Introduction
Akno 10 belongs to a group of medicines called retinoids, which are closely related to vitamin A derivative. It is used to treat severe acne that has not responded to other treatments.
Akno 10 should be used in the dose and duration as advised by your doctor. It should be taken with food, preferably at the same day, each day to avoid a missed dose. It may take several weeks for your symptoms to improve but keep using it regularly to get the most benefit. If you notice no improvement after a few weeks, see your doctor again. Using more medicine or applying it more often than prescribed will not make it work any faster and may increase side effects.
The most common side effects include dry skin, rash and increased liver enzymes. They are not usually serious and often disappear after getting used to the cream but if they bother you or do not go away, tell your doctor. You may need to apply smaller amounts or use it less often. Serious side effects are rare.
Akno 10 may make you more sensitive to sunlight so you should limit exposure to the sun if possible. Drink plenty of water and use moisturizer as it may lead to dryness of the mouth, lips and eyes. It may make your skin more fragile. It is advised, not to have any waxing (hair removal), or laser treatments during treatment. This medicine may lead to birth defects, do consult your doctor if you are pregnant or planning to get pregnant.
How to use Akno 10
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Akno 10 is to be taken with food.
How Akno 10 works
Akno 10 is a derivative of vitamin A. It acts on glands (sebaceous) to reduce the production of a natural substance (sebum) that causes acne. Also, the controlled sebum production kills acne-causing bacteria. It also works as an anti-inflammatory to decrease inflammation (redness and swelling).
What if you forget to take Akno 10?
If you miss a dose of Akno 10, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Administration
Should be taken with food.
Adult Dose
Oral
Severe, Recalcitrant Nodular Acne
Severe nodular acne unresponsive to conventional therapy, including systemic antibiotics
Adult: 0.5-1 mg/kg/day PO divided BID for 15-20 weeks
Dose up to 2 mg/kg/day (as tolerated) if disease is very severe with scarring or is primarily manifested on the trunk
Hepatic impairment: Contraindicated.
Child Dose
Severe, Recalcitrant Nodular Acne
Severe nodular acne unresponsive to conventional therapy, including systemic antibiotics
<12 years: Safety and efficacy not established
>12 years: 0.5-1 mg/kg/day PO divided BID for 15-20 weeks
Dose up to 2 mg/kg/day (as tolerated) if disease is very severe with scarring or is primarily manifested on the trunk
Renal Dose
Renal impairment: Severe: Reduce initial dose (e.g. 10 mg daily), then gradually increase to 1 mg/kg as necessary.
Contraindication
Pregnancy, lactation.
Mode of Action
Isotretinoin is a synthetic retinoid which reduces sebaceous gland size and sebum production. It also regulates cell proliferation and differentiation.
Precaution
Preexisting or predisposition to hypertriglyceridaemia (e.g. DM, obesity or increased alcohol intake). Monitor triglyceride levels. Monitor blood lipids and LFTs at wkly or bi-wkly intervals. Monitor blood glucose in known or suspected DM patients. Genetic predisposition for age-related osteoporosis, history of childhood osteoporosis, osteomalacia or other bone metabolism disorders. Anorexia nervosa. History of psychiatric disorder. May impair night vision. Avoid wax epilation and skin resurfacing procedures for at least 6 mth. Avoid prolonged exposure to UV light or sunlight. Discontinue if hearing impairment, abdominal pain, rectal bleeding, severe diarrhoea or adverse ocular effects occur. Patient should not donate blood during therapy and for at least 1 mth following drug discontinuation.
Lactation: Unknown whether distributed into breast milk; because of potential for serious adverse reactions in nursing infants, do not administer to women who are breastfeeding
Side Effect
>10%
Cheilitis (90%),Xerosis,Xerostomia,Dry nose,Epistaxis,Pruritus,Conjunctivitis (including blepharoconjunctivitis) (40%),Irritation (40%),Increased erythrocyte sedimentation rates (40%),Thinning of hair (which has persisted in rare instances),Palmoplantar desquamation,Skin fragility,Skin infections (eg, paronychial infections),Rash (including erythema, seborrhea, eczema), photosensitivity,Hypertriglyceridemia (25%),Bone or joint pain,Generalized muscle aches,Arthralgia,Decreased HDLs (15%),Increased LFTs (15%),Increased CPK (12-24%),Decreased hemoglobin concentration and hematocrit,Decreased erythrocyte and leukocyte counts,Increased platelet count
1-10%
Decreased bone mineral density (8.8%),Premature epiphyseal closure (3%)
Frequency Not Defined
Lethargy,Fatigue,Headache,Anorexia,Nausea,Vomiting,Increased appetite,Thirst
Potentially Fatal: Anaphylaxis. Haemorrhagic pancreatitis.
Interaction
Additive toxicity with vitamin A or its derivatives. Decreased efficacy of microdosed progesterone (use 2 forms of contraception). May increase risk of bone loss with phenytoin. May increase risk of osteoporosis with systemic corticosteroids. Reduces plasma levels of carbamazepine.
Potentially Fatal: Increased risk of pseudotumor cerebri with tetracyclines.