New Formulations of Isotretinoin for Acne Treatment: Expanded Options and Clinical Implications.

BACKGROUND

Isotretinoin is a widely used and effective drug in the treatment of severe, recalcitrant, nodular acne. However, its poor aqueous solubility limits oral bioavailability and requires administration with a high-fat, high-calorie meal (HF/HC) for optimal absorption; poor patient adherence may decrease effective dosing and treatment efficacy.

OBJECTIVE

This review covers the properties of the lidose isotretinoin and micronized isotretinoin formulations and their use in acne therapy.

METHOD OF LITERATURE SEARCH

PubMed was searched using the terms , , , , and Additional articles were searched using reference lists from the obtained results.

RESULTS

Our review discusses pathology and approved treatment options for acne; provides mechanism of action of isotretinoin; presents clinical challenges associated with isotretinoin safety; and summarizes implications in clinical practice. Newer formulations show enhanced bioavailability in both fed and fasting states.

LIMITATIONS

Few published studies of real-world use of the identified formulations were available.

CONCLUSION

Newer drug delivery technologies can simplify isotretinoin use while maximizing bioavailability and efficacy. Based on our analysis, lidose isotretinoin and micronized isotretinoin improve oral bioavailability, pharmacological bioactivity, and increase therapeutic efficacy in patients who are unwilling or unable to consistently take the medication with an HF/HC meal. Healthcare providers should consider these formulations as tools to optimize treatment based on each patient's individual needs.