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GuardedlyOptimistic

Done Month Three: What the Derm Said

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Hi Guys,

Sorry that it's been a while since i've posted. I did my bloodwork last week and had my derm appointment today. I'M DONE MONTH THREE AND ENTERING MONTH 4. This is my final month. It's so unbelievable how quickly the time went. I hope your holidays went well.

Well, as I mentioned after month 2, my cholesterol had gone up a bit. Good news: It's down this month. Bad news: Triglycerides are up though not to a dangerous level.

I asked my derm whether we should do a month 5 as i'm going to be a whole month under the minimum 120mg/kg of body weight cummulative dosage. And, she said that we'll see how it goes. She says that adding an extra month depends on how I look after month 4. Arghhh.

Then she said that 1/5 people relapse. Ok. Then she said that if I did relapse, since i'm an adult, she would put me on Diane 35. THERE IS NO WAY IN HELL I'M GOING BACK ON DIANE 35. If things were to get bad again, why the hell would I go back on Diane 35? These derms know shit. Sorry for the swearing but i'm sure you understand my frustration.

What else did she say? She said that 60mg is the right dosage for someone 135 pounds to 150 pounds. Okeee. Reading from the posts on the board, it seems that people in this range are given higher dosages. But, heck, what do i know?

LOL. Ok, i think i'm missing some other things she said but if it comes to mind i'll post again.

How are you all doing?

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Then she said that if I did relapse, since i'm an adult, she would put me on Diane 35. THERE IS NO WAY IN HELL I'M GOING BACK ON DIANE 35. If things were to get bad again, why the hell would I go back on Diane 35?

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Hey GO,

Nice to hear from you, long time no post, I was thinking you went to Australia or something smile.gif

I also had the triglycerides problem, it was 280 though I am only in month 2, anyway my derm did not take me off of tane, but said he would once it touches 500 which I pray it will never.

For your situation, I think you should make sure you get the cumulative dosage in, you can insist for the last month, if you derm does not offer it herself.

It is clearly mentioned in the roche medication guide, that not reaching the cumulative dose increases the chances of relapse, so do not give it up without fighting for it smile.gif

Also the dose is not important, I am 145 lb and been given 80 mg, it is the cumulative dose, so if you reach close to 120 mg per kg, then I think you did your part.

I hope you never have to go back on any acne medicine, be hopeful smile.gif.

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Thanks a lot. The reason I went on accutane was because I didn't want to take a drug like Diane 35 indefinitely. There have been scary reports of increases of strokes and heart attacks with regards to people who take it.

I was on it for longer than 2 years. It did clear my acne but when I went off of it, it came back worse than ever.

With regards to the accutane, if I don't get that final month in, i'll go to my general practitioner and get her to prescribe it to me. I don't think my derm believes in the 120mg/kg of weight cummulative dosage. I'm not sure why. I don't know what to do. She's one of the best derms around and has prescribed accutane to thousands of people. I think she's doing this because I didn't get an initial breakout. Arghhh....I don't know what to do.

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Yaa, that is an option. Somehow get the cumulative dosage inside you even if it means changing derms.

For me based on my weight and dosage the cumulative limit will be reached in 3 months.

I am in beginning of month 2, so more than a month to go, I will try to talk to my derm into keeping me into one more month after that, since I would be yet to reach the "liver toxicity" limit of 4 months.

Anway best of luck in your efforts to reach the cumulative.

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Hey GO!

Thanks for reporting your news and I hope everything goes well for you as far as the triglycerides go.

Im just curious - do you have any active acne left? If not, when was your last spot?

Im a few weeks behind you, but in my 3rd month and still have two that popped up today and like 2 that are still trying to heal. (and lots of redmarks and dry patchy ones) :/ And im going to be on 80mgs for a total of 5 months. Which i believe will add up to the 120Mg/kg. I so don't want to go into relapse so I think it would better for you to be safe than sorry... and go that extra month. My derm even told me that if I wanted to go 6 months - just to make extra sure - that I could. Im going to see what my skin looks like and if I have even ONE active blemish - I probably will. I mean, what the hell, I will have gone through hell for 5 months already - whats another month? like I said, i'd rather be safe than have to go through another course. Good luck to you, and we'd love to see some progress pics!

