new guidelines for accutane usage

[Guest guest]

Has anyone heard about new limitations on accutane treatment in the US? A

client of mine was told by her derm yesterday that in a few weeks only the

most severe acne patients will be allowed to receive accutane. She claims

there is an actual cyst requirement ( a number) you have to meet so she won't

be able to use it on as many people as she'd like to any more. Does this

affect the low dose treatment for rosacea or the just the regular strength

acne vulgaris treatment?

Jana

[Guest guest]

I'll be the first to admit that I am NOT an expert on the subject, but I

don't think thats entirely accurate. I am pretty sure that accutane has

lead to several deaths. A few people on it actually committed suicide

because it caused really bad depression. In low doses used for cea, the

potential for side effects is much lower than in these high doses, but

Accutane does have alot of dangerous side effects (Although I am completely

unclear as to whether or not any of these pose a significant risk at low

enough doses, maybe they dont) and the side effects are probably why

accutane is being restricted.

It seems to have SO many benefits for all sorts of different skin disorders,

but its not candy or anything. I dont think its safe to buy online. You

should be having monthly? tests for either your kidneys or liver (I cant

remember which one Accutane might damage... but I know its a risk for one of

them)

[Guest guest]

I'll be the first to admit that I am NOT an expert on the subject, but I

don't think thats entirely accurate. I am pretty sure that accutane has

lead to several deaths. A few people on it actually committed suicide

because it caused really bad depression. In low doses used for cea, the

potential for side effects is much lower than in these high doses, but

Accutane does have alot of dangerous side effects (Although I am completely

unclear as to whether or not any of these pose a significant risk at low

enough doses, maybe they dont) and the side effects are probably why

accutane is being restricted.

It seems to have SO many benefits for all sorts of different skin disorders,

but its not candy or anything. I dont think its safe to buy online. You

should be having monthly? tests for either your kidneys or liver (I cant

remember which one Accutane might damage... but I know its a risk for one of

them)

[Guest guest]

I'll be the first to admit that I am NOT an expert on the subject, but I

don't think thats entirely accurate. I am pretty sure that accutane has

lead to several deaths. A few people on it actually committed suicide

because it caused really bad depression. In low doses used for cea, the

potential for side effects is much lower than in these high doses, but

Accutane does have alot of dangerous side effects (Although I am completely

unclear as to whether or not any of these pose a significant risk at low

enough doses, maybe they dont) and the side effects are probably why

accutane is being restricted.

It seems to have SO many benefits for all sorts of different skin disorders,

but its not candy or anything. I dont think its safe to buy online. You

should be having monthly? tests for either your kidneys or liver (I cant

remember which one Accutane might damage... but I know its a risk for one of

them)

[Guest guest]

everyone can read about the dumb S.M.A.R.T. program at roche's

website or the fda website. basically, a prescriber must certify he

understands that women should be on two forms of contraception, etc.,

has some sort of clue about how to treat acne, and send in for some

yellow stickers. these stickers certify for females that she had the

requisite number of pregnancy tests, saw the roche video, and is

certified to have her rx filled. males get the same yellow sticker

but a box marked male is checked. rx must be filled within 7 days of

date of yellow sticker certification -- and only for a one month

supply. anyone can still be prescribed accutane, off label uses

included, but the real onersome burden is you cannot presribe

refills, phone in rx, and the written rx must have the yellow

sticker. I'm am guessing a lot of low dose accutane patients may get

a rx for accutane 10 mg, quantity 40, sig one capsule qid, of which

the pharmacist may or not meddle. otherwise everyone not using

something like europharmacy.com which sells 30 roaccutane 10mg for

less than 20 euros (less than 20 us dollars at the conversion rate)

will have to be making their way in to a dermatologist every month.

btw, roche, located in switzerland, sells roaccutane much much less

in europe, mexico, and canada than it does in the usa!!

the conspiracy theory is now that roche's patent for accutane

expired, in order to make it so onerous for a generic company to get

the massive usa market, they started this SMART program under the

guise of teratogenic prevention (wonder why they waited over 20

years -- if teratogenic effects bothered them this much) and so they

won't get sued in the USA, and to make it impossible for another

pharmacutical company to market accutane in the usa and take away all

that money they're storing in their secret numbered swiss accounts

after funneling it back to switzerland after finding some loophole in

order not to pay/write off any us taxes they owe to the irs...

btw, if you can walk across the border to mexico, you can bring back

a 90 d supply of accutane rx free, no questions asked.

