Tretiva 10 mg

For a suitable patient Tretiva provides treatment for severe acne that has not improved enough with standard therapy. The goal is to control active lesions and reduce the continuing inflammation associated with skin damage.

Expected treatment benefits include the following.

• Reducing excessive sebum production

• Reducing severe inflammatory acne lesions

• Controlling acne resistant to adequate standard treatment

• Reducing ongoing acne activity that contributes to new scars

Acne returns in some patients after a course. Further treatment requires reassessment. Keep follow up appointments even when the skin looks clearer so your clinician can review progress and decide when the course is complete.

Acne develops through a combination of excess skin oil and blocked follicles together with inflammation. The oil produced by sebaceous glands is called sebum. Too much sebum contributes to the conditions in which acne lesions develop.

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

These effects develop over time rather than clearing acne immediately. Some patients experience an early flare. Contact your dermatologist if worsening is marked or painful instead of increasing the dose yourself.

Take Tretiva 10 mg exactly as prescribed. The product name does not mean that everyone should take one capsule daily. Follow the written instructions for the number of capsules and the timing of each dose.

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 decisions and are not a personal dosing guide.

Conventional isotretinoin capsules are taken with food once or twice daily according to the prescription. Follow the instructions supplied with Tretiva. Swallow capsules whole with water. Do not chew or open them to divide the contents.

Treatment usually continues for several months. Your response and the total amount of treatment influence the duration. Do not extend a course with leftover capsules or restart treatment without another review.

Liver function and blood fats are checked before starting and during treatment. Your clinician sets the testing schedule. Pregnancy testing and prevention measures are required for patients who can become pregnant. Report new mood changes and sexual symptoms at follow up or sooner if they are troublesome.

Follow the supplied leaflet for a missed dose. Do not take a double dose to make up for one that was missed. Seek urgent medical advice after an overdose. Keep the capsules for your own prescribed treatment and never share them.

Dry lips and dry skin are common during isotretinoin treatment. Dry eyes and a dry nose with nosebleeds also occur. Some patients experience muscle or joint discomfort. Blood tests identify changes in liver enzymes or blood fat levels. Use a gentle moisturiser and lip balm. Ask about suitable eye drops if dryness makes contact lenses uncomfortable. Report persistent or troublesome symptoms. Avoid driving when vision is affected.

Stop treatment and seek urgent medical advice for a severe headache with nausea or changes in vision. Severe abdominal pain or bloody diarrhoea needs urgent assessment too. Blistering or peeling skin requires prompt 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 Tretiva 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 use of tetracycline antibiotics

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

Previous depression needs careful assessment rather than automatic exclusion from treatment. Tell your clinician about kidney disease and significant allergies. Check the actual capsule ingredient list because inactive ingredients differ between products. Isotretinoin is not recommended for children younger than 12 or for acne before puberty.

Give your dermatologist a full list of medicines and supplements before starting. Include acne products and vitamins bought without a prescription. Ask a pharmacist to check new products during the course.

Important interactions and products to review include the following.

• Tetracycline antibiotics such as doxycycline and minocycline

• Vitamin A supplements

• Other retinoid medicines

• Strong exfoliating acne treatments

• Medicines that reduce contraceptive effectiveness

• St John's wort

Do not combine isotretinoin with tetracyclines. This combination increases the risk of raised pressure inside the skull. Vitamin A supplements add to retinoid toxicity. Strong exfoliating skin treatments increase irritation.

St John's wort interferes with hormonal contraception. Discuss supplements before use rather than assuming a herbal product is safe alongside treatment. Keep prescribed contraception in place and do not stop another prescribed medicine yourself.

Avoid alcohol or follow the limit set by your clinician because isotretinoin affects liver function and blood fats. Discuss alcohol use before starting.

Use the storage instructions printed on the supplied Tretiva pack.

• Keep capsules in their original packaging until needed

• Follow the temperature limit shown on the pack

• Protect from moisture and excessive heat

• Keep out of the reach and sight of children

• Check the expiry date before taking a capsule

• Do not use capsules from damaged packaging

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