Matching articles for "isotretinoin"

Drugs for Acne

   
The Medical Letter on Drugs and Therapeutics • February 5, 2024;  (Issue 1695)
Acne is common among adolescents and adults. Guidelines for treatment of acne were last published by the American Academy of Dermatology in...
Acne is common among adolescents and adults. Guidelines for treatment of acne were last published by the American Academy of Dermatology in 2016.
Med Lett Drugs Ther. 2024 Feb 5;66(1695):17-20 | Show Full IntroductionHide Full Introduction

Drugs for Rosacea

   
The Medical Letter on Drugs and Therapeutics • February 5, 2024;  (Issue 1695)
Rosacea is a common, chronic inflammatory facial eruption of unknown cause. It is more prevalent in women than in men, and disease onset typically occurs after age 30. Rosacea is characterized by erythema,...
Rosacea is a common, chronic inflammatory facial eruption of unknown cause. It is more prevalent in women than in men, and disease onset typically occurs after age 30. Rosacea is characterized by erythema, telangiectasia, and flushing, and sometimes by recurrent, progressive crops of acneiform papules and pustules, usually on the central part of the face. Some patients develop granulomas and tissue hypertrophy, which may lead to rhinophyma (a bulbous nose), particularly in men. Blepharitis and conjunctivitis are common. Keratitis and corneal scarring occur rarely.
Med Lett Drugs Ther. 2024 Feb 5;66(1695):21-2 | Show Full IntroductionHide Full Introduction

Clascoterone Cream (Winlevi) for Acne

   
The Medical Letter on Drugs and Therapeutics • December 27, 2021;  (Issue 1640)
The FDA has approved Winlevi (Sun), a 1% cream formulation of the androgen receptor inhibitor clascoterone, for treatment of acne vulgaris in patients ≥12 years old. It is the first topical...
The FDA has approved Winlevi (Sun), a 1% cream formulation of the androgen receptor inhibitor clascoterone, for treatment of acne vulgaris in patients ≥12 years old. It is the first topical androgen receptor inhibitor to be approved by the FDA.
Med Lett Drugs Ther. 2021 Dec 27;63(1640):202-4 | Show Full IntroductionHide Full Introduction

Drugs for Acne

   
The Medical Letter on Drugs and Therapeutics • November 30, 2020;  (Issue 1612)
Acne is common among adolescents and young adults, but its prevalence appears to have increased in people of all ages due to prolonged wearing of masks during the COVID-19 pandemic. Guidelines for treatment...
Acne is common among adolescents and young adults, but its prevalence appears to have increased in people of all ages due to prolonged wearing of masks during the COVID-19 pandemic. Guidelines for treatment of acne were last published in 2016.
Med Lett Drugs Ther. 2020 Nov 30;62(1612):188-91 | Show Full IntroductionHide Full Introduction

Minocycline Foam (Zilxi) for Rosacea

   
The Medical Letter on Drugs and Therapeutics • November 16, 2020;  (Issue 1611)
The FDA has approved a 1.5% topical foam formulation of minocycline (Zilxi – Foamix) for treatment of inflammatory lesions of rosacea in adults. It is the only topical minocycline product approved...
The FDA has approved a 1.5% topical foam formulation of minocycline (Zilxi – Foamix) for treatment of inflammatory lesions of rosacea in adults. It is the only topical minocycline product approved for this indication. The same manufacturer markets minocycline foam 4% (Amzeeq) for treatment of acne in patients ≥9 years old.
Med Lett Drugs Ther. 2020 Nov 16;62(1611):179-80 | Show Full IntroductionHide Full Introduction

Addendum: Depression and Suicidality with Isotretinoin

   
The Medical Letter on Drugs and Therapeutics • August 1, 2016;  (Issue 1500)
Our article earlier this year on Drugs for Acne1 stated that the oral retinoid isotretinoin (Accutane, and others) is the most effective drug available for patients with severe nodulocystic acne, but warned...
Our article earlier this year on Drugs for Acne1 stated that the oral retinoid isotretinoin (Accutane, and others) is the most effective drug available for patients with severe nodulocystic acne, but warned that depression, suicidality, myalgia, hypertriglyceridemia, and other adverse effects can occur. One of our readers objected to our listing depression and suicidality, which are the subject of a prominent warning in the package insert, in the same sentence as indisputable side effects such as hyperlipidemia and myalgia.

Depression and suicidal ideation have been reported in patients with severe acne after starting treatment with isotretinoin, including some cases in which symptoms resolved after discontinuation of the drug and reappeared after rechallenge.2 A cause-and-effect relationship has not been established, however, and acne itself is associated with symptoms of anxiety and depression.

