Indications & Dose: ACNE TP Adult Gel (0.05%): Apply sparingly once/twice daily, therapeutic response may not be evident for 6-8 wk | RECALCITRANT NODULAR ACNE PO Adult 0.5-1mg/kg/day in 2 divided doses (dosages as low as 0.05mg/kg/day have been reported to be beneficial) for 15-20 wk or until the total cyst count decreases by 70%. Adjust dose up to 2mg/kg/day in severe disease/scarring/if trunk is involved. Second course may be initiated after a period of > 2 months off therapy Child 12-17 yr: Same as adult dose

Precautions: Should not donate blood during/1 month after stopping therapy, renal impairment, history of depression, affect the performance of skilled tasks such as driving, children <12 yr, avoid excessive exposure to sunlight & UV light, avoid contact with eyes/mouth/other mucous surfaces, should not be applied to eczematous/sunburnt/abraded skin/other topical treatment, especially with keratolytics

ADR: Serious: Chest pain, edema, flushing, palpitation, stroke, tachycardia, vascular thrombotic disease, arthritis, cataracts, color vision disorder, tinnitus, glomerulonephritis, bronchospasm, respiratory infect, allergic reactions, colitis & esophagitis, IBD, pancreatitis, blood disorders, hepatitis, TC level increased, Others: blood glucose increased, arthralgia, aggressive behavior, depression, dizziness, drowsiness, emotional instability, headache, insomnia, lethargy, malaise, paresthesia, seizure, suicidal ideation, alopecia, cutaneous allergic reactions, fragility of skin, hirsutism, rash

DDI: Serious Tetracyclines causes pseudotumour cerebri (benign intracranial HTN), Ritonavir/Indinavir leads to drug toxicity & reduced plasma levels of retinoic acid, Vit A over dosage my occur, Alcohol reduces drug effect markedly

Diet: With food

Monitor: CBC with DC & platelet count, ESR, glucose, CPK, signs of depression, mood alteration, psychosis, aggression, severe skin reactions, pregnancy test, LFT, Lipid profile