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coguz

Is 20mg accutane a day too low?

I'm on week 2 of my secound course of accutane.
In my first course of accutane my dermatologist put me on 20mg a day and after 2-3 months I convinced him to take 30mg a day. After the first course I was clear for about 2 years, but my acne is back ( but way less than the first time).

This time my doctor put me on 20mg a day again again. I'm supposed to do 10 months with 20mg a day. The majority of the people I see online are taking higher doses in a smaller period of time. Is this way also efficient? I weight around 64kg (141 lbs)

Is the low dose responsible for my relapse? I'm afraid that lower (and longer) doses are not so effective.
Edited by coguz
improvement

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(I am not a qualified dermatologist etc. so take my advice with a grain of salt). I have bolded the most important information. Essentially, yes increasing the dose to a certain point will achieve quicker results (for you that maximum is 80mg). PLEASE DO NOT USE THIS AS MEDICAL ADVICE AND ALWAYS CONSULT YOUR DERM OR GP.

From what I have read:
 

  • Accutane works by building up to a certain plasma concentration in the blood/a cumulative dose (i.e it takes time for the drug to build up in your system, hence the long duration of treatment)
  • The half life is 22 hours and the bioavailability is 25%.
  • The duration of treatment is generally 16–30 weeks, depending on dose. 
  • Post-therapy relapse is minimized by treatment courses that amount to a total of at least 120 mg/kg, but there is not necessarily any added benefit when 150 mg/kg is exceeded. Typically, this total dose can be achieved by 4–6 months at 0.5–1.0 mg/kg/day. So according to research you should dose at approximately 42mg a day for 6 months, or around 65mg a day for 4 months. The maximum effective dose for your weight is 55mg/day for 6 months or 80mg/day for 4 months. You should not exceed this.
  • Eighty-five percent of patients who receive a dose of 0.5–1.0 mg/kg/day are virtually clear of their acne by 16 weeks. So the typical range that cures people almost completely within 4 months would be 32-64mg a day for your weight.
  • If the acne is very inflammatory, then a significant reduction in the dose of isotretinoin and addition of oral steroids may be required.


Other things to note: 
  • Make sure you are taking your accutane with a high fat meal! Extremely important!
  • I have compiled this information from a research paper from Allison Layton (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835909/)
  • Lower doses over longer time periods have better safety profiles, and I would recommend this as 20mg will still be effective.

Let me know if you have other questions or you are unsure! Very happy to research further for you! :)

PS - Sorry for the odd formatting, I cut and paste some of the non bolded sentences and cant find out how to change the font.
 

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2 hours ago, Southland97 said:

(I am not a qualified dermatologist etc. so take my advice with a grain of salt). I have bolded the most important information. Essentially, yes increasing the dose to a certain point will achieve quicker results (for you that maximum is 80mg). PLEASE DO NOT USE THIS AS MEDICAL ADVICE AND ALWAYS CONSULT YOUR DERM OR GP.

From what I have read:
 

  • Accutane works by building up to a certain plasma concentration in the blood/a cumulative dose (i.e it takes time for the drug to build up in your system, hence the long duration of treatment)
  • The half life is 22 hours and the bioavailability is 25%.
  • The duration of treatment is generally 16–30 weeks, depending on dose. 
  • Post-therapy relapse is minimized by treatment courses that amount to a total of at least 120 mg/kg, but there is not necessarily any added benefit when 150 mg/kg is exceeded. Typically, this total dose can be achieved by 4–6 months at 0.5–1.0 mg/kg/day. So according to research you should dose at approximately 42mg a day for 6 months, or around 65mg a day for 4 months. The maximum effective dose for your weight is 55mg/day for 6 months or 80mg/day for 4 months. You should not exceed this.
  • Eighty-five percent of patients who receive a dose of 0.5–1.0 mg/kg/day are virtually clear of their acne by 16 weeks. So the typical range that cures people almost completely within 4 months would be 32-64mg a day for your weight.
  • If the acne is very inflammatory, then a significant reduction in the dose of isotretinoin and addition of oral steroids may be required.


Other things to note: 
  • Make sure you are taking your accutane with a high fat meal! Extremely important!
  • I have compiled this information from a research paper from Allison Layton (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835909/)
  • Lower doses over longer time periods have better safety profiles, and I would recommend this as 20mg will still be effective.

Let me know if you have other questions or you are unsure! Very happy to research further for you! :)

PS - Sorry for the odd formatting, I cut and paste some of the non bolded sentences and cant find out how to change the font.
 
Thanks for the answer!
I don't mind taking a longer course on accutane if it's still effective. Atleast with 20mg a day the only side effect I have is dry skin and lips, which is very good.
I always take accutane on my biggest meal of the day (lunch) and I always take two pills of Omega-3 with it. Omega-3 are good fat and they help the cholesterol levels :) Edited by coguz

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I'm on 20mg every other day - i'm 6ft 2 and around 77kg.
It depends on you personally as there isn't a go to number depending on your weight, absorbption and sensitivity. Whichever mg amount works for you, you should keep, rather than keep increasing. Accutane reduces your skins ability to heal, so you have to find a middle ground against effectiveness vs side effects that may last (and example of this would be overly dry skin, or consistent sunburning of the skin).

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On 12/02/2018 at 0:26 PM, Duperele said:

Are you a female or a male? how much do you weight?


Male and I weight around 64kg (141 pounds).  I'm not tall (1.75m = 5.74 feets).

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