Two large population-based cohort studies conducted in Canada and the UK found no evidence that treatment of acne with isotretinoin was associated with an increased risk of depression, suicide, or other psychiatric adverse effects.3 In a small US cohort study in 132 patients 12-19 years old with moderate to severe acne, use of isotretinoin did not increase depressive symptoms compared to use of topical drugs and oral antibiotics, and treatment of acne appeared to decrease symptoms of depression.4 A prospective, observational study in 346 patients ≥16 years old with moderate acne found that treatment with isotretinoin for 30 weeks reduced symptoms of anxiety and depression.5 Other studies have reached similar conclusions.

  1. Drugs for acne. Med Lett Drugs Ther 2016; 58:13.
  2. JD Bremner et al. Retinoic acid and affective disorders: the evidence for an association. J Clin Psychiatry 2012; 73:37.
  3. SS Jick et al. Isotretinoin use and risk of depression, psychotic symptoms, suicide, and attempted suicide. Arch Dermatol 2000; 136:1231.
  4. CY Chia et al. Isotretinoin therapy and mood changes in adolescents with moderate to severe acne: a cohort study. Arch Dermatol 2005; 141:557.
  5. SE Marron et al. Anxiety, depression, quality of life and patient satisfaction in acne patients treated with oral isotretinoin. Acta Derm Venereol 2013; 93:701.


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Med Lett Drugs Ther. 2016 Aug 1;58(1500):102 | Show Full IntroductionHide Full Introduction

In Brief: Dinutuximab (Unituxin) for High-Risk Neuroblastoma (online only)

   
The Medical Letter on Drugs and Therapeutics • March 28, 2016;  (Issue 1491)
The FDA has approved use of dinutuximab (Unituxin [yoo ni tux' in] – United Therapeutics) in combination with interleukin-2 (IL-2), granulocyte-macrophage colony-stimulating factor (GM-CSF), and isotretinoin...
The FDA has approved use of dinutuximab (Unituxin [yoo ni tux' in] – United Therapeutics) in combination with interleukin-2 (IL-2), granulocyte-macrophage colony-stimulating factor (GM-CSF), and isotretinoin for treatment of children with high-risk neuroblastoma who previously responded to first-line therapies. Dinutuximab is a monoclonal antibody that binds to GD2, a glycolipid that is overexpressed on the surface of neuroblastoma cells.1

Dinutuximab received a priority review and orphan drug designation. Approval was based on the results of an open-label trial in 226 patients with high-risk neuroblastoma that had at least a partial response to induction chemotherapy, autologous stem cell transplantation, and radiation. Patients were randomized to receive a combination of dinutuximab, GM-CSF, IL-2, and isotretinoin, or isotretinoin alone. At 2 years, the event-free survival rate, the primary endpoint, was 66% with the dinutuximab regimen and 46% with isotretinoin alone (p<0.01). The overall survival rate was 86% with the dinutuximab regimen compared to 75% with isotretinoin alone (p<0.02).2 The recommended dose of dinutuximab is 17.5 mg/m2 daily infused IV over 10-20 hours for 4 consecutive days for up to 5 cycles. Dinutuximab can cause life-threatening infusion reactions, severe pain requiring treatment with IV opioids, peripheral neuropathy, capillary leak syndrome, visual disturbances, hemolytic-uremic syndrome, and other serious adverse effects. The cost for one 17.5 mg single-use vial is $7,500.3

  1. S Dhillon. Dinutuximab: first global approach. Drugs 2015; 75: 923.
  2. AL Yu et al. Anti-GD2 antibody with GM-CSF, interleukin-2, and isotretinoin for neuroblastoma. N Engl J Med 2010; 363:1324.
  3. Approximate WAC. WAC = wholesaler acquisition cost, or manufacturer's published price to wholesalers; WAC represents published catalogue or list prices and may not represent an actual transactional price. Source: AnalySource® Monthly. March 5, 2016. Reprinted with permission by First Databank, Inc. All rights reserved. ©2016. www.fdbhealth.com/policies/drug-pricing-policy.


