Vitamin A Vs Accutane

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What is Vitamin A and what is it used for?

Vitamin A is a fat-soluble vitamin that plays a role in the growth and development of eyes, bones and teeth. It also helps maintain the lining of the respiratory, digestive and reproductive tracts.

Vitamin A is found in many foods, but it can be hard to get enough Vitamin A from food alone. That’s why some people take supplements with Vitamin A. The recommended daily intake of Vitamin A is 700 micrograms for men and 700 micrograms for women, according to the Office of Dietary Supplements.

Vitamin A Vs Accutane

Hi, I'm contemplating whether to do another course of accutane as it's the only thing that has ever worked to clear up acne. I know there are potential side effects so wanted to find out if taking Vitamin A supplements in capsule form could be used as an alternative to going back onto Accutane. I understand there is danger of Vitamin A toxicity so wanted to find out how Vitamin A supplements compare to Accutane capsules in terms of dosage/amount of Vitamin A. Thanks

 Vitamin A vs. Accutane

Although going on a course of accutane involves visits, bloodwork and potential side effects you have already been on it.  In my experience patients who have gone on a second course of accutane had a much easier time with fewer side effects than they had with their first course.  The problem with taking vitamin A capsules is that it can lead to toxicity and there is no protocol with dosage and blood monitoring,  I would not recommend taking vitamin A capsules instead of Accutane.

The amount of Vitamin A supplements needed to try to obtain the effects of Accutane would be toxic.  Please don’t do it.

Isotretinoin (trade name: Accutane) is a powerful drug used in the treatment of acne. Four to five months of Accutane treatment usually leads to clearing of acne. It is a potent medication that is very effective for nearly all types of breakouts. Accutane is needed for moderate to severe acne that has failed other treatments. It should be used for a severe, scarring acne. Is also used for acne present for many years that has not respond completely to antibiotic pills and creams. While it has many side effects, in some ways it is safer than long-term antibiotic usage. Most other acne-controlling medicines are antibacterial agents, which are effective only if used daily. Over two million people have taken this drug, so a lot is known about its safety and effectiveness.

Accutane is a naturally occurring derivative of vitamin A and is detectable in the bloodstream of all people. Vitamin A in large doses has the same effects as Accutane, both good and bad, but quickly becomes harmful since it builds up in the tissue. (Important: Don’t take any vitamin A while on Accutane). Accutane is formed naturally in the body from the Vitamin A present in the bloodstream. This is why large amounts of Vitamin A taken during pregnancy cause the same birth defects that Accutane does. Fortunately, because it is a naturally occurring product, the body is able to quickly remove Accutane from the bloodstream. It is gone from the blood within nine days and has no lasting effect on future pregnancies.

Accutane “cures” about half of those people who take it so that they never need to do anything else for acne. In the first few weeks of treatment, about one in five patients gets a little worse, and one in 500 patients gets much worse. The rest either get much better, or better for a while. There is nothing else in the world that comes close to being this effective for severe acne. The usual patient takes it for 4 to 6 months, but some need more and must be “retreated” for an additional 4 to 6 months.

Taking Accutane with food increases the absorption of the medicine. The more Accutane one takes, the greater the chance of cure. Unfortunately, side effects depend on the dose as well. At the lowest doses, there are almost no side effects at all. At the highest, everyone get rather nasty side effects, which are related on the drying effects on the oil glands. The dose needs to be adjusted to strike a balance between effectiveness and side effects.

Side effects that are common are listed here. Chapped lips (90%), countered by a using Vaseline or Aquaphor as a lip moisturizer, Dry skin and itching (80%) helped by frequent moisturizer creams, Dryness of nose, mild nosebleed (80%), helped by “AYR nasal gel”, Irritation of the eyelids and eyes (40%), Joint and muscle pains (15%), Temporary hair thinning (10%), Rash (7%), Intestinal symptoms (5%), Urinary symptoms (5%), Headache (5%), Increased sensitivity to sun (5%), Decreased night vision (<1%), Depression, thoughts of suicide (<1%).

Accutane may increase the level of blood fats, sometimes to risky levels. This reverts back to normal when the drug is stopped. Occasionally it may affect the liver. That’s why regular blood tests are necessary during Accutane treatment. There is little risk of any damage if these precautions are followed.

The most damaging side effect of Accutane is serious birth defects if taken during pregnancy. It is critically important for women not to take Accutane while pregnant, and not to become pregnant while taking it. Women who are, or might be, sexually active while taking Accutane must use an effective method of birth control, of which the birth control pill is the most effective. Birth control pills do rarely fail, so an additional method of birth control such as a condom for the male partner or a spermicidal foam or sponge is also needed. Because the birth defects caused by Accutane are so serious, it’s important not to share the pills with others.

Some people develop headaches while on Accutane. These respond to Advil or Tylenol. If a persistent headache develops while on Accutane, the medication should be stopped and the physician notified. Accutane has been reported to cause depression and thoughts of suicide, though a recent study has not shown any correlation. Extremely vigorous exercise should be avoided, as muscle aches can develop.

accutane side effects

Common side effects of Accutane (isotretinoin) include:

  • Dry skin, rash.
  • Itching.
  • Chapped, dry lips.
  • Dry nose, nosebleeds.
  • Dry eyes.
  • Vision problems.
  • Back pain, joint pain.


Accutane (isotretinoin) is prescribed to treat severe, difficult to control acne. Common side effects can include dry skin, chapped lips, vision issues, and joint pain. The more serious, severe side effects of isotretinoin include birth defects, mental health problems, and stomach issues.

