Tretiva (isotretinoin) is a vitamin A derivative most widely used to treat severe acne. Though less common, it is sometimes used in other serious skin conditions and to help treat some types of skin cancer.

This product is highly effective at treating acne, often with permanent results. However, it is associated with serious and permanent side effects, such as stunted growth when used in teenagers. It is also notorious for causing severe birth defects and can damage breastfed infants. Tretiva should be used with care. It is most often prescribed when lesser medications have failed to clear up the condition.

Tretiva is not suitable for patients under 12 years old.

What to Expect from Tretiva

Tretiva comes in capsules, which should be taken with food or a full glass of milk, usually twice per day. Capsules must be swallowed whole, and should not be allowed to dissolve in the mouth as this can cause mouth or throat irritation.

A doctor should determine dosage, as there are many personal variables that need to be taken into account. Dosage often starts low, is quickly raised, and then lowered again to a maintenance dose. Patients should not exceed 2 mg per kg of body weight per day.

For the first 2 to 4 weeks of treatment little difference will be noticeable, and acne may in fact worsen as lesions below the skin are surfaced. After the 4-week mark improvements should begin to be seen. Treatment can last up to 5 months, during which time acne should clear up completely. This effect is often permanent, though some individuals will have acne return at a later time. Treatment can be repeated if necessary.

Tretiva is so effective because it provides numerous benefits to the skin:

• Reduces the size of oil glands
• Reduces the amount of sebum produced
• Reduces the bacteria associated with acne by reducing oil production
• Inhibits production of skin cells inside pores, preventing clogging
• Inhibits inflammation
• Inhibits hardening of the skin
• Promotes healing

Because Tretiva inhibits oil production dry skin is a common side effect of use, which can lead to a number of side effects:

• Dry nose or nosebleed
• Dry, chapped, or cracked lips
• Dry, cracking, or peeling skin
• Dry mouth or eyes
• Itching
• Brittle or otherwise changed fingernails or toenails

Dry skin can be alleviated with use of moisturizers, lip balm, and similar products. The above are not cause for concern unless they become severe.

Also common are headache, drowsiness, and mild hair loss. These side effects should stop occurring within the first few weeks of treatment as the body adjusts. Patients should use caution performing dangerous tasks until drowsiness symptoms are known.

Potential Complications

Tretiva is a potent medication that must not be misused; very high doses or use for longer than 5 months significantly increase risk of serious side effects.

Used as directed serious side effects are rare, but do happen on occasion. Stop treatment and seek immediate medical attention if experiencing:

• Seizures
• Severe blistering, peeling, or redness of skin
• Unusual bruising or bleeding
• Bone or joint pain
• Rapid or irregular heartbeat
• Severe mood or behavioral changes
• Severe stomach or bowel problems
• Any other severe symptom

If addressed early the above can usually be fully resolved; waiting too long can lead to permanent conditions or, in very rare cases, death.

Tretiva can remain in the system for up to 30 days following the last dose. Patients should not donate blood during treatment or for 30 days following the end of treatment. Likewise women must avoid pregnancy or breastfeeding during this time. Men taking Tretiva will have the medication present in semen, and should likewise avoid impregnating anyone during treatment or for the following 30 days. If intercourse cannot be avoided, using two types of contraceptives is recommended.

Tretiva is associated with stunted growth if used in teenagers, and may exacerbate inflammatory bowel disease in patients of any age.

Finally, Tretiva can interact with a wide range of other medications, including over-the-counter drugs, vitamins, and supplements. Non-necessary medications should be avoided during treatment, and patients should check with a doctor regarding safety for those which must be taken.