> Has anyone heard about new limitations on accutane treatment in the

US? A

> client of mine was told by her derm yesterday that in a few weeks

only the

> most severe acne patients will be allowed to receive accutane. She

claims

> there is an actual cyst requirement ( a number) you have to meet so

she won't

this is bogus. chalk this right up there with the dermatologist who

didn't know what minocyline was. maybe we should compile a book of

acutal sayings from stupid dermatologists.

> be able to use it on as many people as she'd like to any more.

Does this

> affect the low dose treatment for rosacea or the just the regular

strength

> acne vulgaris treatment?

>

> Jana

>

>

>

[Guest guest]

everyone can read about the dumb S.M.A.R.T. program at roche's

website or the fda website. basically, a prescriber must certify he

understands that women should be on two forms of contraception, etc.,

has some sort of clue about how to treat acne, and send in for some

yellow stickers. these stickers certify for females that she had the

requisite number of pregnancy tests, saw the roche video, and is

certified to have her rx filled. males get the same yellow sticker

but a box marked male is checked. rx must be filled within 7 days of

date of yellow sticker certification -- and only for a one month

supply. anyone can still be prescribed accutane, off label uses

included, but the real onersome burden is you cannot presribe

refills, phone in rx, and the written rx must have the yellow

sticker. I'm am guessing a lot of low dose accutane patients may get

a rx for accutane 10 mg, quantity 40, sig one capsule qid, of which

the pharmacist may or not meddle. otherwise everyone not using

something like europharmacy.com which sells 30 roaccutane 10mg for

less than 20 euros (less than 20 us dollars at the conversion rate)

will have to be making their way in to a dermatologist every month.

btw, roche, located in switzerland, sells roaccutane much much less

in europe, mexico, and canada than it does in the usa!!

the conspiracy theory is now that roche's patent for accutane

expired, in order to make it so onerous for a generic company to get

the massive usa market, they started this SMART program under the

guise of teratogenic prevention (wonder why they waited over 20

years -- if teratogenic effects bothered them this much) and so they

won't get sued in the USA, and to make it impossible for another

pharmacutical company to market accutane in the usa and take away all

that money they're storing in their secret numbered swiss accounts

after funneling it back to switzerland after finding some loophole in

order not to pay/write off any us taxes they owe to the irs...

btw, if you can walk across the border to mexico, you can bring back

a 90 d supply of accutane rx free, no questions asked.

> Has anyone heard about new limitations on accutane treatment in the

US? A

> client of mine was told by her derm yesterday that in a few weeks

only the

> most severe acne patients will be allowed to receive accutane. She

claims

> there is an actual cyst requirement ( a number) you have to meet so

she won't

this is bogus. chalk this right up there with the dermatologist who

didn't know what minocyline was. maybe we should compile a book of

acutal sayings from stupid dermatologists.

> be able to use it on as many people as she'd like to any more.

Does this

> affect the low dose treatment for rosacea or the just the regular

strength

> acne vulgaris treatment?

>

> Jana

>

>

>

[Guest guest]

everyone can read about the dumb S.M.A.R.T. program at roche's

website or the fda website. basically, a prescriber must certify he

understands that women should be on two forms of contraception, etc.,

has some sort of clue about how to treat acne, and send in for some

yellow stickers. these stickers certify for females that she had the

requisite number of pregnancy tests, saw the roche video, and is

certified to have her rx filled. males get the same yellow sticker

but a box marked male is checked. rx must be filled within 7 days of

date of yellow sticker certification -- and only for a one month

supply. anyone can still be prescribed accutane, off label uses

included, but the real onersome burden is you cannot presribe

refills, phone in rx, and the written rx must have the yellow

sticker. I'm am guessing a lot of low dose accutane patients may get

a rx for accutane 10 mg, quantity 40, sig one capsule qid, of which

the pharmacist may or not meddle. otherwise everyone not using

something like europharmacy.com which sells 30 roaccutane 10mg for

less than 20 euros (less than 20 us dollars at the conversion rate)

will have to be making their way in to a dermatologist every month.

btw, roche, located in switzerland, sells roaccutane much much less

in europe, mexico, and canada than it does in the usa!!

