UNDER REVIEW (September 2016)
Mechanism of Action:
Isotretinoin is a vitamin A derivative which reduces keratinocyte proliferation by binding to nuclear receptors. In addition, the drug reduces sebum production, and limits colonisation of pilosebaceous units by the bacterium Propionibacterium acnes.
Lecture and CAL materials:
- CAL: Nuclear Hormone
Drug specifics
| Alternative drug name | not specified |
| Effects | Isotretinoin noticeably reduces the production of sebum and shrinks the sebaceous glands. It stabilises keratinization and prevents comedones from forming. The exact mechanism of action is unknown, however it is known that it alters DNA transcription. the drug reduces sebum production, and limits colonisation of pilosebaceous units by the bacterium Propionibacterium acnes. All these actions make this a useful drug in the management of acne vulgaris. |
| Adverse actions | See eBNF. Teratogen. Raised lipids. Liver dysfunction |
| Dose | Oral administration up to 1mg/kg daily (Adults). |
| Interactions | See eBNF. |
| Contraindications | not specified |
| Comments | There are many topical agents used to treat acne, and GPs are also able to prescribe courses of oral antibiotics. Patients who fail to respond to these measures, or who have moderate to severe disease resulting in scarring should be considered for treatment with isotretinoin. |
| Contributors |
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