Decutan Uses

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What is Decutan?

Decutan is used to treat severe, disfiguring nodular acne. It should be used only after other acne medicines have been tried and have failed to help the acne. Decutan may also be used to treat other skin diseases as determined by your doctor.

Decutan must not be used to treat women who are able to bear children unless other forms of treatment have been tried first and have failed. Decutan must not be taken during pregnancy because it causes birth defects in humans. If you are able to bear children, it is very important that you read, understand, and follow the pregnancy warnings for Decutan.

Decutan is available only under a registered distribution program called the iPLEDGE™ program.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, Decutan is used in certain patients with the following medical conditions:

Decutan indications

An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.
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Severe Recalcitrant Nodular Acne

Decutan (isotret (isotret (Decutan capsules) inoin capsules) inoin capsules) is indicated for the treatment of severe recalcitrant nodular acne. Nodules are inflammatory lesions with a diameter of 5 mm or greater. The nodules may become suppurative or hemorrhagic. "Severe," by definition, means "many" as opposed to "few or several" nodules. Because of significant adverse effects associated with its use. Decutan (isotret (isotret (Decutan capsules) inoin capsules) inoin capsules) should be reserved for patients with severe nodular acne who are unresponsive to conventional therapy, including systemic antibiotics. In addition, Decutan (isotret (isotret (Decutan capsules) inoin capsules) inoin capsules) is indicated only for those female patients who are not pregnant, because Decutan can cause severe birth defects.

A single course of therapy for 15 to 20 weeks has been shown to result in complete and prolonged remission of disease in many patients. If a second course of therapy is needed, it should not be initiated until at least 8 weeks after completion of the first course, because experience has shown that patients may continue to improve while off isotret (isotret (isotret (Decutan capsules) inoin capsules) inoin capsules) inoin capsules. The optimal interval before retreatment has not been defined for patients who have not completed skeletal growth.

How should I use Decutan?

Use Decutan as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Ask your health care provider any questions you may have about how to use Decutan.

Uses of Decutan in details

There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.
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This medication is used to treat severe cystic acne (also known as nodular acne) that has not responded to other treatment (e.g., benzoyl peroxide or clindamycin applied to the skin or tetracycline or minocycline taken by mouth). It belongs to a class of drugs known as retinoids. It works by decreasing facial oil (sebum) production. High amounts of sebum can lead to severe acne. If left untreated, severe acne may cause permanent scarring.

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

This medication may also be used to treat a certain type of cancer (neuroblastoma).

How to use Decutan

Read the Medication Guide provided by your pharmacist before you start using Decutan and each time you get a refill. Read and sign a Patient Information/Informed Consent form before you start taking this medication. If you have any questions about Decutan, consult your doctor or pharmacist before taking the medication.

Swallow capsules whole. Do not crush or chew them. Decutan is usually taken twice daily for 15-20 weeks, or as directed by your doctor. Directions for most generic forms of Decutan state that it should be taken with meals. However, the FDA has indicated that the Decutan brand may be taken with or without food. Food helps increase absorption of this drug into your bloodstream. Ask your doctor or pharmacist for more information. Take this drug with a full glass of water, and do not lie down for 10 minutes after taking it.

The dosage is based on your medical condition, weight, and response to treatment.

Your acne may worsen during the first few days of taking this drug, and it may take up to 1-2 months before you notice the full benefit of this medication. If severe acne returns, a second course of treatment may be started after you have stopped taking the drug for 2 months. The manufacturer does not recommend long-term use of Decutan. Do not take more than the recommended dose.

Since this drug can be absorbed through the skin and lungs and may harm an unborn baby, women who are pregnant or who may become pregnant should not handle this medication or breathe the dust from the capsules.

Decutan description

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Decutan is a medication used for the treatment of severe acne. It is sometimes used in prevention of certain skin cancers. It is a retinoid, meaning it derives from vitamin A and is found in small quantities naturally in the body. Decutan binds to and activates nuclear retinoic acid receptors (RAR), thereby regulating cell proliferation and differentiation. This agent also exhibits immunomodulatory and anti-inflammatory responses and inhibits ornithine decarboxylase, thereby decreasing polyamine synthesis and keratinization.