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Med Lett Drugs Ther. 2016 Mar 28;58(1491):e48 | Show Full IntroductionHide Full Introduction

Drugs for Acne

   
The Medical Letter on Drugs and Therapeutics • February 1, 2016;  (Issue 1487)
The pathogenesis of acne is multifactorial: follicular hyperkeratinization, bacteria, sebum production, androgens, and inflammation all play a role. The gram-positive microaerophilic bacteria...
The pathogenesis of acne is multifactorial: follicular hyperkeratinization, bacteria, sebum production, androgens, and inflammation all play a role. The gram-positive microaerophilic bacteria Propionibacterium acnes promotes development of acne lesions by secreting chemotactic factors that attract leukocytes to the follicle, causing inflammation.
Med Lett Drugs Ther. 2016 Feb 1;58(1487):13-5 | Show Full IntroductionHide Full Introduction

Drugs for Rosacea

   
The Medical Letter on Drugs and Therapeutics • February 1, 2016;  (Issue 1487)
This common, chronic inflammatory facial eruption of unknown cause is more prevalent in women than in men. Rosacea is characterized by erythema and telangiectasia, and sometimes by recurrent, progressive...
This common, chronic inflammatory facial eruption of unknown cause is more prevalent in women than in men. Rosacea is characterized by erythema and telangiectasia, and sometimes by recurrent, progressive crops of acneiform papules and pustules, usually on the central part of the face. Some patients develop granulomas and tissue hypertrophy, which may lead to rhinophyma (a bulbous nose), particularly in men. Blepharitis and conjunctivitis are common. Keratitis and corneal scarring occur rarely.
Med Lett Drugs Ther. 2016 Feb 1;58(1487):16-7 | Show Full IntroductionHide Full Introduction

Ivermectin Cream (Soolantra) for Rosacea

   
The Medical Letter on Drugs and Therapeutics • April 13, 2015;  (Issue 1466)
The FDA has approved a 1% cream formulation of the antiparasitic drug ivermectin (Soolantra – Galderma) for topical treatment of inflammatory lesions of rosacea. Ivermectin is available in the US in...
The FDA has approved a 1% cream formulation of the antiparasitic drug ivermectin (Soolantra – Galderma) for topical treatment of inflammatory lesions of rosacea. Ivermectin is available in the US in tablets (Stromectol, and generics) for treatment of onchocerciasis and other worm infestations and as a 0.5% lotion (Sklice) for treatment of head lice.
Med Lett Drugs Ther. 2015 Apr 13;57(1466):51-2 | Show Full IntroductionHide Full Introduction

Brimonidine Gel (Mirvaso) for Rosacea

   
The Medical Letter on Drugs and Therapeutics • October 14, 2013;  (Issue 1427)
The FDA has approved the selective alpha2-adrenergic receptor agonist brimonidine as a 0.33% gel (Mirvaso – Galderma) for topical treatment of adults with persistent facial erythema of rosacea....
The FDA has approved the selective alpha2-adrenergic receptor agonist brimonidine as a 0.33% gel (Mirvaso – Galderma) for topical treatment of adults with persistent facial erythema of rosacea. Brimonidine is also available in ophthalmic formulations for treatment of glaucoma.
Med Lett Drugs Ther. 2013 Oct 14;55(1427):82-3 | Show Full IntroductionHide Full Introduction

Drugs for Acne, Rosacea and Psoriasis

   
The Medical Letter on Drugs and Therapeutics • January 1, 2013;  (Issue 125)
The pathogenesis of acne is multifactorial: follicular hyperkeratinization, bacteria, sebum production, androgens, and inflammation all play a role. The gram-positive microaerophilic bacteria...
The pathogenesis of acne is multifactorial: follicular hyperkeratinization, bacteria, sebum production, androgens, and inflammation all play a role. The gram-positive microaerophilic bacteria Propionibacterium acnes promote development of acne lesions by secreting chemotactic factors that attract leukocytes to the follicle, causing inflammation.
Treat Guidel Med Lett. 2013 Jan;11(125):1-8 | Show Full IntroductionHide Full Introduction

Drugs That May Cause Psychiatric Symptoms

   
The Medical Letter on Drugs and Therapeutics • December 15, 2008;  (Issue 1301)
Many drugs can cause psychiatric symptoms, but a causal connection is often difficult to establish. Psychiatric symptoms that emerge during drug treatment could also be due to the underlying illness, previously...
Many drugs can cause psychiatric symptoms, but a causal connection is often difficult to establish. Psychiatric symptoms that emerge during drug treatment could also be due to the underlying illness, previously unrecognized psychopathology, or psychosocial factors. The withdrawal of some drugs can cause symptoms such as anxiety, psychosis, delirium, agitation or depression.

