You weigh about 50kg.

A daily dose of 0.5-1.0 mg/kg/day is typical (25-50mg/day for you), but sometimes Derms go higher, particularly for severe and/or body acne.

If you took 80mg/day then that would be 1.6mg/kg/day for you, quite a high dose but this may be necessary for your nodular/cystic acne on your armpits. Plus, such a high dose has been shown to be safe and effective according to the following study:

BACKGROUND:

Isotretinoin, for acne treatment, is associated with high rates of permanent remission. However, at recommended doses of 0.5-1.0 mg/kg/day for 5-6 months [average cumulative dose: 120-150 mg/kg], more than 20% of patients experience a relapse within two years that requires further medical management.

OBJECTIVE:

To examine outcomes of high-dose isotretinoin in a cohort with cystic acne, as well as measuring its impact on quality of life (QOL).

METHODS:

A single dermatologist, single institution investigation within an academic tertiary care center in Bronx, NY. Eighty patients with nodulocystic acne, maintained on oral isotretinoin at a dose of 1.3 mg/kg/day or greater, were studied from 2006-2009 while additionally participating in a QOL survey. Main outcome measures included documented events, acne clearance, presence of relapse, and quality of life parameters.

RESULTS:

The mean daily dose of isotretinoin was 1.6 mg/kg/day for an average time course of 178 days [cumulative dose: 290 mg/kg]. No side effects or laboratory abnormalities led to discontinuation of treatment. There were no psychiatric symptoms. One-hundred percent (100%) of patients were disease-free upon completion of treatment. During the three-year study period, 10 patients (12.5%) developed a relapse that required an additional course of isotretinoin. Analysis of QOL domains (self-perception, role-social, symptoms) revealed significant improvement following isotretinoin therapy (p = 0.0124, p = 0.0066, p = 0.0265, respectively).

CONCLUSIONS:

Isotretinoin prescribed at 1.5 mg/kg/day or greater for 5-6 months [cumulative total dose of 290 mg/kg] is safe and effective compared to current standard dosing practices. We propose the use of high-dose isotretinoin (>1.3 mg/kg/day) as a treatment option in severe nodulocystic acne and encourage larger, prospective, multicenter studies into this therapeutic approach.

Thanks for the information on dosage. It's particularly interesting to see the references into the medical literature.

Steve.

You weigh about 50kg.

A daily dose of 0.5-1.0 mg/kg/day is typical (25-50mg/day for you), but sometimes Derms go higher, particularly for severe and/or body acne.

If you took 80mg/day then that would be 1.6mg/kg/day for you, quite a high dose but this may be necessary for your nodular/cystic acne on your armpits. Plus, such a high dose has been shown to be safe and effective according to the following study:

BACKGROUND:

Isotretinoin, for acne treatment, is associated with high rates of permanent remission. However, at recommended doses of 0.5-1.0 mg/kg/day for 5-6 months [average cumulative dose: 120-150 mg/kg], more than 20% of patients experience a relapse within two years that requires further medical management.

OBJECTIVE:

To examine outcomes of high-dose isotretinoin in a cohort with cystic acne, as well as measuring its impact on quality of life (QOL).

METHODS:

A single dermatologist, single institution investigation within an academic tertiary care center in Bronx, NY. Eighty patients with nodulocystic acne, maintained on oral isotretinoin at a dose of 1.3 mg/kg/day or greater, were studied from 2006-2009 while additionally participating in a QOL survey. Main outcome measures included documented events, acne clearance, presence of relapse, and quality of life parameters.

RESULTS:

The mean daily dose of isotretinoin was 1.6 mg/kg/day for an average time course of 178 days [cumulative dose: 290 mg/kg]. No side effects or laboratory abnormalities led to discontinuation of treatment. There were no psychiatric symptoms. One-hundred percent (100%) of patients were disease-free upon completion of treatment. During the three-year study period, 10 patients (12.5%) developed a relapse that required an additional course of isotretinoin. Analysis of QOL domains (self-perception, role-social, symptoms) revealed significant improvement following isotretinoin therapy (p = 0.0124, p = 0.0066, p = 0.0265, respectively).

CONCLUSIONS:

Isotretinoin prescribed at 1.5 mg/kg/day or greater for 5-6 months [cumulative total dose of 290 mg/kg] is safe and effective compared to current standard dosing practices. We propose the use of high-dose isotretinoin (>1.3 mg/kg/day) as a treatment option in severe nodulocystic acne and encourage larger, prospective, multicenter studies into this therapeutic approach.

Also see here

Good luck

Wow, thanks for the info! I wonder if my derm read those scientific articles.

I feel more assured now, especially since the relapse rate seems to drop from 20% to 12.5% with high-dosage isotretinoin. Though I kind of wish I started with 20 mg a day, then 40mg the next month, and then 80mg for the remaining months, even if it meant an extra month. Maybe then, I'd have less of an initial breakout. 😛

There are additional meds you can get to combat the initial breakout: prednisone or an oral antibiotic called erythromycin. If you are worried about the initial breakout, I suggest you talk to the Dermatologist about these meds.

Thanks again! I will be sure to ask my derm about those medications.