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Hey GO!

Thanks for reporting your news and I hope everything goes well for you as far as the triglycerides go.

Im just curious - do you have any active acne left? If not, when was your last spot?

Im a few weeks behind you, but in my 3rd month and still have two that popped up today and like 2 that are still trying to heal. (and lots of redmarks and dry patchy ones) :/ And im going to be on 80mgs for a total of 5 months. Which i believe will add up to the 120Mg/kg. I so don't want to go into relapse so I think it would better for you to be safe than sorry... and go that extra month. My derm even told me that if I wanted to go 6 months - just to make extra sure - that I could. Im going to see what my skin looks like and if I have even ONE active blemish - I probably will. I mean, what the hell, I will have gone through hell for 5 months already - whats another month? like I said, i'd rather be safe than have to go through another course. Good luck to you, and we'd love to see some progress pics!

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Hey!!! I missed your posts and am happy to see that you are posting again even though you sound frustrated.

You know that joke about doctors calling what they do practice? Well, I think that's true. Doesn't your dermatologist know your feelings regarding Diane-35? Just because you didn't suffer an initial breakout, doesn't mean that she should push for one. It seems like this is a short time to be on Accutane. I've heard the minimal is usually five months.

But, the most important question is how is your skin looking? Are you satisfied with the results thus far?

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Hey GO,

I'm also a little skepical about only going 4 months on tane. During my second treatment I went only four months and you all know how that turned out: a long remission but none the less I'm on tane for a third time. If you explain to your derm that you really really want to do a fifth month and that you can handle it she may just give in to your request. Let her know how strongly you feel about it and how much you don't want to go back on Diane 35. Hopefully she'll respect your wishes. I'm keeping my fingers crossed for you that your derm prolongs your treatment. Use me as an example if you'd like, anything to help a fellow taner out.

Good luck and keep us posted! biggrin.gif

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Hey GO, thanks for the update!

I had my derm appointment today. My cholesterol was a bit high, but nothing to worry about. I'm also scheduled for a 4-month course, which I think is too short - I'd much rather do 5, or even 6 if I could. My derm says that after 4 months, if I still have activity on my face, we'll do a 5th...so it's another "we'll see" situation. Oh, I asked about my red marks too, and I got the usual "they'll fade with time" response.

I don't understand this whole 120mg/kg thing cumulative dosage, I've never heard of it before, what does it mean?

Others have already asked, but how does your skin look?? Are you happy? Do you break out at all anymore? Let us know biggrin.gif

Mae biggrin.gif

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Hey GO, thanks for the update!

I had my derm appointment today. My cholesterol was a bit high, but nothing to worry about. I'm also scheduled for a 4-month course, which I think is too short - I'd much rather do 5, or even 6 if I could. My derm says that after 4 months, if I still have activity on my face, we'll do a 5th...so it's another "we'll see" situation. Oh, I asked about my red marks too, and I got the usual "they'll fade with time" response.

I don't understand this whole 120mg/kg thing cumulative dosage, I've never heard of it before, what does it mean?

Others have already asked, but how does your skin look?? Are you happy? Do you break out at all anymore? Let us know biggrin.gif

Mae biggrin.gif

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My derm said around 1mg/kg, which im on, but i know you ca n even go up to 2mg/kg dependant on severity.

Also, my derm originally said that i'd be on it for 20 mg and im not heading into 6th month. Crazy. I finish in another 20days time or something like that.

I think derms can chop and change. SOme derms can probably be manipulated ( bad but true) And im sure that if you express real real concerns for relapses, they could put you on for another month. Or say, you can feel cysts under the skin. Sly, but worth a try. Eeeeek.

Hope alls well my sweets,

Frankie x

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Hey Guys,

Quick update as i'm running out the door. My face is 100% acne free. I have lots of red spots that aren't noticeable with makeup. Last month I had 5 blemishes. So, i've been free again for a week. I read a Canadian Accutane monogram that I found on the net that said that people are given accutane for no longer than 4 months, as indicated by roche. This is new to me as I always thought it was 4-5 months now they're saying it's 3-4 months. There is great variability with regards to how much they give you during this time. Although past research shows that 120mg/kg of body weight, cummulative is what we should strive for, some more recent research says that less can also be more. What the hell is going on? Can you sense my frustration? LOL.

