Tretiva: The Gold Standard in Severe Acne Treatment
Tretiva
| Product dosage: 10mg | |||
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| Package (num) | Per pill | Price | Buy |
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| Product dosage: 20mg | |||
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| Package (num) | Per pill | Price | Buy |
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| 360 | 2.00 $
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| Product dosage: 30mg | |||
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| Package (num) | Per pill | Price | Buy |
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| Product dosage: 40mg | |||
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| Product dosage: 5mg | |||
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Tretiva represents a significant advancement in systemic retinoid therapy, specifically formulated for the management of severe, recalcitrant nodular acne unresponsive to conventional treatments. As a bioequivalent formulation of isotretinoin, it targets the primary pathogenic factors of acne with a high degree of efficacy. This medication is strictly prescribed under the supervision of a dermatologist due to its potent mechanism of action and requires a thorough understanding of its administration and monitoring protocols. The following information provides a comprehensive overview for healthcare professionals and informed patients.
Features
- Active Pharmaceutical Ingredient: Isotretinoin (10 mg, 20 mg soft gelatin capsules).
- Pharmacological Class: Systemic Retinoid.
- Mechanism of Action: Reduces sebaceous gland size and sebum production, inhibits C. acnes proliferation, normalizes follicular keratinization, and exhibits anti-inflammatory properties.
- Presentation: Box of 10 x 10 strips.
- Bioavailability: Enhanced by lipid-rich meals; administration with food is mandatory.
Benefits
- Achieves long-term remission or permanent cure in a significant majority of patients with severe cystic acne.
- Addresses all four major pathophysiological factors of acne vulgaris simultaneously.
- Prevents and reduces the formation of severe, disfiguring acne scars.
- Improves overall skin texture and reduces oiliness for an extended period post-therapy.
- Positively impacts psychosocial well-being and quality of life by resolving a highly visible condition.
Common use
Tretiva (isotretinoin) is indicated for the treatment of severe recalcitrant nodular acne. This condition is characterized by numerous, large, inflammatory, tender nodules that have proven resistant to standard acne treatments, including systemic antibiotics. It is not intended for the treatment of mild or moderate acne or for first-line therapy. Its use is reserved for cases where the potential benefits outweigh the significant risks associated with the drug.
Dosage and direction
Dosage is highly individualized based on patient weight, disease severity, and treatment response. The recommended dosing range is 0.5 to 1.0 mg/kg/day, administered in two divided doses with meals. A cumulative target dose of 120–150 mg/kg per treatment course is associated with lower relapse rates. A standard course of therapy is typically 15 to 20 weeks. Treatment courses may be repeated after a minimum two-month drug-free interval if necessary. It is absolutely critical that the capsule is swallowed whole with a full glass of water and not chewed or sucked, as the contents can cause severe irritation to the oropharyngeal mucosa.
Precautions
Pregnancy Prevention Program: Tretiva is a major human teratogen and is absolutely contraindicated in pregnancy. Female patients of childbearing potential must use two effective forms of contraception simultaneously for at least one month before, throughout, and for one month after therapy. Two negative pregnancy tests are required before initiation. Psychiatric Effects: Patients should be monitored for symptoms of depression, mood changes, psychosis, aggression, and rarely, suicidal ideation. Discontinuation of therapy may be necessary if severe symptoms occur. Hepatotoxicity: Regular monitoring of liver function tests (LFTs) is mandatory before and during treatment. Lipid Effects: Significant elevations in serum triglycerides and cholesterol can occur. Baseline and periodic serum lipid assessments are required. Ocular Effects: May cause dry eyes, conjunctivitis, and night blindness. Contact lens wearers may experience intolerance. Corneal opacities have been reported. Musculoskeletal Effects: Can cause premature epiphyseal closure in adolescents. Muscle aches, joint pain, and elevated creatine phosphokinase (CPK) may occur, potentially increasing risk of injury during vigorous physical activity. Pancreatitis: Discontinue therapy immediately if symptoms of pancreatitis (e.g., severe abdominal pain, vomiting) occur, especially if accompanied by hypertriglyceridemia. Photosensitivity: Increased susceptibility to sunburn is common. Patients should be advised to use sunscreen and protective clothing.
