Reticap
Generic Name
Isotretinoin
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| reticap 10 mg capsule | ৳ 40.00 | ৳ 400.00 |
Description
Overview of the medicine
Reticap 10 mg capsule contains Isotretinoin, a potent retinoid used to treat severe forms of acne, particularly cystic or nodular acne that has not responded to other treatments. It works by reducing the size and activity of sebaceous glands and decreasing sebum production in the skin.
Uses & Indications
Dosage
Adults
Typically 0.5-1 mg/kg body weight per day, divided into one or two doses, taken with food. Treatment course usually lasts 15-20 weeks. Cumulative dose often 120-150 mg/kg.
Elderly
Use with caution. Dosage adjustment may be required.
Renal_impairment
Start with a lower dose (e.g., 10 mg/day or 0.1 mg/kg/day).
How to Take
Take the capsule orally, whole, with food, usually once or twice daily. Do not chew or crush the capsule.
Mechanism of Action
Isotretinoin reduces the size and sebum secretion of sebaceous glands. It also normalizes follicular keratinization and reduces the growth of Propionibacterium acnes (P. acnes), a key factor in acne development. It also possesses anti-inflammatory properties.
Pharmacokinetics
Onset
Clinical effects may take several weeks to months to become apparent.
Excretion
Excreted primarily via fecal route and to a lesser extent renally.
Half life
Isotretinoin: approximately 10-20 hours; its active metabolite, 4-oxo-isotretinoin: approximately 17-50 hours.
Absorption
Variable absorption from the gastrointestinal tract; enhanced when taken with a fatty meal.
Metabolism
Primarily hepatic, via CYP2C8, CYP2C9, and CYP3A4 enzymes, forming a major active metabolite (4-oxo-isotretinoin).
Side Effects
Contraindications
- Pregnancy and lactation.
- Hypersensitivity to Isotretinoin or any component of the formulation.
- Severe hepatic impairment.
- Severe hyperlipidemia.
- Concomitant use of tetracyclines.
- Hypervitaminosis A.
Drug Interactions
Phenytoin
May increase the risk of osteomalacia.
Tetracyclines
Increased risk of pseudotumor cerebri (benign intracranial hypertension).
Vitamin A supplements
Increased risk of hypervitaminosis A.
Systemic corticosteroids
May increase the risk of osteoporosis or bone damage.
Progestin-only birth control pills
May reduce the efficacy of progestin-only contraceptives, requiring alternative methods.
Storage
Store below 30°C in a dry and cool place. Protect from light and moisture. Keep out of reach of children.
Overdose
Overdose may lead to symptoms of hypervitaminosis A, including severe headache, nausea, vomiting, facial flushing, ocular changes, and dry skin. Management is symptomatic and supportive.
Pregnancy & Lactation
Isotretinoin is Category X in pregnancy and absolutely contraindicated due to severe teratogenic risk. It is also contraindicated during breastfeeding as it may pass into breast milk and harm the infant.
Side Effects
Contraindications
- Pregnancy and lactation.
- Hypersensitivity to Isotretinoin or any component of the formulation.
- Severe hepatic impairment.
- Severe hyperlipidemia.
- Concomitant use of tetracyclines.
- Hypervitaminosis A.
Drug Interactions
Phenytoin
May increase the risk of osteomalacia.
Tetracyclines
Increased risk of pseudotumor cerebri (benign intracranial hypertension).
Vitamin A supplements
Increased risk of hypervitaminosis A.
Systemic corticosteroids
May increase the risk of osteoporosis or bone damage.
Progestin-only birth control pills
May reduce the efficacy of progestin-only contraceptives, requiring alternative methods.
Storage
Store below 30°C in a dry and cool place. Protect from light and moisture. Keep out of reach of children.
Overdose
Overdose may lead to symptoms of hypervitaminosis A, including severe headache, nausea, vomiting, facial flushing, ocular changes, and dry skin. Management is symptomatic and supportive.
Pregnancy & Lactation
Isotretinoin is Category X in pregnancy and absolutely contraindicated due to severe teratogenic risk. It is also contraindicated during breastfeeding as it may pass into breast milk and harm the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date (check product label for exact date).
Availability
Available in pharmacies and hospitals
Approval Status
DGDA approved
Patent Status
Patent expired, generic available
Clinical Trials
Numerous clinical trials have been conducted to evaluate the efficacy and safety of Isotretinoin in severe acne, supporting its widespread approval and use.
Lab Monitoring
- Liver function tests (LFTs) before and periodically during treatment.
- Lipid profile (triglycerides and cholesterol) before and periodically during treatment.
- Complete blood count (CBC).
- Pregnancy tests for women of childbearing potential, monthly before, during, and one month after treatment.
Doctor Notes
- Strict contraception is essential for female patients of childbearing potential due to the severe teratogenic risk of Isotretinoin.
- Regular monitoring of liver function and lipid profile is crucial before and during treatment.
- Patients must be educated about potential psychiatric adverse effects (e.g., depression, suicidal ideation) and advised to report any changes immediately.
Patient Guidelines
- Strictly use contraception and avoid pregnancy during and for one month after treatment.
- Do not donate blood during treatment and for one month after stopping the medication.
- Use moisturizers and lip balm for dry skin and lips.
- Avoid excessive sun exposure and use sunscreen.
- Avoid waxing and laser skin treatments during and for at least 6 months after treatment.
Missed Dose Advice
If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and resume your regular dosing schedule. Do not double the dose.
Driving Precautions
Isotretinoin may cause impaired night vision or other visual disturbances in some patients. Exercise caution when driving or operating hazardous machinery, especially at night.
Lifestyle Advice
- Protect skin from sun exposure. Stay hydrated.
- Use eye drops if experiencing dry eyes.
- Avoid contact lenses if severe dry eyes occur.
- Limit alcohol intake as it may increase liver strain.
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