort of skin deformation that causes patients to develop plate-like skin, resembling those of scales, and causes death shortly after birth.
The drug, also known as accutane in the United States prior to July 2009, is a non-selective medication, which means that its effects apply equally to healthy and malign cells. It is used in cancer treatments because of its ability to kill rapidly dividing cells and slow down the growth of tumors. It is a retinoid, which makes it naturally found in small quantities within the human body, but not enough to generate the effects needed for use in treatment. Accutane has been known to cause birth defects, which have placed it under strict government regulation in the US; these, along with pharmaceutical industry restrictions, have made it difficult to acquire the drug.
Accutane is a known teratogen, a substance able to cause birth defects when taken during pregnancy. As a result, pregnant and breastfeeding women are strongly advised not to use the medication. Visual and hearing impairment, deformed earlobes, and mental retardation are few of the most common defects suffered because of this. Between 1982 and 2003, an estimated 2,000 American women took the drug while they are pregnant. 160 infants were born with defects. In 2005, Food and Drug Administration set programs and regulations that make sure that female patients do not receive the drug during pregnancy. Despite the lack of data that it can be excreted through seminal fluid, the programs were extended to male patients as well.
Dryness of the skin, possible infection of the cuticles, rashes, hyperlipidaemia and back pains are other known side effects of this drug. Rarer side effects are known to be cataracts, disturbances in menstrual flow, pancreatitis, hepatitis, psychosis and depression. According to a Mexican study, male patients taking the drug also have the risk of experiencing erectile dysfunction. . Hair loss, a decrease in night vision, degenerative disc disease and acne rosacea have been known to manifest as side effects of this drug, even after treatment has been discontinued.
The mechanism of action for this medication is currently unknown. Recent studies have found signs that it amplifies the production of neutrophil-gelatinase-associated lipocalin in the skin – a substance believed to cause apoptosis in sebaceous gland cells. Apoptosis is the term for cellular death due to internal factors. The effect it has on the sebum production of the skin is temporary, but reports indicate that the remission of any condition that has been treated with Accutane is “complete and prolonged.”
Across the US, purchase of the drug requires a physician’s prescription, making the drug hard to acquire. In fact, the FDA iPLEDGE program regulates the number of medical professionals who can prescribe the drug. However, since the patent on the drug lapsed in 2002, isotretinoin has become more available over the Internet. While private importation of the drug is currently legal, its use could constitute a violation of existing statues.