Birth defects are among the most serious side effects of Accutane. Taking isotretinoin during pregnancy may also result in miscarriage, premature birth, and infant death.

Women of childbearing potential must enroll in a special pregnancy prevention program (iPLEDGE) before being prescribed isotretinoin because of the drug’s risks. Men and women without reproductive potential who use isotretinoin must also participate in the iPLEDGE program.

Accutane side effects have led to more than 7,000 lawsuits against the manufacturer of Accutane.

Common side effects of Accutane (isotretinoin) include:

  • Dry skin, rash
  • Itching
  • Chapped, dry lips
  • Dry nose, nosebleeds
  • Dry eyes
  • Vision problems
  • Back pain, joint pain

Serious side effects of Accutane (isotretinoin) include:

  • Birth defects, premature birth
  • Miscarriage, infant death
  • Depression, suicidal thoughts or behavior
  • Inflammatory bowel disease
  • Crohn’s Disease
  • Ulcerative Colitis

Accutane and Birth Defects

Birth defects from isotretinoin can range from miscarriages to babies born with slits where ears should be.

Since 1985, isotretinoin’s label has contained a black box warning detailing its “extremely high risk” of “severe birth defects.” The label warns female patients who are or may become pregnant to avoid taking isotretinoin.

The boxed warning also lists possible birth defects that can happen with isotretinoin. These birth defects include anything from ear, eye and other face-related abnormalities to abnormal skull development.

Birth defects from isotretinoin can also affect the central nervous system, immune system (thymus gland), certain hormones (parathyroid), and heart.

Isotretinoin and Pregnancy

About half of Accutane users are women of childbearing age. This makes birth defects associated with Accutane-use a significant concern.

From 1982 to 2006, more than 2,000 isotretinoin users became pregnant. These pregnancies resulted in many spontaneous or elective abortions.

As a result, Roche initiated a pregnancy prevention program (iPLEDGE).

FACT

Women of child-bearing potential taking isotretninoin must undergo monthly blood tests to check for pregnancy.

The iPLEDGE program is required for isotretinoin users. This program requires women to take monthly pregnancy tests at a doctor’s office. Men and women without reproductive potential who use isotretinoin must also participate in the iPLEDGE program.The iPLEDGE program has decreased, but not completely stopped, birth defects from isotretinoin.

Results of one study showed an average of three pregnancies for every 1,000 patients taking isotretinoin.

Accutane’s Link to Crohn’s Disease and Ulcerative Colitis

Studies link Accutane to two types of gastrointestinal disorders: Crohn’s disease and ulcerative colitis (UC).

Both Crohn’s and UC are inflammatory bowel diseases (IBD), but the conditions affect patients in different ways.

Crohn’s can occur anywhere in the digestive tract but most often affects the lower end of the small intestine. UC more commonly affects the lining of the large intestine (colon) and the rectum.

Symptoms common with both conditions include abdominal pain and cramping, weight loss, diarrhea, fever, fatigue, mouth sores, joint pain and swelling, and blood in the stool.

Crohn’s cannot be cured. UC can only be cured with surgery to remove the large intestine. Both conditions can be managed with medications.

Accutane and Inflammatory Bowel Diseases (IBD)

A study released in 2009 found Accutane users had almost double the chance of developing a serious bowel disorder than those who never took Accutane.

Researchers at the University of North Carolina Chapel Hill presented evidence confirming that a link exists between isotretinoin and IBD.

They compared 8,189 cases of IBD with 21,832 healthy individuals. The results of the study showed people taking isotretinoin had a 1.68 times higher risk of developing IBD than people who did not use the drug.

This number increased to 2.67 times the risk among patients who filled four or more prescriptions of Accutane.

Patients who use isotretinoin are 4.36 times more likely to develop UC than patients who don’t take the drug.

Conflicting Research

Studies published since 2013 refute a link between isotretinoin and IBD. Some authors have instead proposed a link between severe acne and a predisposition to IBD. Both conditions involve inflammation.

The studies also conclude that the occurrence of IBD in patients taking isotretinoin may be coincidental based on the person’s age. IBD usually begins around 19 years of age. This is around the same age that a patient might experience severe acne and start taking isotretinoin.

Still, isotretinoin’s most recent drug label includes a warning about the possibility of developing IBD.

Depression and Suicide

Studies also linked Accutane to psychiatric disorders.

From 1982 to May 2000, the FDA received hundreds of reports linking isotretinoin use to depression.

These reports included 37 suicides, 110 hospitalizations for depression or suicidal behavior, and 284 cases of non-hospitalized depression.

FACT

Reports received by the FDA showed 37 suicides among isotretinoin users over an 18-year time period.

Isotretinoin and Depression

Roche responded to the reports of depression and suicide in 1998 by adding a warning to the medication’s label. The warning stated that isotretinoin could cause mental health disorders.

Before 2005, reports of depression and suicide linked to the use of isotretinoin accounted for the fourth-highest number of adverse reactions occurring in the U.S.

Researchers still don’t understand how isotretinoin causes mental health events. Definitive proof of an association between depression and isotretinoin is still lacking.

Ongoing Research

A 2017 study in the Journal of the American Academy of Dermatology concluded that there may not be an association between isotretinoin and depression at all.

The study was a meta-analysis, or evidence-based examination, of published literature. It included all literature regarding the relationship between isotretinoin and depression up to Sept. 30, 2016.

Results showed no apparent association between isotretinoin and an increased risk for depression. This study, and others, have shown that treating acne could actually reduce symptoms of depression.

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