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[paperbag]

I am a 36 year old male. I had acne from 18-25. At the time, Benzamycin cured it. It was a miracle drug. I haven't had acne since then. I thought it was gone...done...I was too old.

When I first got acne and was looking for a cure, I promised myself I would never take Accutane.

Starting in the fall of 2010 I started to get occassional acne. By fall of 2011 I had a real bad break out. It started becoming more frequent. By January of this year it was non stop.

I had no idea what was happening to me. At first...I didn't even think it was acne. I thought I was developing chronic hives. I even got tested for hives and allergies. A dermatologist put me on 2 allegra and 2 zyrtec a day. Nothing helped.

At the same time, I was also treating it as if it might be acne. I tried topical Benzaclin first, the old tried and true life saver. That burned my skin. I tried doxycycline. Then Bactrim. Then minocycline, topical clindamycin, and topical Atralin combined. The acne just got worse and worse.

Last Tuesday, I went to a dermatologist determined to get Accutane.

They took my blood and had me sign the iPLEDGE. They said they started people on 40mg. The doctor told me to take it 2 times a week, since my acne was not so bad.

I asked for 10mg because I was so scared of the side effects. I weigh 150 pounds.

I went to Walgreens and they had to special order the pills, since 10mg is an unusual dose. I had to wait a day.

On Wednesday, I got my prescription filled. 30 pills of 10mg Claravis. I was so happy.

Wednesday, I took my first pill. My skin cleared up in a day. The pores on my nose, which are huge, closed. The beads of oil that sit in those pores were gone.
My face felt dry...tight. A good feeling, compared to constantly oily.
My face got whiter. The redness was gone.
That night, I sat in the park with a friend for a few hours. I felt free.
I woke up the next day....no new acne. A miracle.

I thought...wow...I definitely will only need this 2 times a week, it's so strong. I was more worried about side effects that day, than if the accutane would work. I thought I would save so much money, because if I took it only 2 times a week, 30 pills would last 4 months, so it wouldn't be so expensive.

Friday, I woke up with new acne. Saturday...new acne. Sunday...new acne. Today...new acne.

Now I regret asking for such a low dose. I don't know if this is the "initial break out" or simply the dose isn't high enough.

I am taking one pill every day now, instead of one pill two times a week. I feel my dose is way too low now. I was trying to be cautious. Now I regret it, because the acne is just not stopping.

Maybe I am being unrealistic, since I've only been on Accutane less than 1 week.

Can someone, an "accutane veteran", please help me out? I have no one to ask for advice. The dermatologist I go to is well known, but...hard to get through to an actual doctor.

I had to find out myself that I should take the Accutane with a fatty meal. I am pretty good at research.

Anyway...I have lots of questions. If someone could please help. Also PLEASE, feel free to pm me. I feel very alone.

Here's my questions:

1.Is it possible to get another prescription from my doctor before the 1 month supply is up? Should I even bother calling?

2.Is there some kind of restriction in the iPLEDGE database on getting a second prescription before the 1 month is up? Will it not allow it?

3.Could I be having an initial breakout after a few days on such a low dose of 10mg?

4. Will 10mg do anything at all? Anyone else benefit from this low a dose? Am I screwed until I can get on a higher dose?

5. Is it possible to get more than 1 prescription from more than 1 doctor, or does the iPLEDGE system catch that?

6. Does anyone use online pharmacies, such as legit Canadian pharmacies, to save money? I just looked today at one online Canadian pharmacy, and their price is 1/3 the price at Walgreens. It is a very legit pharmacy. I just am having a real hard time paying $200 for a 1 month supply of any drug.

Well that's all I can think of for now. If anyone can answer any of these questions, or help out in any way, I'd greatly appreciate it. I could just use someone to talk to, some advice from someone who has been through this and is willing to listen and help.

thank you all

[paperbag]

Hey BeautifulDisasters thanks for your reply.

I guess I am stuck with 10mg this month? I feel so sad. I wish I had asked for 20mg.

They actually wanted to start me on 40mg, but I was too afraid of side effects, so I asked for the lowest dose possible. They were pretty flexible in terms of dose. They let me decide. I think if I would have asked for a higher dose than 40mg, they would have said no, but since I asked for a lower dose, they were ok with it. Less risk for them. But their suggestion was 40mg to start, then increase to 80mg.

I feel the medication is working somewhat...I have less break outs. But my face is still oily. They told me I wouldn't need any topical acne medication any more, just moisturizer. It sounded so freeing. No more acne washes, no more topicals....Well my skin is still very oily and I still have to use Neutrogena 2% salicylic acid acne wash and topical Clindamycin 1%. So I know the dose is not high enough I read about everyone having dry lips, dry eyes, etc. I don't feel dry at all on my skin. This really sucks having to wait. I am pretty mad at myself. I wanted to play it safe and start with the lowest dose, but now I feel like I just wasted a month and $200.