So, ....truth is....they still don't know how accutane works. Nice eh? After 30 years on the market, not one study that indicates its mechanism. Bloody hell. Anyway, I don't really know what to do. I'm going to go to my General practioner towards the end of my fourth month and discuss it with her.

Bless you all. And, if you have any other questions feel free to ask? Did I miss anything?

OO, this is the Roche Accutane monogram I found that says that 3-4 months is good. Stardard dose is 1mg/kg of body weight and yet I skimmed through it and couldn't find anything about the 120mg/kg cummulative. Could it be that they don't believe in this measurement anymore? Hmmmmm? Who knows? What do you guys think?

Oh, you need adobe 6.0 to view it. I think you should read it. Please tell me what you think?

http://www.rochecanada.com/pdf/Accutane%20PM%20E.pdf

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I'm also wanting to stay on for 5 months to reach 120mg/kg. I DON'T want to have to go through this again!

Hey GO! I'll check my booklet.

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Guest Craigems

Good stuff GO keep up da good stuff babe.

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GO - our derm still prescribes 80 mg for 6 months. Don't know what that adds up to but it's a lot. DD is done tomorrow - yeah - she's clear. Hang in there. I know it's confusing.

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Thanks for the link GO, good information. I think I've read that one before, if I remember correctly. I was also surprised about the 12-16 week "normal" course, ie. 3-4 months. I was always under the impression that most people took it for 6 months. When my derm told me mine would be 4 (or 5 if I was still breaking out), I thought he was being too cautious and I was a little mad I might be jipped at having a fully effective course. But maybe the new studies show that 4 is just as effective? 3 in my opinion seems like too little. My face is not 100% clear yet and I'm 2.5 months in already. I doubt that just two more weeks of Tane will be enough to put me in remission for a long time.

My opinion on my own skin at least, is that I would like to be 100% clear for at least a full month before going off the Tane. I'm kinda annoyed because I just got 2 more zits today, but hopefully they'll go down fast. I'm not touching them one bit.

My derm today took a look at my face and said, "It looks like it's just starting to work", so I guess that I'm not crazy and it really could be better than this. That actually made me quite relieved - I was starting to think my skin is just un-fixable or something.

Reading that link actually did help me realize that taking Tane with food is actually very important - there was a little blurp about how when taken with food, isotretinoin aborbs double the amount it would on an empty stomach or something. That is significant! I'm going to make more of an effort to eat a meal before taking my pill. Sometimes I get careless or too busy and end up having to take it just with a glass of milk, no food. Probably not the best environment for the drug.

Thanks again for the link! Good stuff.

Mae

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GO: Excellent link! Thank you. It just goes to show me how far away I am from getting any degree in the medical field.

I am kinda angry, though, that this information isn't listed in the Accutane booklets I received. Sure, some of the medical terms used seem foreign to me but I'm not an idiot and I can research and figure them out. For instance, my weight loss is now listed as a side effect. I thought it was but now I have it in writing. This is also the only thing I've read that contains anything regarding alcoholism.

It also concerns me because it makes some mention of doctors prescribing Accutane needing to be knowledgable about retinoids. A lot of dermatologists in my area don't specialize in acne. They are more focused on skin cancer.

But anyway - - CONGRATULATIONS on your clear skin!!! I remember when you started months ago and how worried you were. I am so happy that you made the leap of faith and got where you deserve to be! eusa_dance.gif

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Thanks guys smile.gif I wish you guys all the best as well smile.gif I don't know. What bothers me most about accutane is that they don't know how it works. What if, let's just say: What if: the effects of accutane could have been accomplished using a more aggressive natural method? Isn't it suspect that they still don't know how it works? Yeah right. I'm sorry, i'm digressing. Anyway, this is what I think: We have many glands in our body. Tane doesn't only reduce the output and size of sebaceous glands, I think it does so to all endocrine glands to some extent. Moreover, because it affects DNA transcription perhaps for some it turns off the acne gene therefore the effects appear like a cure. I'm rambling here, all i'm saying is that this stuff better work or i'm going to raise all hell with my doctors.

HEHE, have a nice day!

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