the conspiracy theory is now that roche's patent for accutane

expired, in order to make it so onerous for a generic company to get

the massive usa market, they started this SMART program under the

guise of teratogenic prevention (wonder why they waited over 20

years -- if teratogenic effects bothered them this much) and so they

won't get sued in the USA, and to make it impossible for another

pharmacutical company to market accutane in the usa and take away all

that money they're storing in their secret numbered swiss accounts

after funneling it back to switzerland after finding some loophole in

order not to pay/write off any us taxes they owe to the irs...

btw, if you can walk across the border to mexico, you can bring back

a 90 d supply of accutane rx free, no questions asked.

> Has anyone heard about new limitations on accutane treatment in the

US? A

> client of mine was told by her derm yesterday that in a few weeks

only the

> most severe acne patients will be allowed to receive accutane. She

claims

> there is an actual cyst requirement ( a number) you have to meet so

she won't

this is bogus. chalk this right up there with the dermatologist who

didn't know what minocyline was. maybe we should compile a book of

acutal sayings from stupid dermatologists.

> be able to use it on as many people as she'd like to any more.

Does this

> affect the low dose treatment for rosacea or the just the regular

strength

> acne vulgaris treatment?

>

> Jana

>

>

>

[Guest guest]

you don't need any lab work for doses of 10 mg/d. you have more

likelihood of abnormal values by being on full dose minoycline and

you don't need lab work for being on full dose minocyline. odds are

that if you have abnormal lab parameters while on minocin 100 mg bid,

you will normalize if you switch to accutan 10 mg qd and your rosacea

will improve, provided you cut ALL topicals!

important to note that if you are female, you MUST know how to

prevent pregnancy and be on two forms of birth control. cynics

aside, one would be incorrect to assume that having severe

inflammatory rosacea is a form of birth control -- even though it may

seriously impact your dating opportunities...

that being said, anyone on the .5 - 1 mg/kg/d and over, definately

needs what is recommended by roche. per the NEW package insert:

lipids pre accutane and then at 4 wks, more with pts with obesity,

diabets, etoh, metabolic disorder, etc

liver function tests pre accutane and then biweekly until response

has been established

glucose, cpk, CBC, monthly or so

but mainly they care (to protect themselves, remember a deformed baby

is worth more in court than a patient with a bad pancreas) about

sensitive urine/serum monthly preg tests for female pts.

> I'll be the first to admit that I am NOT an expert on the subject,

but I

> don't think thats entirely accurate. I am pretty sure that

accutane has

> lead to several deaths. A few people on it actually committed

suicide

> because it caused really bad depression. In low doses used for

cea, the

> potential for side effects is much lower than in these high doses,

but

> Accutane does have alot of dangerous side effects (Although I am

completely

> unclear as to whether or not any of these pose a significant risk

at low

> enough doses, maybe they dont) and the side effects are probably

why

> accutane is being restricted.

>

> It seems to have SO many benefits for all sorts of different skin

disorders,

> but its not candy or anything. I dont think its safe to buy

online. You

> should be having monthly? tests for either your kidneys or liver (I

cant

> remember which one Accutane might damage... but I know its a risk

for one of

> them)

[Guest guest]

you don't need any lab work for doses of 10 mg/d. you have more

likelihood of abnormal values by being on full dose minoycline and

you don't need lab work for being on full dose minocyline. odds are

that if you have abnormal lab parameters while on minocin 100 mg bid,

you will normalize if you switch to accutan 10 mg qd and your rosacea

will improve, provided you cut ALL topicals!

important to note that if you are female, you MUST know how to

prevent pregnancy and be on two forms of birth control. cynics

aside, one would be incorrect to assume that having severe

inflammatory rosacea is a form of birth control -- even though it may

seriously impact your dating opportunities...

that being said, anyone on the .5 - 1 mg/kg/d and over, definately

needs what is recommended by roche. per the NEW package insert:

lipids pre accutane and then at 4 wks, more with pts with obesity,

diabets, etoh, metabolic disorder, etc

liver function tests pre accutane and then biweekly until response

has been established

glucose, cpk, CBC, monthly or so

but mainly they care (to protect themselves, remember a deformed baby

is worth more in court than a patient with a bad pancreas) about

sensitive urine/serum monthly preg tests for female pts.