My friend encouraged me to start Accutane, and she said she never got a break out, and it helped immediately. I also read a thread somewhere of a man on 20mg accutane a day, and his posts described accutane as a miracle. Like you said, he got better from day 1 and just kept getting better. So in my head, I hoped I would have the same response and be lucky like my friend and that guy. But either my dose is too low, or I'm not so lucky.

I guess my expectations weren't realistic. Though I was told by the doctor, at 10mg, I shouldn't get any initial break out or any side effects. You can really keep breaking out for 3 months? When does it get better?

I have read that Accutane is supposed to be taken twice a day in the Roche Accutane package insert. It says it is designed to be taken twice a day, yet I'm only taking it once a day, and from what I've seen, a lot of people only take it once a day.

Also, from reading the package insert, I found that I should take it with fatty food. The package insert says this increases absorption of accutane by over 2 fold. So I am learning a lot from reading on my own.

I did not realize I gave them my social security number. Now that you mention it, I do remember filling that in on the iPLEDGE form and wondered why they wanted that.
So if I went to another doctor and asked for an accutane prescription, and they tried to get me a second prescription, the iPLEDGE system would catch it and stop them? I'm guessing the doctor would not be too happy if they found out I had a previous prescription.

The reason I mention online pharmacies is because my friend did it that way. I won't mention the pharmacy because I don't know if it's against forum rules to do that. But she got hers online, and it worked for her. She took 20mg twice a week. It is so much cheaper. Online, the price for 30 10mg pills is $45. At Walgreens with my prescription savings card, it is $200. I don't have insurance. That's a huge difference. And I figure they must take accutane in other countries. Well...I won't get into the whole online pharmacy debate.

But I did want to ask....does Canada participate in the iPLEDGE system? Because I have no worries concerning ordering Accutane from legitimate online Canadian pharmacies. I just don't want to show up twice in the iPLEDGE system. Otherwise I would fax my prescription to a Canadian pharmacy, and also fill it at Walgreens, to save money.

I hope this doesn't all sound too shady. I'm desperate ...like a lot of folks with acne, and $200 a month is just so greedy to charge people who are really suffering.

thanks for your advice. I really appreciate it. Any more advice, feel free to post more.

[paperbag]

Hi BeatifulDisasters,

thanks for your answers.

I am now taking 20mg; 10mg twice a day. During the day I take 10mg I get from Walgreens. Then at night I take 10mg I get from an online pharmacy.

I have some more questions.

The most noticeable side effect is burning around the sides of my nostrils. I tend to get a lot of oil on my nose and sides of nose. My nose is probably the oiliest part, but ironically I don't get much acne there at all. The pores are so big, I think all the oil just flows out all over my nose, but doesn't get clogged.
Anyway, I'm noticing that the skin right next to my nose, in the "creases" where my nostrils attach to my face, is burning somewhat. It's not painful, not on-fire burning. But I feel it, and wonder if it's actually a pimple, because a lot of times I'll feel warmth when a pimple is coming on. So I go to the bathroom to see if it's pimples. But there's nothing there. It's just a burning senation...a sensation of really dry skin. I don't know why it's just in this one area. Have you noticed a burning senation around your nostrils?

My other question is, when I was prescribed Accutane, they told me to take 10mg twice a week. The prescription says take every day, but they told me to ignore that. They didn't think I'd need any more than 10mg twice a week...which is strange because 10mg is such a low dose. I found myself quickly needing 10mg every day, then 20mg every day. So now I'm up to 20mg everyday, including the secret online pharmacy pill, and that is working much better. I really need it, otherwise I get a lot of acne.

So I'm wondering how do I go to my doctor at the next appointment and say I'd like to go from 10mg twice a week (what they think I'm taking) to 20mg once a day (what I'm really taking) ? I want to ask them for 20mg pills. It wouldn't be such a leap if they knew I was taking 10mg every day, but to go from 10mg twice a week (in their mind) to 20mg every day, might be asking too much? I don't know. Is there any good way to phrase this? That I want to both go up in dose, and increase the frequency? I think 20mg every day is still a low dose, so I'm hoping they're ok with it.

I'm also wondering if I should call them and tell them I'm taking 10mg every day, instead of twice a week. I actually did try calling and leaving a message for the nurses yesterday, but they were closed. They are open today even though it's a saturday, so I'm hoping someone will call me back.

thanks again for your help

To the best of my knowledge you are probably stuck with the 10 MG this month. I started on 40MG everyday and moved to 60MG daily and I take them at my pills all at the same time. I don't split them into one in the day and one at dinner or something. You are correct that eating it with a fatty meal does increase it's effectiveness. I would agree that research is the best thing you can do on this drug. I found out so many things on this forum that my dermatologist never told me. Like taking the pill with a fatty meal. I understand about being scared about the side effects, trust me we all go into this medication scared of the outcome. You just need to weigh it out and decided if the risk is worth it to you. Sounds like you have tried all the run of the mill antibiotics and topicals. I have taken all those too. Nothing helped my acne out and it was starting to get worse and worse and it made sense for my next step to be accutane.

