Accutane - an editorial

[Brady Barrows]

http://www.rosaceans.com/html/accutane.html

If you still decide to take Accutane for rosacea, at least you were warned if you read the editorial and down the road you will find out if it is worth the risks.

[irishgenes]

All these side effects are for the high doses. Even Vitamin A in high doses is toxic.

[Bradley]

I'm not too sure we can say that the high-dose side-effects don't relate also to the low-dose treatments because I don't think any definitive research has been performed.

Moreover, many consider low-dose accutane as slightly more dangerous due to many patients having to take it for up to a year or more which can have detrimental effects on the body.

I think both high-doses for short-term treatment and low-doses for low-term treatment have the potential to harm the body in quite similar ways.

[irishgenes]

What about this statement that "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..."? And "At the lowest doses, there are almost no side effects at all. At the highest, everyone gets rather nasty side effects..." From this website: http://www.aocd.org/skin/dermatologi.../accutane.html

This is from a dermatologists' association website, so I gave it credibility and started taking 2 mg. a day. My skin has never looked better. There is an extreme fear of Accutane based on high-dose studies, but high dose Vitamin A causes the same side effects. Yet nobody is scared of taking 5000 IU of Vitamin A. Everyone must make the risk/benefit decision for himself, of course, but when your nose develops permanent swelling and you are afraid you are going to wind up like WC Fields, that might be the time to get over your fears and try Accutane. You can always quit if you get depressed or develop other intolerable side effects.

[Brady Barrows]

My limited understanding on this subject is that Vitamin A is natural and cannot ever be prescribed or made into a prescription drug. However, synthetic Vitamin A can be made into a pharmaceutical drug by altering the chemical structure of Vitamin A, voila, ACCUTANE. It is quite obvious why the government regulates the pharmaceutical industry but sometimes the industry regulates the government with lobbying. There is quite a lot of money being made with Accutane but no amount of compensation will replace an organ that is damaged for life. There are definite risks associated with this drug and it hasn't been around all that long. The long term effects of low dose accutane will show up in the years ahead and no doubt the subject of further law suits, rosaceans will without a doubt be interested in the class actions suits in this regard.

It makes sense to me that the natural Vitamin A is obviously better than anything synthetic.

[drnase]

My limited understanding on this subject is that Vitamin A is natural and cannot ever be prescribed or made into a prescription drug. However, synthetic Vitamin A can be made into a pharmaceutical drug by altering the chemical structure of Vitamin A, voila, ACCUTANE. It is quite obvious why the government regulates the pharmaceutical industry but sometimes the industry regulates the government with lobbying. There is quite a lot of money being made with Accutane but no amount of compensation will replace an organ that is damaged for life. There are definite risks associated with this drug and it hasn't been around all that long. The long term effects of low dose accutane will show up in the years ahead and no doubt the subject of further law suits, rosaceans will without a doubt be interested in the class actions suits in this regard.

It makes sense to me that the natural Vitamin A is obviously better than anything synthetic.

Actually Brady, it is the opposite. Most drugs are discovered from nature and then analyzed to see what the active parts where, the inactive parts and the dangerous parts.

With regards to accutane, it has been designed to negate many of the natural side effects. Now obviously at high doses you cant stop the side effects. Most of the studies with accutane have been at 80 mgs/kg to 120 ,gs/kg becaus that is the indicatiopn for cystic acnt.

[Brady Barrows]

Actually Brady, it is the opposite. Most drugs are discovered from nature and then analyzed to see what the active parts where, the inactive parts and the dangerous parts.

With regards to accutane, it has been designed to negate many of the natural side effects. Now obviously at high doses you cant stop the side effects. Most of the studies with accutane have been at 80 mgs/kg to 120 ,gs/kg becaus that is the indicatiopn for cystic acnt.

Geoffrey,
I didn't know that. My knowledge is admittedly miniscule when discussing this subject. All I know is that it was available online and now it is not, in the USA. I think it is possible to obtain it in countries outside the USA online but I am not sure. There are several websites by lawyers interested in attracting Accutane users. That seems a bit unusual since I haven't seen any lawyers making websites for Metrogel, Elidel, Ivermectin, Doxycyline or Tetracycline. I assume that low dose accutane use has not been done long enough to be the subject of clinical studies on what side effects may occur. I am sure you will be following this and will report what happens to rosaceans who have taken low dose accutane for years and the long term risk consequences. It is amazing how fast time flies since we both began posting on rosacea subjects. Within no time the reports will be coming in on low dose accutane use side effects and risks. A rosacea flush away in time....

[ian]

Accutane can still be purchased online. As a matter of fact, of the 10 or so European pharmacies that I have bookmarked - only one of them discontinued selling/shipping Accutane. Suprisingly, the prices haven't gone up either.

[rant]

The lawyers advertising on the internet for people who've suffered side effects from Accutane are the equivalent of ambulance chasers. The birth defect issues were a hot topic in the 90s and the infamous senator's son who suicided by crashing a small plane was blamed on Accutane.

