Isotretinoin 20 (Tretiva 20 Capsule)

Tretiva 20 Capsule, containing Isotretinoin 20 mg, is a prescription retinoid by Intas Pharmaceuticals Ltd. Available in strips of 10 soft gelatin capsules, it treats severe acne (nodular, cystic) unresponsive to other therapies in adults and adolescents ≥12 years. Requires a prescription due to serious risks, including teratogenicity, psychiatric effects, and liver toxicity.

Uses

• Treats severe acne (nodulocystic, conglobate) resistant to antibiotics or topical treatments

• Manages acne with scarring risk or significant psychological distress

• Off-label: Treats rosacea, folliculitis, or seborrheic dermatitis (as prescribed)

Side Effects

• Common: Dry skin/lips/eyes, nosebleeds, peeling, joint/muscle pain, photosensitivity

• Rare: Headache, hair thinning, fatigue, elevated triglycerides/cholesterol

• Serious: Teratogenicity (severe birth defects), depression/suicidal thoughts, liver damage (jaundice), pseudotumor cerebri (severe headache, vision changes), inflammatory bowel disease flare, severe allergic reactions

Seek emergency help for severe depression, vision changes, or allergic reactions. Consult a doctor for persistent side effects.

How to Use

• Dosage: Adults/adolescents ≥12 years: 0.5–1 mg/kg/day (e.g., 20–40 mg for 60 kg person), divided into 1–2 doses, with food for 4–6 months. Max cumulative dose: 120–150 mg/kg. Adjust for tolerance.

• Administration: Swallow whole with a high-fat meal to enhance absorption. Do not crush/chew.

• Missed Dose: Take as soon as remembered unless near next dose; do not double dose.

• Overdose: Seek urgent help for symptoms like headache, vomiting, or flushing. Call Poison Help (1-800-222-1222).

How Capsule Works Tretiva 20 Capsule

Isotretinoin, a vitamin A derivative, reduces sebum production by shrinking sebaceous glands, normalizes keratinization to prevent clogged pores, decreases Propionibacterium acnes growth, and exerts anti-inflammatory effects. It clears severe acne and prevents scarring, with effects visible in 1–2 months and lasting post-treatment in most cases.

Safety Advice

• Allergies: Avoid if allergic to Isotretinoin, vitamin A, or excipients (e.g., soybean oil, parabens).

• Health Conditions: Contraindicated in pregnancy, breastfeeding, liver disease, hyperlipidemia, or hypervitaminosis A. Caution in depression, diabetes, or inflammatory bowel disease.

• Drug Interactions:

  • Avoid tetracyclines (e.g., doxycycline; risk of pseudotumor cerebri).

  • Reduces efficacy of oral contraceptives; use two contraception methods.

  • Increased bleeding risk with Eliquis (Apixaban).

  • List all medications to doctor.

• Pregnancy/Breastfeeding: Highly teratogenic; avoid in pregnancy (mandatory negative pregnancy test before/during use). Use two contraception methods 1 month before, during, and 1 month after treatment. Avoid breastfeeding (excreted in milk).

• Driving: Avoid at night if vision impaired or dizzy.

• Alcohol: Avoid; increases liver toxicity and triglyceride risks.

• Storage: Store at 20–25°C, away from light, moisture, and children.