It took me about 2 weeks at 40MG before I noticed that I was drying out. I never had a oily face really, but I did notice my hair drying out and lips drying out. I wasn't noticeable dry until a month in though. So I wouldn't expect to be needing to use eye drops and lip moisturizers just yet. It will happen though.

I wish that I was one of those people that the medication did all positive things from day one. Yes I was really breaking out for 3 months. I was really thinking I would be clear at month 3 but that wasn't the case at all. I talk to lots of people on this site in the accutane boards and it is a lot more common than you would think. BUT it really can help people from day one, it varies so much between people it is nuts. There really is no guessing how much or how fast the drug is going to help. Most people end the courses with amazing results though.

I can't touch on the online pharmacies because I have never used one before. I am not sure at all about canada and if they use the iPledge system. It seems to be a US program though.

I would not go see another doctor and get another accutane prescription. I would imagine if one found out about the other prescription you wouldn't get prescriptions for it any longer. Plus they would sign you up for the iPledge program again and you would already have a conflicting account. I would just wait it out till next month and give the 10MG time to work and see how you are handling side effects and see what your progress is at that time. There is still time for things to change. Next month you can talk to your doctor and ask to be moved up to the 40 mg and see how things are then. I think you will be happier with a higher dose by the sounds of it. Then you can get it filled where ever you want at that point.

You aren't wasting a month you are getting your body used to the medication. Think of it that way.

[paperbag]

I know Accutane makes your skin sensitive to sunlight.

I am wondering, has anyone else here noticed that Accutane makes them break out when they go out in the sun?

I don't know if I'm imagining this or not. It seems like if I go outside in the sun, I get more acne.

[start]

Two things

1) It's the size of the dose and not the length of the course that matters. 10mg is way too little

2) People start noticing the effects usually after a couple of months. The shortest course that I've heard of is 3 months but I don't think that's long enough

[paperbag]

Well I wanted to post an update.

I'm feeling pretty disappointed tonight. I can't sleep.

Previously, I was taking 10mg Claravis (from Walgreens) during the day, then 10mg of some Isotretinoin that I get from an overseas pharmacy at night. This was working really well. Lot of dryness, flaking, but much reduced acne. Almost completely clear. I thought I was going to be one of those lucky ones.

I saw my dermatologist Thursday. I had my dose upped to 20mg Claravis per day. That's....20mg of legit accutane (Claravis) from Walgreens.

I also ordered some 20mg isotretinoin from overseas to go with the 20mg Claravis from Walgreens.

So I'm actually on 40mg/day now. One 20mg pill in the morning (Claravis), and one 20mg pill at night (overseas isotretinoin).

I weight about 145 pounds, which is 66kg.

I wanted to start conservatively with the dose to see how I responded, because I had heard so many accutane horror stories. My dose at 40mg/day is getting close to the "normal" dose. It's more than 0.5mg/kg/day.

I'm up tonight at 2am because I'm breaking out a lot more. My skin is not peeling as bad, which both concerns me and makes me feel better. I'm concerned because the peeling skin let me know the accutane was working.

I don't really understand why I'm breaking out so badly now after increasing my dose from 20mg to 40mg, unless the increased dose is causing an increase in breakouts. Has anyone else experienced a breakout when their accutane dose was increased?

I'd say right now my skin feels as bad as it did pre-accutane. Getting constant, very inflammed acne.

The only good thing is that the side effects have subsided somewhat. I can't believe that accutane is not working as well, since the dose is higher. The only thing I can think of ....and hope and pray....is that it's a break out from a higher dose of accutane.

I've been on accutane 1 month now. I'm worried that 1 month is too late for the initial break out, and that the accutane is just not working. I'm worried that I'm seeing the acne get worse after an initial improvement. It just doesn't make sense to me.

I have to use topical Clindamycin 1% solution a lot more than I was. Those angry red big pimples are back.

I hope someone can reply and confirm that it's just a break out in response to the increased dose. Because otherwise I feel pretty sad. I was doing so well. It all seemed to be working so fast.

Can some accutane veteran please reply and help me understand what's going on? I don't have any one else to talk to about this. Obviously I'm very upset if I can't sleep and it's 2am.

Thank you all,
Your up at night, can't sleep, breaking out, worried friend
paperbag

[lionfish]

.................

I'm not an Accutane veteran because I have only just started taking it myself.......... however, even basic research will show you that Accutane is NOT a miracle cure. Most Drs are giving people this drug for a minimum of 3 months but more usually 6 months.

Many people see an initial breakout ("IB") which can not only be worse than the original problem but can also last a good few weeks.... some people even say they get IB's after dosage increases. A lot of people only start to see the benefits towards the end of a 6 month course on Accutane and some even comment that their skin didn't even clear up properly until a few months AFTER finishing with Accutane.

I would suggest reading through the Accutane logs and Review section of this site and maybe looking up some YouTube videos in order to give yourself a better idea of how it works / more realistic expectations.

Also, I hope you are telling your DR that you are buying additional drugs from an online pharmacy? It sounds like a risky thing to do as you don't know if the source is legit of if the medication is safe and so on...