Monitoring of isotretinoin therapy by measuring the plasma levels of isotretinoin and 4-oxo-isotretinoin. A useful tool for management of severe acne

Dermatology : International Journal for Clinical and Investigative Dermatology
B Almond-RoeslerC E Orfanos

Abstract

Isotretinoin for oral therapy in severe acne conglobata and acne nodulocystica represents a significant achievement; however, the drug exerts several mucocutaneous and systemic adverse effects, besides its teratogenic potency. The aim of this study was to investigate the plasma levels of isotretinoin and of 4-oxo-isotretinoin over long-term treatment of severe acne and to assess any correlation with the given dose, the clinical improvement and the occurrence of side effects. Forty-one patients with severe acne and acne-related disorders were studied under long-term oral intake of isotretinoin. Therapeutic effects and side effects were evaluated prior, during and at the end of therapy. The plasma levels of isotretinoin and of its major metabolite 4-oxo-isotretinoin were measured by reversed-phase HPLC and were correlated with the administered oral dose and the number and frequency of side effects. Dose-dependent plasma levels of isotretinoin and its metabolite were observed. At a mean dosage of 0.75-1.0 mg/kg/day, 404 +/- 142 ng/ml were measured, whereas the plasma levels of 4-oxo-isotretinoin were 1-2x higher. The plasma levels correlated well with the orally administered dose of isotretinoin and the observed mucocutaneous side...Continue Reading

Citations

Jun 28, 2014·PloS One·Feng-Chi ChenChao Agnes Hsiung
Apr 1, 2006·The Journal of Investigative Dermatology·Amanda M NelsonDiane M Thiboutot
Oct 16, 2007·Neurotoxicology and Teratology·Sherry A FergusonKimberly J Berry
Dec 13, 2006·Neurotoxicology and Teratology·Sherry A Ferguson, Kimberly J Berry
May 17, 2006·Basic & Clinical Pharmacology & Toxicology·Sherry A FergusonJohn F Young
Jun 22, 2010·Journal of Cellular and Molecular Medicine·Yoav MaysharNissim Benvenisty
Jun 14, 2005·Food and Chemical Toxicology : an International Journal Published for the British Industrial Biological Research Association·Sherry A FergusonSyed F Ali
Oct 11, 2019·Reproductive Toxicology·Katerine S SailiThomas B Knudsen

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