Active Ingredients: Isotretinoin
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Therefore, even if a patient takes the proper daily dosage and duration of oral isotretinoin, the lack of co-ingestion with food, especially with high-fat food intake, will lower GI absorption and could adversely affect both efficacy and relapse.
Being able to take isotretinoin in the absence of a high-fat meal without an adverse effect on GI absorption of the drug could be beneficial to adolescents and young adults. Most patients who take isotretinoin for AV are over 14 years of age, with an average age of 22 years.
Breakfast consumption during the teenage years is alarmingly inconsistent.
In a survey of 1,001 high school students with a mean age of 16. Common reasons cited for skipping breakfast included lack of time, lack of hunger, or dieting to lose weight. Skipping breakfast was more prevalent in girls and in older children and adolescents.
In fact, it has been estimated that if all doses of isotretinoin were given during a complete fast, the dose would be effectively reduced by one-third to one-half compared with dosing in the presence of a meal. The Global Alliance to Improve Outcomes in Acne used a validated questionnaire to assess the risk of poor adherence in patients receiving treatment for AV from the Americas, Europe, and Asia and reported an overall adherence rate of only 50 percent.
Although reasons for poor adherence were examined, they were not stratified according to the type of treatment for AV. Therefore, it is unknown if and to what extent food intake contributed to poor adherence.
References 1. Systemic retinoids. In: Wolverton SE, editor. Comprehensive Dermatologic Drug Therapy.