Anyone else find it oddly coincidental that Roche decided to agree to all this extra bullshit restrictions shortly AFTER their patent ran out? :)

The unfortunate thing is that people are going to needlessly suffer with horrible acne because many physicians will not be willing to take the time to go through all the additional steps. It's a shame too, because there really isn't any drug more effective for combating acne. And, in particular, there isn't really any drug out there besides Accutane/Iso for battling nodular acne effectively. Ah well.

[/rant]

[Bradley]

What about this statement that "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..."? And "At the lowest doses, there are almost no side effects at all. At the highest, everyone gets rather nasty side effects..."

Vitamin A is of course naturally occurring in everybody because it is stored in the liver, however accutane is definitely not the same as vitamin a. Accutane is a derivative of vitamin a which means it's structural make-up has been chemically altered. Because of this, it would be wrong to assume that taking accutane in low doses on a permanent basis is as safe as, or even provides the same results as, taking 5,000IUs of naturally occurring vitamin a.

Taking 5,000IUs of vitamin a (which is the RDA) daily forever will not give you the same effects that 2.5mg of accutane does with regards to treating rosacea/acne. If it did then Roche would never have created accutane and we would all be posting about how well we are doing on our course of natural vitamin a supplements. Although, this does not mean that everyone will not benefit from 5,000IUs daily. There are a few who are deficient in vitamin a so this can help. Taking 5,000IUs of vitamin a does not scare anyone Irish because it is the RDA and our body requires this vitamin. At the same time, our body does not require accutane.

Having done much research into the subject previously, I have tried to see whether I could replicate accutane's potent effects on acne/rosacea by hyper-dosing with natural vitamin a (from fish liver oil). Two years ago I took between 80,000IUs-140,000IUs everyday for about 6-8weeks. At this dose I would have been taking I think the equivalent of 20mg/day of accutane but I can't say that is 100% accurate because I haven't got the calculations with me that I made back then. I didn't experience any side-effects except for very slight dryness on my lips.

There is medical evidence that says it is 'safe' to take up to around 300,000IUs per day of vitamin a for a year. Moreover, the upper limit to taking vitamin a is 22,000IU approx. I tried 22,000IU originally, prior to hyper-dosing, for two months and didn't obtain results. It was then that I decide to try hyper-dosing but since I didn't see any change at all in my skin/oil production after a further two months of hyper-dosing I decided to quit entirely.

Considering both accutane and natural vitamin a, I would say the majority of their side-effects are the same if taken for 6-12+months. However, I would also say all the positive effects are not the same. You will get clearance with accutane but it's highly unlikely your skin won't change with vitamin a. This is because accutane has been chemically manipulated to leave small trace amounts of the retinoic acid in your skin receptors ergo they are almost genetically programmed differently. Naturally occurring vitamin a will not do this and thus permanent side-effects are greatly diminished on high-dose natural vitamin a.

The truth is there really is no documented evidence relating to how exactly the body responds to long-term low dose accutane but I think it is better to assume that it will not react very positively than say if taking RDA amounts of natural vitamin a are safe then surely we are safe taking low-dose accutane.

I think it is better to verge on the side of caution in this matter because as hard as it is to realise, a red face/nose is better than a permanently damaged liver/body/brain.

This is why if and when I start my course of accutane, I will only take it for about 6-7months then stop for around 3months to give my body a break. At that point I will reconsider whether to start another course because for me a year on a drug is too long.

PS:

so I gave it credibility and started taking 2 mg. a day. My skin has never looked better.

Irish what method are you using to get 2mg of accutane per day?

[irishgenes]

I know that Accutane is a derivative of Vitamin A; otherwise, it would not be patentable. But what surprised me was the statement that it is "present in the bloodstream of ALL people" (even those NOT taking Accutane)! I had not heard that before. Maybe the dermatologists' association is lying? Is a "derivative" the same as a "metabolite"? Can drug companies get patents for a chemical which occurs when the healthy human body converts a vitamin into something else? If this is true, then it is possible that people with skin diseases like acne and papular/pustular rosacea may be lacking in their ability to convert natural Vitamin A into isotretinoin, and Accutane in tiny doses simply by-passes our body's inability to convert Vitamin A into skin-friendly metabolites. That would make it almost healthy instead of something greatly to be feared!

Another very interesting thing I read, I have posted elsewhere, but I will post it here again, as it is pertinent to the topic of Accutane safety. The doctor notes that people on Accutane are told by the drug manufacturer to avoid additional Vitamin A based on no scientific data. He believes that Accutane may bind to Vitamin A receptors without fulfilling the functions of retinol (Vitamin A), creating hypovitaminosis A. Thus some of the toxic effects of (high-dose) Accutane may be due to a deficiency of Vitamin A!
http://dermatology.cdlib.org/95/lett...oin/danby.html

Of course, I am no expert and am not arguing for or against this theory. I'm just throwing this out there and saying that the "conventional wisdom" may be incorrect. I want to know the TRUTH, so if anyone has any proof that Accutane (that is, isotretinoin) is NOT in the bloodstream of ALL people, I would like to see it. If it is not true, then the College of Dermatology needs to be told that their website is incorrect.