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Med Lett Drugs Ther. 2008 Dec 15;50(1301):100-3 | Show Full IntroductionHide Full Introduction

Drugs for Acne, Rosacea and Psoriasis

   
The Medical Letter on Drugs and Therapeutics • November 1, 2008;  (Issue 75)
The pathogenesis of acne is multifactorial: follicular hyperkeratinization, bacteria, sebum production, androgens and inflammation all play a role. The gram-positive microaerophilic bacteria Propionibacterium...
The pathogenesis of acne is multifactorial: follicular hyperkeratinization, bacteria, sebum production, androgens and inflammation all play a role. The gram-positive microaerophilic bacteria Propionibacterium acnes promote development of acne lesions by secreting chemotactic factors that attract leukocytes to the follicle, causing inflammation.
Treat Guidel Med Lett. 2008 Nov;6(75):75-82 | Show Full IntroductionHide Full Introduction

Dangerous Drugs

   
The Medical Letter on Drugs and Therapeutics • December 6, 2004;  (Issue 1197)
At a US Senate hearing prompted by the withdrawal of Vioxx, an FDA officer cited 5 drugs as potentially dangerous. It may be useful to revisit Medical Letter reviews of these...
At a US Senate hearing prompted by the withdrawal of Vioxx, an FDA officer cited 5 drugs as potentially dangerous. It may be useful to revisit Medical Letter reviews of these drugs.
Med Lett Drugs Ther. 2004 Dec 6;46(1197):97 | Show Full IntroductionHide Full Introduction

Blue light (ClearLight) for Acne Vulgaris

   
The Medical Letter on Drugs and Therapeutics • June 23, 2003;  (Issue 1159)
A high-intensity, narrow-band blue light (ClearLight -Lumenis) approved by the FDA for treatment of moderate inflammatory acne vulgaris has been featured in some stories in fashion magazines. This review...
A high-intensity, narrow-band blue light (ClearLight -Lumenis) approved by the FDA for treatment of moderate inflammatory acne vulgaris has been featured in some stories in fashion magazines. This review describes the etiology and treatment of acne, as well as the mechanism of action, clinical studies, adverse effects, dosage and cost of the drug.
Med Lett Drugs Ther. 2003 Jun 23;45(1159):50-1 | Show Full IntroductionHide Full Introduction

Drugs of Choice for Cancer

   
The Medical Letter on Drugs and Therapeutics • March 1, 2003;  (Issue 7)
The tables in this article list drugs used for treatment of cancer in the USA and Canada and their major adverse effects. The choice of drugs in Table I is based on the opinions of Medical Letter consultants....
The tables in this article list drugs used for treatment of cancer in the USA and Canada and their major adverse effects. The choice of drugs in Table I is based on the opinions of Medical Letter consultants. Some drugs are listed for indications for which they have not been approved by the US Food and Drug Administration. In some cases, such as elderly patients or those with many co-morbid illnesses, the regimen of choice might not be suitable. For many of the cancers listed, surgery and/or radiation therapy may be the treatment of choice or may also be part of the management. Anticancer drugs and their adverse effects are listed in Table II on page 46. A partial list of brand names appears on page 52.
Treat Guidel Med Lett. 2003 Mar;1(7):41-52 | Show Full IntroductionHide Full Introduction

Drugs That May Cause Psychiatric Symptoms

   
The Medical Letter on Drugs and Therapeutics • July 8, 2002;  (Issue 1134)
Many drugs can cause psychiatric symptoms, but a causal connection is often difficult to establish. Psychiatric symptoms that emerge during drug treatment may also be due to the underlying illness, previously...
Many drugs can cause psychiatric symptoms, but a causal connection is often difficult to establish. Psychiatric symptoms that emerge during drug treatment may also be due to the underlying illness, previously unrecognized psychopathology, or psychosocial factors. The withdrawal of some drugs can cause symptoms such as anxiety, psychosis, delirium, agitation or depression.
Med Lett Drugs Ther. 2002 Jul 8;44(1134):59-62 | Show Full IntroductionHide Full Introduction

Tazarotene (Tazorac) for Acne

   
The Medical Letter on Drugs and Therapeutics • June 10, 2002;  (Issue 1132)
Tazarotene (taz ar' oh teen, Tazorac - Allergan), an acetylinic retinoid marketed for treatment of psoriasis (Medical Letter 1997; 39:105), is also available as a 0.1% gel and cream for treatment of...
Tazarotene (taz ar' oh teen, Tazorac - Allergan), an acetylinic retinoid marketed for treatment of psoriasis (Medical Letter 1997; 39:105), is also available as a 0.1% gel and cream for treatment of acne.
Med Lett Drugs Ther. 2002 Jun 10;44(1132):52-3 | Show Full IntroductionHide Full Introduction

Drugs of Choice For Cancer Chemotherapy (combined issue 1087-1088)

