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Chacham

Accutane Cumulative Dosing

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I just started Accutane back in September :dance: . My dermatologist initially began me on 40 mg daily. The second visit he raised it to 60 mg, and my third visit he again prescribed me 60 mg daily. My question is this: What is the normal total cumulative dose I should expect? The last time I had an appoitment he was worried maybe I couldn't cope with the dryness (especially the lips "ouch"), so he mentioned that I didn't have to stay at the dosage level. But I'm worried that if we do that I won't have the full advantage of Accutane if I just stop at the dosage level prescribed to me. I did explain to him I could cope with the dryness as long as I could do what it took to get rid of the acne. I mean, would a higher level dosage really make a difference? Thanks to all who reply.

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The recommended cumulative dose is 125-150mg/kg. Although some derms dose the old way and don't pay attention to the cumulative. I didn't come anywhere near the recommended cumulative during my last course and i'm still clear so far.

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The recommended cumulative dose is 125-150mg/kg. Although some derms dose the old way and don't pay attention to the cumulative. I didn't come anywhere near the recommended cumulative during my last course and i'm still clear so far.

I am so not a math person...what does that mean?

I am 122 lbs and take 40 mg/day.

At my last appt, I asked my derm about the "cumulative" dose, and he was puzzled by that term. He said that based on my weight, I was at the recommended dose level. He also said I could go up to 60mg at my next appt if I am not clear yet.

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it means that all of the accutane that you've taken throughout your course should add up to a ratio of 125-150mg per kilogram of body weight.

You weigh @ 55kg.. assuming you take a 5 month course of 40mg/day (which adds up to 6000mg), you'll have reached a ratio of 109mg/kg of bodyweight.

If you continue on 40mg/day for 6 months, you'll have reached a cumulative dose ratio of 131mg/kg of bodyweight.

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it means that all of the accutane that you've taken throughout your course should add up to a ratio of 125-150mg per kilogram of body weight.

You weigh @ 55kg.. assuming you take a 5 month course of 40mg/day (which adds up to 6000mg), you'll have reached a ratio of 109mg/kg of bodyweight.

If you continue on 40mg/day for 6 months, you'll have reached a cumulative dose ratio of 131mg/kg of bodyweight.

Thanks!

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it means that all of the accutane that you've taken throughout your course should add up to a ratio of 125-150mg per kilogram of body weight.

You weigh @ 55kg.. assuming you take a 5 month course of 40mg/day (which adds up to 6000mg), you'll have reached a ratio of 109mg/kg of bodyweight.

If you continue on 40mg/day for 6 months, you'll have reached a cumulative dose ratio of 131mg/kg of bodyweight.

Thanks!

NP

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At my last appt, I asked my derm about the "cumulative" dose, and he was puzzled by that term.

Many doctors are not familiar with the study that concept comes from, especially if they are older.

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The recommended cumulative dose is 125-150mg/kg. Although some derms dose the old way and don't pay attention to the cumulative. I didn't come anywhere near the recommended cumulative during my last course and i'm still clear so far.

I did two courses, 10 years apart, which ended up being 1/2 the recommended cumulative dose for me (about 60-70 mg / kg) and it worked really well both times, but not permanently. This time, another 10 years later, I'm really shooting for a full cumulative dose and hope it will work even longer or permanently. My body (blood work) can't handle a high dosage like 1 mg/kg per day, so I'm doing .5 - .75 mg/kg per day for a longer period.

If your doc is not familiar with the cumulative dosage, go on the web and find a legitimate source that touts the cumulative dose - best if it actually cites studies. Print it and bring it to the doc.

Really be assertive in finishing the cumulative dose. If your blood work is OK, my guess is the doc will not have a problem with it. If not, you could consider buying some generics on line to finish your course self-prescribed. I'm not recommending that, but it is a possibility. If your blood work is OK that is.

My understanding from what I've read is that the daily dose is not important, but the cumulative dose is. Daily dose is usually .5 to 1.0 MG per KG (e.g. 40-80 mg for a 175 lb person like me). The old standard of 1 mg per kg per day for 4-5 months does indeed come out to that magic threshhold. But you can reach the threshold by lower dosages for longer periods. .5 mg/kg. per day for that person would obviously take twice as long.

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The recommended cumulative dose is 125-150mg/kg. Although some derms dose the old way and don't pay attention to the cumulative. I didn't come anywhere near the recommended cumulative during my last course and i'm still clear so far.

I did two courses, 10 years apart, which ended up being 1/2 the recommended cumulative dose for me (about 60-70 mg / kg) and it worked really well both times, but not permanently. This time, another 10 years later, I'm really shooting for a full cumulative dose and hope it will work even longer or permanently. My body (blood work) can't handle a high dosage like 1 mg/kg per day, so I'm doing .5 - .75 mg/kg per day for a longer period.

If your doc is not familiar with the cumulative dosage, go on the web and find a legitimate source that touts the cumulative dose - best if it actually cites studies. Print it and bring it to the doc.

Really be assertive in finishing the cumulative dose. If your blood work is OK, my guess is the doc will not have a problem with it. If not, you could consider buying some generics on line to finish your course self-prescribed. I'm not recommending that, but it is a possibility. If your blood work is OK that is.

My understanding from what I've read is that the daily dose is not important, but the cumulative dose is. Daily dose is usually .5 to 1.0 MG per KG (e.g. 40-80 mg for a 175 lb person like me). The old standard of 1 mg per kg per day for 4-5 months does indeed come out to that magic threshhold. But you can reach the threshold by lower dosages for longer periods. .5 mg/kg. per day for that person would obviously take twice as long.

My dr is great...and when I did ask him about it, he told me that he learns a lot from his patients, because we are doing so much research on the drugs we take.

I know if I give him the study, he'll listen.

Any good websites to research?

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My dr is great...and when I did ask him about it, he told me that he learns a lot from his patients, because we are doing so much research on the drugs we take.

I know if I give him the study, he'll listen.

Any good websites to research?

Do a search for +isotretinoin +"cumulative dosage". One I found quickly that looks "credible" for an MD is:

http://www.medscape.com/viewarticle/472395

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The recommended cumulative dose is 125-150mg/kg. Although some derms dose the old way and don't pay attention to the cumulative. I didn't come anywhere near the recommended cumulative during my last course and i'm still clear so far.

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The recommended cumulative dose is 125-150mg/kg. Although some derms dose the old way and don't pay attention to the cumulative. I didn't come anywhere near the recommended cumulative during my last course and i'm still clear so far.

what's the old way? i figured out my cumulative dose based on how long i will be taking accutane and it is 182 mg/kg which is more than the recommended.

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There is people that done accutane for like 3 months and are clear forever, like my friend (he was suppose to be on it for 6 months but stopped early) and he has been clear for like 4 years now. And there is people on tane on high doses for a long period of time and relapse, reading on this board there was somebody with a dose of 150mg per day for like 10 months and relapsed. It just says that some studies suggest a cumulative dose of 120-150mg/kg will provide longer remission but back in the days, nobody ever did a cumulative dose!

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so if i weigh 80 kg and i'm on 10 mg a day... im going to have to take this shit for 4 years... lol

oh boy

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what's the old way?

The old way is what's described in the packet that comes with the med. Four to six months at a dosage from 0.5mg/kg up to 2mg/kg for severe, unresponsive cases, with most people dosed about 1mg/kg. But some derms dose a third way with an arbitrary fixed dosage that they determine based on severity, bloodwork, and their own experience treating patients. For instance i was kept at 20mg for three months, and then 40mg for three months, which means i didn't even get close to the low end of the recommended dosage until the last 3 months.

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