Decutan dosage

Decutan (Decutan) should be administered with a meal.

The recommended dosage range for Decutan (Decutan) is 0.5 to 1.0 mg/kg/day given in two divided doses with food for 15 to 20 weeks. In studies comparing 0.1, 0.5, and 1.0 mg/kg/day, it was found that all dosages provided initial clearing of disease, but there was a greater need for retreatment with the lower dosages. During treatment, the dose may be adjusted according to response of the disease and/or the appearance of clinical side effects — some of which may be dose related. Adult patients whose disease is very severe with scarring or is primarily manifested on the trunk may require dose adjustments up to 2.0 mg/kg/day, as tolerated. Failure to take Decutan (Decutan) with food will significantly decrease absorption. Before upward dose adjustments are made, the patients should be questioned about their compliance with food instructions.

The safety of once daily dosing with Decutan (Decutan) has not been established. Once daily dosing is not recommended.

If the total nodule count has been reduced by more than 70% prior to completing 15 to 20 weeks of treatment, the drug may be discontinued. After a period of 2 months or more off therapy, and if warranted by persistent or recurring severe nodular acne, a second course of therapy may be initiated. The optimal interval before retreatment has not been defined for patients who have not completed skeletal growth. Long-term use of Decutan (Decutan), even in low doses, has not been studied, and is not recommended. It is important that Decutan (Decutan) be given at the recommended doses for no longer than the recommended duration. The effect of long-term use of Decutan on bone loss is unknown.

Contraceptive measures must be followed for any subsequent course of therapy.

Table 4 : Decutan (Decutan) Dosing by Body Weight (Based on Administration With Food)

Body Weight Total mg/day
kilograms pounds 0.5 mg/kg 1 mg/kg 2 mg/kg*
40 88 20 40 80
50 110 25 50 100
60 132 30 60 120
70 154 35 70 140
80 176 40 80 160
90 198 45 90 180
100 220 50 100 200
*See DOSAGE AND ADMINISTRATION: the recommended dosage range is 0.5 to 1.0 mg/kg/day.

How supplied

Soft gelatin capsules, 10 mg (light pink), imprinted Decutan (Decutan) 10 ROCHE. Boxes of 100 containing 10 Prescription Paks of 10 capsules (NDC 0004-0155-49).

Soft gelatin capsules, 20 mg (maroon), imprinted Decutan (Decutan) 20 ROCHE. Boxes of 100 containing 10 Prescription Paks of 10 capsules (NDC 0004-0169-49).

Soft gelatin capsules, 40 mg (yellow), imprinted Decutan (Decutan) 40 ROCHE. Boxes of 100 containing 10 Prescription Paks of 10 capsules (NDC 0004-0156-49).

Storage

Store at controlled room temperature (59° to 86°F, 15° to 30°C). Protect from light.

REFERENCES

1. Peck GL, Olsen TG, Yoder FW, et al. Prolonged remissions of cystic and conglobate acne with 13-cis-retinoic acid. N Engl J Med 300:329-333, 1979.

2. Pochi PE, Shalita AR, Strauss JS, Webster SB. Report of the consensus conference on acne classification. J Am Acad Dermatol 24:495-500, 1991.

3. Farrell LN, Strauss JS, Stranieri AM. The treatment of severe cystic acne with 13-cis-retinoic acid: evaluation of sebum production and the clinical response in a multiple-dose trial. J Am Acad Dermatol 3:602-611, 1980.

4. Jones H, Blanc D, Cunliffe WJ. 13-cisretinoic acid and acne. Lancet 2:1048-1049, 1980.

8. Strauss JS, Rapini RP, Shalita AR, et al. Decutan therapy for acne: results of a multicenter dose-response study. J Am Acad Dermatol 10:490-496, 1984.

Distributed by: Roche Laboratories Inc., 340 Kingsland Street, Nutley, New Jersey 07110-1199. PI Revised: January 2010.

Decutan interactions

See also:
What other drugs will affect Decutan?

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Laboratory Tests

REFERENCES

7. Dicken CH, Connolly SM. Eruptive xanthomas associated with Decutan (13-cis-retinoic acid). Arch Dermatol 116:951-952, 1980.

Decutan side effects

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What are the possible side effects of Decutan?