   
The Medical Letter on Drugs and Therapeutics • September 18, 2000;  (Issue 1087)
The tables in this article list drugs used for treatment of cancer in the USA and Canada. The choices of drugs in Table 1 is based on the opinions of Medical Letter consultants. Some drugs are listed for...
The tables in this article list drugs used for treatment of cancer in the USA and Canada. The choices of drugs in Table 1 is based on the opinions of Medical Letter consultants. Some drugs are listed for indications for which they have not been approved by the US Food and Drug Administration. For many of the cancers listed, surgery and/or radiation therapy are also part of the management of the disease.
Med Lett Drugs Ther. 2000 Sep 18;42(1087):83-92 | Show Full IntroductionHide Full Introduction

Drugs of Choice for Cancer Chemotherapy

   
The Medical Letter on Drugs and Therapeutics • March 14, 1997;  (Issue 996)
The tables that follow list drugs used for treatment of cancer in the USA and Canada and their major adverse effects. The choice of drugs in Table I is based on the opinions of Medical Letter consultants....
The tables that follow list drugs used for treatment of cancer in the USA and Canada and their major adverse effects. The choice of drugs in Table I is based on the opinions of Medical Letter consultants. Some drugs are listed for indications for which they have not been approved by the US Food and Drug Administration. For most of the cancers listed, surgery and/or radiation therapy are part of the management of the disease. Anticancer drugs and their adverse effects are listed in Table II.
Med Lett Drugs Ther. 1997 Mar 14;39(996):21-8 | Show Full IntroductionHide Full Introduction

Azelaic Acid - A New Topical Drug for Acne

   
The Medical Letter on Drugs and Therapeutics • June 7, 1996;  (Issue 976)
Azelaic acid, a naturally occurring heptanedicarboxylic acid, has been marketed in the USA as a 20% cream (Azelex - Allergan) for treatment of acne. The drug has been available in Europe for several...
Azelaic acid, a naturally occurring heptanedicarboxylic acid, has been marketed in the USA as a 20% cream (Azelex - Allergan) for treatment of acne. The drug has been available in Europe for several years.
Med Lett Drugs Ther. 1996 Jun 7;38(976):52-3 | Show Full IntroductionHide Full Introduction

Tretinoin for Photodamaged Skin

   
The Medical Letter on Drugs and Therapeutics • March 20, 1992;  (Issue 866)
Tretinoin (tret' i noyn; all-trans-retinoic acid; Retin-A), a derivative of vitamin A, has been used for years for topical treatment of acne. More recently, it has also been used to improve the appearance of...
Tretinoin (tret' i noyn; all-trans-retinoic acid; Retin-A), a derivative of vitamin A, has been used for years for topical treatment of acne. More recently, it has also been used to improve the appearance of skin damaged by chronic exposure to the sun, although not approved for this indication by the US Food and Drug Administration.
Med Lett Drugs Ther. 1992 Mar 20;34(866):28-9 | Show Full IntroductionHide Full Introduction

Topical Metronidazole For Rosacea

   
The Medical Letter on Drugs and Therapeutics • August 11, 1989;  (Issue 798)
A topical formulation of 0.75% metronidazole gel (MetroGel - Curatek), an antibacterial, antiparasitic agent, was recently approved by the US Food and Drug Administration for treatment of...
A topical formulation of 0.75% metronidazole gel (MetroGel - Curatek), an antibacterial, antiparasitic agent, was recently approved by the US Food and Drug Administration for treatment of rosacea.
Med Lett Drugs Ther. 1989 Aug 11;31(798):75-6 | Show Full IntroductionHide Full Introduction

Tretinoin for Aging Skin

   
The Medical Letter on Drugs and Therapeutics • July 15, 1988;  (Issue 770)
Tretinoin (all-trans-retinoic acid; Retin-A), a vitamin A metabolite used for years for topical treatment of acne, is now being used (without the approval of the US Food and Drug Administration) to improve...
Tretinoin (all-trans-retinoic acid; Retin-A), a vitamin A metabolite used for years for topical treatment of acne, is now being used (without the approval of the US Food and Drug Administration) to improve the appearance of aging skin. Available by prescription in various concentrations in cream, gel and liquid formulations, tretinoin is chemically similar to isotretinoin (13-cis-retinoic acid; Accutane), an oral drug used for treatment of severe acne which has recently caused concern because of its teratogenicity (Morbid Mortal Weekly Rep, 37:171, March 25, 1988).
Med Lett Drugs Ther. 1988 Jul 15;30(770):69-70 | Show Full IntroductionHide Full Introduction