Contraindications
- Pregnancy, breastfeeding, and women who may become pregnant during or within one month of treatment who are unable or unwilling to comply with strict contraceptive measures.
- Hypersensitivity to isotretinoin, other retinoids, or any component of the formulation (including soya lecithin).
- Severely elevated baseline serum triglycerides or hyperlipidemia.
- Concomitant use of tetracyclines due to increased risk of pseudotumor cerebri.
Possible side effect
Very Common (>1/10): Cheilitis (dry, cracked lips), dry skin, dry nasal mucosa (potentially leading to epistaxis), conjunctivitis, dry eyes, pruritus, palmoplantar desquamation, increased skin fragility, facial dermatitis, thinning of hair. Common (1/10 to 1/100): Rash, skin infections, nonspecific gastrointestinal symptoms, headache, arthralgia, myalgia, fatigue, elevated serum triglycerides and cholesterol, transient elevation of liver transaminases. Uncommon (1/100 to 1/1000): Hepatitis, inflammatory bowel disease, corneal opacities, hearing impairment, severe skin reactions (e.g., erythema multiforme, Stevens-Johnson syndrome), Gram-positive bacterial infections, hyperuricemia, glomerulonephritis. Rare (<1/1000): Idiopathic intracranial hypertension (pseudotumor cerebri), severe birth defects, psychosis, depression, suicidal ideation, aggression, pancreatitis, vasculitis.
Drug interaction
- Tetracyclines (e.g., doxycycline, minocycline): Concurrent use is contraindicated due to a significantly increased risk of pseudotumor cerebri.
- Vitamin A Supplements: Concomitant use must be avoided due to additive toxic effects and risk of hypervitaminosis A.
- Systemic Corticosteroids: May potentiate the risk of osteoporosis or other adverse skeletal effects.
- Phenytoin: Isotretinoin may decrease serum levels of phenytoin.
- St. John’s Wort: May reduce the effectiveness of hormonal contraceptives, compromising the pregnancy prevention program.
Missed dose
If a dose is missed, it should be skipped and the next dose taken at the regular time. The patient should never take a double dose to make up for the missed one. Maintaining a consistent dosing schedule with meals is important for optimal absorption and efficacy.
Overdose
Symptoms of acute overdose are consistent with hypervitaminosis A, including vomiting, facial flushing, cheilitis, abdominal pain, headache, dizziness, and ataxia. The drug is highly protein-bound; therefore, dialysis is unlikely to be beneficial. Treatment is supportive and symptomatic. Medical attention should be sought immediately.
Storage
Store at room temperature (below 25°C/77°F) in a dry place, protected from light and moisture. Keep the blister strips in the outer carton until use. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging.
Disclaimer
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your dermatologist or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here. The use of Tretiva must be managed by a qualified physician familiar with its risks, benefits, and monitoring requirements.
Reviews
- “As a dermatologist with over 20 years of practice, Tretiva has been a cornerstone in managing severe cystic acne. The transformation in patients’ skin and, more importantly, their self-esteem, is profound. Rigorous patient selection and monitoring are non-negotiable.” – Dr. A. Sharma, MD (Dermatology)
- “After struggling with severe acne for a decade and failing multiple antibiotics, a 6-month course of Tretiva changed my life. The side effects were challenging (extremely dry lips and skin), but the results were worth it. My skin has been clear for two years now.” – Patient M, 28.
- “The pharmacokinetic profile is reliable, and I find it to be consistently effective in achieving treatment goals. The mandatory iPledge program in the US, while complex, is a critical component of ensuring safe use in female patients.” – Clinical Pharmacist, Specializing in Dermatology.
- “The psychological burden of my acne was immense. Tretiva was a difficult journey with monthly blood tests and dry skin, but it was the only thing that worked. I wish I had started it sooner.” – Patient K, 22.
- “From a formulary perspective, Tretiva offers a cost-effective alternative to the reference-listed drug while maintaining bioequivalence. Its inclusion has improved patient access to this essential therapy.” – Hospital Pharmacy Director.