The following adverse reactions with Decutan or other Decutan products are described in more detail in other sections of the labeling:

Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of Decutan cannot be directly compared to rates in clinical trials of other drugs and may not reflect the rates observed in practice.

The adverse reactions listed below reflect both clinical experience with Decutan, and consider other adverse reactions that are known from clinical trials and the post-marketing surveillance with oral Decutan. The relationship of some of these events to Decutan therapy is unknown. Many of the side effects and adverse events seen in patients receiving Decutan are similar to those described in patients taking very high doses of vitamin A (dryness of the skin and mucous membranes, e.g., of the lips, nasal passage, and eyes).

Dose Relationship

Cheilitis and hypertriglyceridemia are adverse reactions that are usually dose related. Most adverse reactions reported in clinical trials with Decutan were reversible when therapy was discontinued; however, some persisted after cessation of therapy.

Body as a Whole

The following adverse reactions have been reported in a clinical trial conducted with Decutan and a generic product of Decutan® (Decutan): fatigue, irritability, pain. In addition to the above adverse reactions, the following adverse reactions have been reported with Decutan: allergic reactions, including vasculitis, systemic hypersensitivity, edema, lymphadenopathy, weight loss.

Cardiovascular

The following adverse reactions have been reported with Decutan: vascular thrombotic disease, stroke, palpitation, tachycardia.

Endocrine/Metabolism and Nutritional

The following adverse reactions have been reported in a clinical trial conducted with Decutan and a generic product of Decutan® (Decutan): decreased appetite, weight fluctuation, hyperlipidaemia. In addition to the above adverse reactions, the following adverse reactions have been reported with Decutan: hypertriglyceridemia, alterations in blood sugar.

Gastrointestinal

The following adverse reactions have been reported in a clinical trial conducted with Decutan and a generic product of Decutan® (Decutan): lip dry, chapped lips, cheilitis, nausea, constipation, diarrhea, abdominal pain, vomiting. In addition to the above adverse reactions, the following adverse reactions have been reported with Decutan: inflammatory bowel disease, hepatitis, pancreatitis, bleeding and inflammation of the gums, colitis, esophagitis/esophageal ulceration, ileitis, and other nonspecific gastrointestinal symptoms.

Hematologic

The following adverse reactions have been reported with Decutan: allergic reactions, anemia, thrombocytopenia, neutropenia, rare reports of agranulocytosis.

Infections and infestations

The following adverse reactions have been reported in a clinical trial conducted with Decutan and a generic product of Decutan® (Decutan): nasopharyngitis, hordeolum, upper respiratory tract infection. In addition to the above adverse reactions, the following adverse reaction has been reported with Decutan: infections (including disseminated herpes simplex).

Laboratory Abnormalities

The following changes in laboratory tests have been noted in a clinical trial conducted with Decutan and a generic product of Decutan® (Decutan): blood creatine phosphokinase (CPK) increased, blood triglycerides increased, alanine aminotransferase (SGPT) increased, aspartate aminotransferase (SGOT) increased, gamma-glutamyltransferase (GGTP) increased, blood cholesterol increased, low density lipoprotein (LDL) increased, white blood cell count decreased, blood alkaline phosphatase increased, blood bilirubin increased, blood glucose increased, high density lipopoprotein (HDL) decreased, bone mineral density decreased. In addition to the above adverse reactions, the following adverse reactions have been reported with Decutan: increased LDH, elevation of fasting blood sugar, hyperuricemia, decreases in red blood cell parameters, decreases in white blood cell counts (including severe neutropenia and rare reports of agranulocytosis), elevated sedimentation rates, elevated platelet counts, thrombocytopenia, white cells in the urine, proteinuria, microscopic or gross hematuria.

Musculoskeletal and Connective Tissue

The following adverse reactions have been reported in a clinical trial conducted with Decutan and a generic product of Decutan® (Decutan): decreases in bone mineral density, musculoskeletal symptoms (sometimes severe) including back pain, athralgia, musculoskeletal discomfort, musculoskeletal pain, neck pain, pain in extremity, myalgia, musculoskeletal stiffness. In addition to the above adverse reactions, the following adverse reactions have been reported with Decutan: skeletal hyperostosis, calcification of tendons and ligaments, premature epiphyseal closure, tendonitis, arthritis, transient pain in the chest, and rare reports of rhabdomyolysis.

