ROACUTANCE is a naturally occurring “retinoic acid”. It has a potential “antineoplastic activity”. It joins with the “retinoic acid” and activates its receptors. The activation of “retinoic acid receptors” will act as a transcription factors that will promote apoptosis and cell differentiation. It will also exhibit anti-inflammatory responses and immunomodulatory responses. It inhibit the production of “ornithine decarboxylase”, thus reduce the keratinization and polyamine synthesis. It has molecular formula of C20H28O2 and has a molecular weight of has a molecular weight of 300.44 (Goodfield et al, 2010).
The medicine ROACCUTANE whose scientific name is Isotretinoin. It yellow orange in colour and completely insoluble in water. However, it is soluble in “methylene chloride” and somewhat soluble in alcohol. It is sensitive to light as well as heat particularly in the form of solution. Its melting point is 372 to 374° F. Biological half-life of ROACUTANCE is 10 to 20 hours. ROACUTANCE is available in 10mg as well as in 20mg capsules for the administration through oral route. It also contains the yellow beeswax, hydrogenated soya oil, soya oil and partially hydrogenated soya oil (Goodfield et al, 2010).
It is indicated in the treatment of “recalcitrant nodular acne”, acne conglobate and inflammatory acne. It is also used in the treatment of severe rosacea and gram-negative folliculitis. It is used in the “keratinization disorders”, like palmoplantar keratoderma, keratosis follicularis and PRP (pityriasis rubra pilaris). ROACCUTANE is helpful and recommended in patients with “severe cystic acne” who did not show any positive response to the conventional therapy such as “systemic antibiotics”.
It is contraindicated in the pregnancy. It is also recommended that women with childbearing potential should not administer this medicine, unless and until her pregnancy is omitted. It is contraindicated in women who are breast feeding. In is contraindicated in patients with impaired functions of liver and it is also contraindicated in patients with increased lipid values in the blood. The administration of ROACUTANCE is prohibited with exfoliative or keratolytic anti-acne agents because it may cause local irritation. Moreover, the interaction of ROACUTANCE can diminish the effects of progesterone if given with progesterone preparations. Lastly, the continuous treatment with vitamin A should be avoided because it may lead to “hypervitaminosis A” (Goodfield et al, 2010).
It belongs to the group dermatologic agents which is defined as the group of drugs that are used to prevent or treat disorders of skin and to provide daily care to skin.
ROACUTANCE is teratogenic. It can cause side effects like dry eyes, dryness of skin and cheilitis. These effects are generally termed mucocutaneous effects. Besides this, psychotic symptoms and depression are reported among patients who have used ROACCUTANE. It may also cause inflammatory bowel disorder, even in those patients who did not have any history of this disorder. Mild to moderate elevations of liver enzymes are observed in patient who used ROACCUTANE.
Goodfield MJ, Cox NH, Bowser A, McMillan JC, Millard LG, Simpson NB, Ormerod AD (June 2010). “Advice on the safe introduction and continued use of isotretinoin in acne in the U.K. 2010” (PDF). The British Journal of Dermatology. 162 (6): 1172–9. doi:10.1111/j.1365-2133.2010.09836.x. PMID 21250961