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 20 mg capsule | ৳ 75.00 | ৳ 750.00 |
Description
Overview of the medicine
Reticap 20 mg capsule contains Isotretinoin, a synthetic retinoid (a derivative of vitamin A). It is primarily used for the treatment of severe forms of acne (such as nodular or conglobate acne, or acne at risk of permanent scarring) that have not responded to adequate courses of standard therapy with systemic antibiotics and topical treatment.
Uses & Indications
Dosage
Adults
Initial dose: 0.5 mg/kg/day, usually taken once or twice daily with food. Dose may be increased to 1 mg/kg/day if needed. A cumulative dose of 120-150 mg/kg is often associated with optimal outcomes.
Elderly
Isotretinoin is not typically used in elderly patients, as severe acne is rare in this age group. Dosage adjustments may be considered based on renal or hepatic function.
Renal_impairment
In patients with severe renal impairment, treatment should be initiated at a lower dose (e.g., 10 mg/day) and gradually increased up to 1 mg/kg/day or until the patient has received the maximum tolerated dose.
How to Take
Take orally with food, preferably with the main meal, to maximize absorption. Capsules should be swallowed whole and not chewed or opened.
Mechanism of Action
Isotretinoin reduces the size and activity of sebaceous glands, leading to a substantial reduction in sebum production. It also inhibits follicular keratinization, preventing the formation of comedones, and possesses anti-inflammatory properties, thereby targeting multiple pathogenic factors of acne.
Pharmacokinetics
Onset
Clinical effects typically observed within several weeks, with full effect potentially taking several months.
Excretion
Excreted almost equally in feces and urine.
Half life
Isotretinoin: 10-20 hours; 4-oxo-isotretinoin (major metabolite): 10-50 hours.
Absorption
Variable absorption, significantly increased when taken with a high-fat meal.
Metabolism
Primarily hepatic metabolism via cytochrome P450 enzymes (CYP2C8, CYP2C9, CYP3A4, CYP2B6) to active and inactive metabolites, principally 4-oxo-isotretinoin.
Side Effects
Contraindications
- Pregnancy and breastfeeding.
- Women of childbearing potential unless all conditions of the Pregnancy Prevention Programme are met.
- Hepatic impairment.
- Severe hyperlipidaemia.
- Hypervitaminosis A.
- Hypersensitivity to Isotretinoin or any excipients.
- Concomitant tetracycline therapy.
Drug Interactions
Tetracyclines
Increased risk of pseudotumor cerebri (benign intracranial hypertension).
Vitamin A supplements
Increased risk of hypervitaminosis A.
Topical keratolytic or exfoliative anti-acne agents
May increase local irritation.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose are similar to hypervitaminosis A (e.g., headache, nausea, vomiting, facial flushing, cheilitis, abdominal pain). Management is symptomatic and supportive.
Pregnancy & Lactation
Isotretinoin is a potent human teratogen, causing severe birth defects. It is absolutely contraindicated during pregnancy and in women who may become pregnant. It is also contraindicated during breastfeeding due to the potential for excretion in breast milk and subsequent harm to the infant.
Side Effects
Contraindications
- Pregnancy and breastfeeding.
- Women of childbearing potential unless all conditions of the Pregnancy Prevention Programme are met.
- Hepatic impairment.
- Severe hyperlipidaemia.
- Hypervitaminosis A.
- Hypersensitivity to Isotretinoin or any excipients.
- Concomitant tetracycline therapy.
Drug Interactions
Tetracyclines
Increased risk of pseudotumor cerebri (benign intracranial hypertension).
Vitamin A supplements
Increased risk of hypervitaminosis A.
Topical keratolytic or exfoliative anti-acne agents
May increase local irritation.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose are similar to hypervitaminosis A (e.g., headache, nausea, vomiting, facial flushing, cheilitis, abdominal pain). Management is symptomatic and supportive.
Pregnancy & Lactation
Isotretinoin is a potent human teratogen, causing severe birth defects. It is absolutely contraindicated during pregnancy and in women who may become pregnant. It is also contraindicated during breastfeeding due to the potential for excretion in breast milk and subsequent harm to the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2-3 years from manufacturing date, refer to packaging for exact date.
Availability
Available in pharmacies
Approval Status
Approved by DGDA/FDA
Patent Status
Off-patent (Generic)
Clinical Trials
Extensive clinical trials have demonstrated Isotretinoin's high efficacy in treating severe acne. Ongoing research explores its long-term safety profile and potential new indications.
Lab Monitoring
- Liver function tests (LFTs) at baseline and periodically during treatment.
- Lipid profile (triglycerides and cholesterol) at baseline and periodically.
- For females of childbearing potential, regular pregnancy tests.
Doctor Notes
- Emphasize strict adherence to the Pregnancy Prevention Programme for all female patients of childbearing potential.
- Regularly monitor liver function tests and lipid profiles.
- Counsel patients on potential psychiatric adverse effects, including depression and suicidal ideation.
Patient Guidelines
- Strictly adhere to the Pregnancy Prevention Programme; use two effective methods of contraception.
- Do not donate blood during treatment and for one month after stopping.
- Avoid excessive sun exposure and use high-SPF sunscreen.
- Avoid waxing and laser skin treatments during and for at least 6 months after treatment due to increased skin fragility.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose.
Driving Precautions
Isotretinoin may impair night vision and cause fatigue. Patients should be cautious when driving or operating machinery, particularly at night.
Lifestyle Advice
- Regularly use moisturizers for skin and lips to manage dryness.
- Stay well-hydrated.
- Limit alcohol intake, especially if liver enzyme elevation is a concern.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
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