Neurological

The following adverse reactions have been reported in a clinical trial conducted with Decutan and a generic product of Decutan® (Decutan): headache, syncope. In addition to the above adverse reactions, other adverse reactions reported with Decutan include: pseudotumor cerebri, dizziness, drowsiness, lethargy, malaise, nervousness, paresthesias, seizures, stroke, weakness.

Psychiatric

The following adverse reactions have been reported in clinical trials conducted with Decutan and a generic product of Decutan® (Decutan): suicidal ideation, insomnia, anxiety, depression, irritability, panic attack, anger, euphoria, violent behaviors, emotional instability. In addition to the above adverse reactions, the following adverse reactions have been reported with Decutan: suicide attempts, suicide, aggression, psychosis and hallucination auditory. Of the patients reporting depression, some reported that the depression subsided with discontinuation of therapy and recurred with reinstitution of therapy.

Reproductive System

The following adverse reaction has been reported with Decutan: abnormal menses.

Respiratory

The following adverse reactions have been reported in a clinical trial conducted with Decutan and a generic product of Decutan® (Decutan): epistaxis, nasal dryness. In addition to the above adverse reactions, the following adverse reactions have been reported with Decutan: bronchospasms (with or without a history of asthma), respiratory infection, voice alteration.

Skin and Subcutaneous Tissue

The following adverse reactions have been reported in a clinical trial conducted with Decutan and a generic product of Decutan® (Decutan): dry skin, dermatitis, eczema, rash, dermatitis contact, alopecia, pruritus, sunburn, erythema. In addition to the above adverse reactions, the following adverse reactions have been reported with Decutan: acne fulminans, alopecia (which in some cases persists), bruising, dry nose, eruptive xanthomas, erythema multiforme, flushing, fragility of skin, hair abnormalities, hirsutism, hyperpigmentation and hypopigmentation, nail dystrophy, paronychia, peeling of palms and soles, photoallergic/photosensitizing reactions, pruritus, pyogenic granuloma, rash (including facial erythema, seborrhea, and eczema), Stevens-Johnson syndrome, sunburn susceptibility increased, sweating, toxic epidermal necrolysis, urticaria, vasculitis (including Wegener's granulomatosis), abnormal wound healing (delayed healing or exuberant granulation tissue with crusting).

Special Senses

Hearing: The following adverse reactions have been reported with Decutan: tinnitus and hearing impairment.

Ocular: The following adverse reactions have been reported in clinical trials conducted with Decutan and a generic product of Decutan® (Decutan): dry eye, visual acuity reduced, vision blurred, eye pruritis, eye irritation, asthenopia, decreased night vision, ocular hyperemia, increased lacrimation, and conjunctivitis. In addition to the above adverse reactions, the following adverse reactions have been reported with Decutan: corneal opacities, decreased night vision which may persist, cataracts, color vision disorder, conjunctivitis, eyelid inflammation, keratitis, optic neuritis, photobia, visual disturbances.

Renal and Urinary

The following adverse reactions have been reported in clinical trials conducted with Decutan: glomerulonephritis, nonspecific urogenital findings.

Decutan contraindications

See also:
What is the most important information I should know about Decutan?

Hypersensitivity to Decutan. Hepatic or renal insufficiency. Hypervitaminosis A. Patients with excessively elevated blood lipid values.

Blood donation by patients during and within 1 month of Decutan treatment to women of childbearing potential should be avoided.

Use in pregnancy & lactation: Decutan is highly teratogenic. It is therefore contraindicated in women who are pregnant or who may become pregnant while undergoing treatment. There is an extremely high risk that a deformed infant will result if pregnancy occurs while taking Decutan un any amount even for short periods. Potentially all exposed fetuses can be affected. Major human fetal abonormalities related to Decutan administration have documented, including hydrocephalus, microcephalus, abnormalities of the external ear (micropinna, small or absent external auditory canals), microphthalmia, cardiovascular abnormalities and cerebellar malformation.

As Decutan is highly lipophilic, the passage of the drug in human milk is very likely. Because of the potential for adverse effects, the used of Decutan should be avoided by nursing mothers.