> I'll be the first to admit that I am NOT an expert on the subject,

but I

> don't think thats entirely accurate. I am pretty sure that

accutane has

> lead to several deaths. A few people on it actually committed

suicide

> because it caused really bad depression. In low doses used for

cea, the

> potential for side effects is much lower than in these high doses,

but

> Accutane does have alot of dangerous side effects (Although I am

completely

> unclear as to whether or not any of these pose a significant risk

at low

> enough doses, maybe they dont) and the side effects are probably

why

> accutane is being restricted.

>

> It seems to have SO many benefits for all sorts of different skin

disorders,

> but its not candy or anything. I dont think its safe to buy

online. You

> should be having monthly? tests for either your kidneys or liver (I

cant

> remember which one Accutane might damage... but I know its a risk

for one of

> them)

[Guest guest]

you don't need any lab work for doses of 10 mg/d. you have more

likelihood of abnormal values by being on full dose minoycline and

you don't need lab work for being on full dose minocyline. odds are

that if you have abnormal lab parameters while on minocin 100 mg bid,

you will normalize if you switch to accutan 10 mg qd and your rosacea

will improve, provided you cut ALL topicals!

important to note that if you are female, you MUST know how to

prevent pregnancy and be on two forms of birth control. cynics

aside, one would be incorrect to assume that having severe

inflammatory rosacea is a form of birth control -- even though it may

seriously impact your dating opportunities...

that being said, anyone on the .5 - 1 mg/kg/d and over, definately

needs what is recommended by roche. per the NEW package insert:

lipids pre accutane and then at 4 wks, more with pts with obesity,

diabets, etoh, metabolic disorder, etc

liver function tests pre accutane and then biweekly until response

has been established

glucose, cpk, CBC, monthly or so

but mainly they care (to protect themselves, remember a deformed baby

is worth more in court than a patient with a bad pancreas) about

sensitive urine/serum monthly preg tests for female pts.

> I'll be the first to admit that I am NOT an expert on the subject,

but I

> don't think thats entirely accurate. I am pretty sure that

accutane has

> lead to several deaths. A few people on it actually committed

suicide

> because it caused really bad depression. In low doses used for

cea, the

> potential for side effects is much lower than in these high doses,

but

> Accutane does have alot of dangerous side effects (Although I am

completely

> unclear as to whether or not any of these pose a significant risk

at low

> enough doses, maybe they dont) and the side effects are probably

why

> accutane is being restricted.

>

> It seems to have SO many benefits for all sorts of different skin

disorders,

> but its not candy or anything. I dont think its safe to buy

online. You

> should be having monthly? tests for either your kidneys or liver (I

cant

> remember which one Accutane might damage... but I know its a risk

for one of

> them)

[Guest guest]

I am not the biggest Accutane advocate on the planet. I question

whether Accutane usage from what I now believe was pre-rosacea

actually led to a severe case of rosacea down the road.

Having said that, from what I understand, there is little evidence to

support Accutane as a cause of severe depression or suicidal

ideation. Bear in mind, the vast majority of Accutane users are

adolescents and young adults. I believe the *overall* suicide rate is

highest among this age group to begin with and, from what I've read

on the subject, the suicide rate among Accutane users in that age

group is actually lower than that of non-users in the same age group.

I really believe there is a bit of media hysteria here brought on and

possibly funded by the fierce competition in the pharmaceutical

industry and politicians seeking pet causes to advance their careers.

I hate to sound cynical, but my experience with this condition,

coupled with some insight into the NRS/Galderma relationship has

really changed my perception of the industry.

As there are medical studies that support the usage of low dose

accutane for some rosacea sufferers, I hate to see the FDA eliminate

this as a treatment option for us when we have so few options in the

first place. It may not be a medicine I would choose, but I hate to

take away anyone's option to use it should they wish to do so.

Informed consent should be the rule of law IMO.

> I'll be the first to admit that I am NOT an expert on the subject,

but I

> don't think thats entirely accurate. I am pretty sure that

accutane has

> lead to several deaths. A few people on it actually committed

suicide

> because it caused really bad depression. In low doses used for

cea, the

> potential for side effects is much lower than in these high doses,

but

> Accutane does have alot of dangerous side effects (Although I am

completely

> unclear as to whether or not any of these pose a significant risk

at low

> enough doses, maybe they dont) and the side effects are probably

why

> accutane is being restricted.

