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vincent168

Always ~1mg/kg?

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I just started accutane recently and am on 40mg/day. I weight over 80kg so I am wondering is the doctor giving me 40mg to start and would always go to 80mg/day eventually since I weight over 80kg? Or it really just depends if your acne is getting better or not for them to increase dosage. What I thought was that they must prescribe ~1mg/kg towards the end of the treatment as it would decrease the likelihood of returning acne (despite acne getting better or not with lower dosage)

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I just started accutane recently and am on 40mg/day. I weight over 80kg so I am wondering is the doctor giving me 40mg to start and would always go to 80mg/day eventually since I weight over 80kg? Or it really just depends if your acne is getting better or not for them to increase dosage. What I thought was that they must prescribe ~1mg/kg towards the end of the treatment as it would decrease the likelihood of returning acne (despite acne getting better or not with lower dosage)

No, not everyone gets 1 mg/kg/day. In fact, what dose of Accutane your derm prescribes you depends on many things, including: your derm's personal approach to treatment, the guidelines in your country, the severity and location of your acne, your clinical response to the drug (whether it is working), and how you tolerate its side effects.

Generally, however, all reasonable dosages of Accutane (whether 0.1 mg/kg/day, 0.5 mg/kg/day, 1.0 mg/kg/day, or higher) yield a comparable degree of acne clearance (85-90%) by the 4-5 month mark of treatment. The real question is whether your acne will relapse to a significant extent following treatment. That depends mainly on your age (younger = more likely to relapse), on your pre-treatment acne severity (more severe = more likely to relapse), and on the cumulative dose of Accutane you receive during treatment (higher = less chance of relapse, arguably up to a point). You can't alter the first two factors, but you can change the last. Statistically, a cumulative dose of 120 mg/kg to 150 mg/kg gives you the best chance of permanent remission. If you weigh 80kg, you should therefore aim for 9600 mg to 12000 mg of Accutane in total. This could be achieved by 40 mg/day in a lower dose, lower side effect, long-term course of 8-10 months; by 80 mg/day in a higher dose, higher side effect, short-term course of 4-5 months; or by something in between.

I suggest you talk about these aspects with your derm.

Edited by jimmy188

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I'm 145 lbs (65 kilos) and my derm prescribed me 80mg daily for mild/light moderate but persistent acne so I guess it just depends. It's usually somewhere from .5-2.5 mg/kg.

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Yea he said 8 months atm 40mg/day, I'm not sure if its one of those things where they up to dose later or I'm staying at 40mg/day. I will ask him next month (next consultation)

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