Isoshine 20 mg

For an appropriately assessed patient Isoshine provides treatment for severe acne that has remained active despite other medicines. The goal is better control of inflammatory lesions and less ongoing acne activity.

Treatment benefits include the following.

• Reducing excessive skin oil production

• Reducing severe inflammatory acne lesions

• Treating acne resistant to adequate standard therapy

• Limiting active acne that contributes to further scarring

Acne returns in some patients after treatment. A further course requires reassessment. Continue scheduled reviews even when the skin improves so the clinician can decide when treatment is complete and discuss ongoing skin care.

Acne involves several processes. Excess sebum contributes to blocked follicles. Inflammation and the follicle environment also play a part in the development of acne lesions. Sebum is the oil naturally produced by glands in the skin.

Isotretinoin suppresses sebaceous gland activity and reduces sebum production. It also reduces inflammation and helps control follicle blockage. The reduction in oil makes the follicle environment less favourable for acne associated bacteria.

Improvement takes time. Some patients experience a flare early in treatment. Contact your dermatologist if acne worsens substantially or becomes unusually painful. Do not increase the number of capsules to try to clear the skin faster.

Take Isoshine 20 mg according to your written prescription. Do not decide the daily dose from the product name. Ask your prescriber about unclear instructions.

For conventional oral isotretinoin a common starting dose is 0.5 mg per kilogram of body weight daily. The usual daily range is 0.5 mg to 1 mg per kilogram. Lower doses are used for selected patients according to tolerability and clinical needs. These ranges explain prescribing practice and are not instructions to calculate your own dose.

Conventional isotretinoin capsules are taken with food once or twice daily according to the prescription. Follow the instructions on your supplied Isoshine pack and leaflet. Swallow the capsule whole with water. Do not chew or open it to divide the contents.

Treatment generally lasts several months. The duration depends on the response and the total amount of treatment received. Do not restart leftover capsules after a course or extend treatment without another clinical review.

Dry lips and dry skin are common with isotretinoin. Dry eyes and a dry nose with nosebleeds also occur. Some patients experience muscle or joint discomfort. Changes in liver enzymes or blood fat levels are detected through blood tests. Use a gentle moisturiser and lip balm. Ask about suitable eye drops if dryness affects contact lens comfort. Tell your clinician about persistent or troublesome symptoms. Avoid driving when vision is affected.

Stop treatment and seek urgent medical advice for a severe headache with nausea or vision changes. Severe abdominal pain or bloody diarrhoea also needs urgent assessment. Blistering or peeling skin requires prompt medical help. Seek emergency care for breathing difficulty or swelling of the face or throat. Report new depression or major behavioural changes promptly. Thoughts of self harm need immediate help. Stop Isoshine and contact your prescriber immediately if pregnancy occurs or is suspected.

Do not take isotretinoin if any of the following applies.

• Pregnancy or plans for pregnancy during treatment or within one month after stopping

• Breastfeeding

• Inability to follow the required pregnancy prevention measures

• Allergy to isotretinoin or another capsule ingredient

• Liver impairment

• Excessively high blood fat levels

• Excess vitamin A in the body

• Current treatment with tetracycline antibiotics

If you can become pregnant follow the effective contraception plan agreed with your clinician for one month before starting. Continue throughout treatment and for one month after the last dose. Attend the required pregnancy tests. Contact the prescriber immediately about a missed period or contraceptive failure.

Tell your clinician about previous depression and other mental health concerns. These require assessment rather than automatic exclusion from treatment. Discuss kidney disease and significant allergies too. Check the actual ingredient list because capsule excipients differ between brands. Isotretinoin is not recommended for children younger than 12 or for acne before puberty.

Provide a full list of medicines and supplements before starting Isoshine. Include products used on the skin and vitamins bought without a prescription. Ask a pharmacist to check new medicines during treatment.

Important products to review include the following.

• Tetracycline antibiotics including doxycycline and minocycline

• Vitamin A supplements

• Other retinoid medicines

• Strong exfoliating acne products

• Medicines that reduce contraceptive effectiveness

• St John's wort

Isotretinoin must not be combined with tetracyclines because the combination increases the risk of raised pressure inside the skull. Vitamin A supplements add to retinoid toxicity. Strong exfoliating treatments increase skin irritation.

St John's wort interferes with hormonal contraception. Discuss herbal supplements before adding them to your routine. Keep prescribed contraception in place and do not stop another prescribed medicine yourself to manage an interaction.

Avoid alcohol or follow the limit agreed with your clinician because treatment affects liver function and blood fats.

Follow the storage instructions printed on your supplied Isoshine pack.

• Keep capsules in their original packaging until use

• Follow the temperature limit stated on the pack

• Protect the medicine from moisture and excessive heat

• Keep out of the reach and sight of children

• Check the expiry date before use

• Do not use capsules from damaged packaging

• Return unwanted or expired medicine to a pharmacy for safe disposal