It is recommended that the patient use 2 forms of effective contraception to prevent pregnancy, during treatment and for 1 month after discontinuation of treatment. Testing serve to reming the patient of the importance of avoiding pregnancy. If pregnancy occurs, patient should be counseled on whether to continue the pregnancy. Decutan therapy starts only on the second day or third day of the next normal period.



Active ingredient matches for Decutan:

Isotretinoin in Iceland, Malta, Tunisia.


List of Decutan substitutes (brand and generic names)

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Unit description / dosage (Manufacturer)Price, USD
D Acne I 20mg Capsule (Glenmark Pharmaceuticals Ltd)$ 0.24
20 mg x 10's (Elnova)$ 1.57
Elvac 20mg SG-CAP / 10 (Elnova)$ 1.57
ELVAC soft-gelatin cap 20 mg x 10's (Elnova)$ 1.57
Elvac 20mg SG-CAP / 10 (Elnova)$ 1.57
Epuris capsule 40 mg (Cipher Pharmaceuticals Inc (Canada))
Epuris capsule 10 mg (Cipher Pharmaceuticals Inc (Canada))
Epuris capsule 20 mg (Cipher Pharmaceuticals Inc (Canada))
Epuris capsule 30 mg (Cipher Pharmaceuticals Inc (Canada))
Eudyna 0.05% w/w Cream (Zydus Cadila)$ 0.59
Capsule; Oral; Isotretinoin 10 mg
Capsule; Oral; Isotretinoin 20 mg
Capsules; Oral; Isotretinoin 10 mg
Capsules; Oral; Isotretinoin 20 mg
GRAFEEX soft-gelatin cap 20 mg x 60's (Bryogen Pharma)$ 225.30
I 20 CAPSULE 1 strip / 10 capsules each (Prism Life Sciences Ltd)$ 1.87
I DERIVA 10MG CAPSULE 1 strip / 10 capsules each (Glenmark Pharmaceuticals Ltd)$ 1.29
I DERIVA 20MG CAPSULE 1 strip / 10 capsules each (Glenmark Pharmaceuticals Ltd)$ 2.10
I Deriva 20mg Capsule (Glenmark Pharmaceuticals Ltd)$ 0.21
I Sac 10 mg Capsule (Systopic Laboratories (P) Ltd.)$ 0.09
I Sure 20 mg Tablet (Assure Lifescience Pvt Ltd)$ 0.17
I-RET cap 20 mg x 10's (Adcock Ingram)$ 1.96
Inotrin 150+1.5+114 Capsule (H.L.Healthcare Pvt. Ltd.)$ 0.05
Irec 20 mg Capsule (Gary Pharmaceuticals Pvt. Ltd.)$ 0.14
Irec 10 mg Capsule (Gary Pharmaceuticals Pvt. Ltd.)$ 0.08
Iret 20mg CAP / 10 (Cosme Healthcare (CFL Pharmaceuticals Ltd))$ 2.67
20 mg x 10's (Cosme Healthcare (CFL Pharmaceuticals Ltd))

References

  1. DailyMed. "ISOTRETINOIN: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. PubChem. "Isotretinoin". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
  3. DrugBank. "Isotretinoin". http://www.drugbank.ca/drugs/DB00982 (accessed September 17, 2018).

Reviews

The results of a survey conducted on ndrugs.com for Decutan are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Decutan. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.

User reports

Consumer reported useful

No survey data has been collected yet


Consumer reported price estimates

No survey data has been collected yet


3 consumers reported time for results

To what extent do I have to use Decutan before I begin to see changes in my health conditions?
As part of the reports released by ndrugs.com website users, it takes 1 week and a few days before you notice an improvement in your health conditions.
Please note, it doesn't mean you will start to notice such health improvement in the same time frame as other users. There are many factors to consider, and we implore you to visit your doctor to know how long before you can see improvements in your health while taking Decutan. To get the time effectiveness of using Decutan drug by other patients, please click here.
Users%
1 week1
33.3%
2 weeks1
33.3%
1 month1
33.3%


1 consumer reported age

Users%
16-291
100.0%


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Information checked by Dr. Sachin Kumar, MD Pharmacology

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