>

> It seems to have SO many benefits for all sorts of different skin

disorders,

> but its not candy or anything. I dont think its safe to buy

online. You

> should be having monthly? tests for either your kidneys or liver (I

cant

> remember which one Accutane might damage... but I know its a risk

for one of

> them)

[Guest guest]

I am not the biggest Accutane advocate on the planet. I question

whether Accutane usage from what I now believe was pre-rosacea

actually led to a severe case of rosacea down the road.

Having said that, from what I understand, there is little evidence to

support Accutane as a cause of severe depression or suicidal

ideation. Bear in mind, the vast majority of Accutane users are

adolescents and young adults. I believe the *overall* suicide rate is

highest among this age group to begin with and, from what I've read

on the subject, the suicide rate among Accutane users in that age

group is actually lower than that of non-users in the same age group.

I really believe there is a bit of media hysteria here brought on and

possibly funded by the fierce competition in the pharmaceutical

industry and politicians seeking pet causes to advance their careers.

I hate to sound cynical, but my experience with this condition,

coupled with some insight into the NRS/Galderma relationship has

really changed my perception of the industry.

As there are medical studies that support the usage of low dose

accutane for some rosacea sufferers, I hate to see the FDA eliminate

this as a treatment option for us when we have so few options in the

first place. It may not be a medicine I would choose, but I hate to

take away anyone's option to use it should they wish to do so.

Informed consent should be the rule of law IMO.

> I'll be the first to admit that I am NOT an expert on the subject,

but I

> don't think thats entirely accurate. I am pretty sure that

accutane has

> lead to several deaths. A few people on it actually committed

suicide

> because it caused really bad depression. In low doses used for

cea, the

> potential for side effects is much lower than in these high doses,

but

> Accutane does have alot of dangerous side effects (Although I am

completely

> unclear as to whether or not any of these pose a significant risk

at low

> enough doses, maybe they dont) and the side effects are probably

why

> accutane is being restricted.

>

> It seems to have SO many benefits for all sorts of different skin

disorders,

> but its not candy or anything. I dont think its safe to buy

online. You

> should be having monthly? tests for either your kidneys or liver (I

cant

> remember which one Accutane might damage... but I know its a risk

for one of

> them)

[Guest guest]

I am not the biggest Accutane advocate on the planet. I question

whether Accutane usage from what I now believe was pre-rosacea

actually led to a severe case of rosacea down the road.

Having said that, from what I understand, there is little evidence to

support Accutane as a cause of severe depression or suicidal

ideation. Bear in mind, the vast majority of Accutane users are

adolescents and young adults. I believe the *overall* suicide rate is

highest among this age group to begin with and, from what I've read

on the subject, the suicide rate among Accutane users in that age

group is actually lower than that of non-users in the same age group.

I really believe there is a bit of media hysteria here brought on and

possibly funded by the fierce competition in the pharmaceutical

industry and politicians seeking pet causes to advance their careers.

I hate to sound cynical, but my experience with this condition,

coupled with some insight into the NRS/Galderma relationship has

really changed my perception of the industry.

As there are medical studies that support the usage of low dose

accutane for some rosacea sufferers, I hate to see the FDA eliminate

this as a treatment option for us when we have so few options in the

first place. It may not be a medicine I would choose, but I hate to

take away anyone's option to use it should they wish to do so.

Informed consent should be the rule of law IMO.

> I'll be the first to admit that I am NOT an expert on the subject,

but I

> don't think thats entirely accurate. I am pretty sure that

accutane has

> lead to several deaths. A few people on it actually committed

suicide

> because it caused really bad depression. In low doses used for

cea, the

> potential for side effects is much lower than in these high doses,

but

> Accutane does have alot of dangerous side effects (Although I am

completely

> unclear as to whether or not any of these pose a significant risk

at low

> enough doses, maybe they dont) and the side effects are probably

why

> accutane is being restricted.

>

> It seems to have SO many benefits for all sorts of different skin

disorders,

> but its not candy or anything. I dont think its safe to buy

online. You

> should be having monthly? tests for either your kidneys or liver (I

cant

> remember which one Accutane might damage... but I know its a risk

for one of

> them)