Akno 10mg Soft Capsule

Uses of Akno 10

• Acne

How does Akno 10 work?

Isotretinoin is a synthetic retinoid that reduces sebaceous gland size and sebum production. It also regulates cell proliferation and differentiation.

Side Effects of Akno 10

• Common side effects include dry skin, rash, increased liver enzymes, cheilitis (lip inflammation), xerosis (dry skin), xerostomia (dry mouth), and more.
• Serious side effects are rare and may include anaphylaxis and hemorrhagic pancreatitis.

Quick Suggestions:

• Take Akno 10 with food.
• Avoid exposure to sunlight while using Akno 10. Use protective measures such as sunscreen or protective clothing.
• Avoid face waxing and laser treatment while using this medicine, as it makes your skin more fragile.
• Avoid taking tetracycline as it may reduce the activity of Akno 10.
• Do not take Akno 10 if you are pregnant, planning pregnancy, or breastfeeding.
• It may cause dryness of the mouth, lips, and eyes. Drink plenty of water, use moisturizer, and avoid wearing contact lenses. Inform your doctor if it bothers you.

Indications:

Isotretinoin is prescribed to treat severe forms of acne, including nodular or conglobate acne, or acne that is at risk of causing permanent scarring, when other treatments like systemic antibacterials and topical therapies have not been effective.

Pharmacology

Isotretinoin, a derivative of vitamin A, exerts its therapeutic effects in the treatment of acne through various mechanisms:

• Cell Cycle Regulation: Isotretinoin modulates the cell cycle, leading to altered differentiation, survival, and apoptosis (programmed cell death) of skin cells. This regulation helps in preventing the formation of clogged pores.
• Sebum Production Reduction: One of the key actions of isotretinoin is its ability to significantly reduce sebum (skin oil) production. This is important because excessive sebum production can contribute to the development of acne.
• Acne-Causing Bacteria: While isotretinoin does not directly kill acne-causing bacteria, it creates an environment less conducive to their growth. By reducing sebum production and altering the microenvironment of the skin, it makes it more difficult for bacteria to thrive.
• Retinol-Binding Protein (RBP) and Nuclear Retinoic Acid Receptor (RAR): Isotretinoin has a low affinity for RBP and RAR. Instead, it is thought to primarily exert its effects through other retinoic acid receptors.
• RARγ Receptor: Both retinoic acid and its metabolite 4-oxo isotretinoin bind to the RARγ receptor. This receptor is believed to play a role in isotretinoin's ability to treat acne.
• Apoptosis of Sebocytes: Isotretinoin induces apoptosis (cell death) of sebocytes, the cells responsible for producing sebum. This leads to a reduction in sebum production.
• Reduction in Hyperkeratosis: Isotretinoin helps reduce hyperkeratosis (excessively thickened outer layer of skin) through mechanisms that are not fully understood. By reducing hyperkeratosis, it decreases the formation of acne lesions.
• Enhanced Immune Mechanism: Isotretinoin may enhance the skin's immune response, making it more effective at combating inflammation and infections associated with acne.
• Chemotaxis Alteration: Isotretinoin can influence the chemotaxis of monocytes, a type of white blood cell. This alteration in chemotaxis helps reduce inflammation, a common feature of acne.

Dosage & Administration of Akno 10

Adult Dose:

• Oral Severe, Recalcitrant Nodular Acne: 0.5-1 mg/kg/day PO divided BID for 15-20 weeks. Dose up to 2 mg/kg/day (as tolerated) if the disease is very severe with scarring or primarily on the trunk.
• Hepatic impairment: Contraindicated.

Child Dose:

• Severe, Recalcitrant Nodular Acne: <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 the disease is very severe with scarring or primarily 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.

Should be taken with food.

Interaction

• Additive toxicity with vitamin A or its derivatives.
• Decreased efficacy of microdosed progesterone (use 2 forms of contraception).
• May increase the risk of bone loss with phenytoin.
• May increase the risk of osteoporosis with systemic corticosteroids.
• Reduces plasma levels of carbamazepine.
• Potentially fatal: Increased risk of pseudotumor cerebri with tetracyclines.

Contraindications

Pregnancy, lactation.

Pregnancy & Lactation

Pregnancy is an absolute contraindication for isotretinoin treatment. If, despite all precautions, you become pregnant during or within a month after isotretinoin treatment, there is a high risk of severe and serious fetal malformations. These malformations can affect various parts of the body, including the central nervous system, face, ears, eyes, heart, and more. The risk of miscarriage is also increased. If a woman undergoing isotretinoin treatment becomes pregnant, the treatment must be immediately discontinued, and the patient should seek advice and evaluation from a specialist in teratology. Isotretinoin is highly lipophilic, which means it can pass into breast milk. Because infants exposed to isotretinoin through breast milk may experience adverse reactions, nursing mothers should not take isotretinoin.

Precautions & Warnings

• Patients with preexisting or predisposition to hypertriglyceridemia, monitor triglyceride levels.
• Monitor blood lipids and liver function at weekly or bi-weekly intervals.
• Monitor blood glucose in known or suspected diabetes mellitus patients.
• Use caution in patients with a history of psychiatric disorders.
• May impair night vision.
• Avoid wax epilation and skin resurfacing procedures for at least 6 months.
• Avoid prolonged exposure to UV light or sunlight.
• Discontinue if hearing impairment, abdominal pain, rectal bleeding, severe diarrhea, or adverse ocular effects occur.
• Patients should not donate blood during therapy and for at least 1 month 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.

Storage Conditions

Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.