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I believe Accutane He does have some other issues like low B, D, vitamins , cholesterol My question is, Should I even worry about taking the antibiotic if I am going to take the Accutane I am currently taking Isotretinoin accutane , but I m supposed to be having a LeFort I Maxillofacial surgery in a month. No one mentioned that I need to stop taking accutane , but everything I m My baseline liver test was ALT and AST pre accutane and after one month the went to after two months on accutane.
How bad is this? I ve tried Accutane , but had such severe mood swings, I took myself off it. Looking for alternative to Accutane , which is supposed to clear acne up permanently, but without mood swings Coronavirus Doctor Consultation Are you a Doctor?
Login Register. Your Name :. Your e-mail :. Password :. Confirm Password :. Remember me. Sunday, August 31, Day 10 -- Joyous rib pain. The side effects are really kicking in now. My lips are still just semi-dry, but the Aquaphor has really been helping to keep them in good shape.
My ribs and back are actually suffering the most, and I never even knew it was possible for a person's ribs to hurt like this. It's not excrutiating by any means, but it's still not fun. Sleeping sucks too because my back gives me the most trouble then. I'm sure the fact that I've been sleeping on a couch for the past 2 months doesn't help, but it's just too hot for us in the bedroom right now. I haven't felt sad or irritable at all so far, which is REALLY odd because I've been struggling with depression for quite some time now.
I think the reason I don't feel shitty is because I'm really hopeful about being on 'tane and finally having a chance at clear skin. My "initial breakout" thus far has still just been whiteheads. This site complies with the HONcode standard for trustworthy health information: verify here. This content does not have an English version. This content does not have an Arabic version. See more conditions. Drugs and Supplements Isotretinoin Oral Route.
Products and services. Thank you for subscribing! Sorry something went wrong with your subscription Please, try again in a couple of minutes Retry. We study 33, people who take Accutane or have Rib cage pain. No report of Rib cage pain is found in people who take Accutane. With medical big data and AI algorithms, eHealthMe enables everyone to run phase IV clinical trial to detect adverse drug outcomes and monitor effectiveness. Accutane has active ingredients of isotretinoin.
It is often used in acne. Rib cage pain is found to be associated with 3 conditions by eHealthMe. You can discuss the study with your doctor, to ensure that all drug risks and benefits are fully discussed and understood.
By proceeding, I accept the Terms and Conditions. Could the costochondritis been caused from taking the accutane View answer. How long time i should waite before conception after the last dose of accutane? Taking 40 mg accutane for 2 months Alkaline phophatase normal 17 yr old male Other readings normal Should I continue or reduce dose or stop taking accutane My son was on Accutane 2 years ago, and always had some lip issues, but about 6 months ago. I believe Accutane He does have some other issues like low B, D, vitaminscholesterol My question is, Should I even worry about taking the antibiotic if I am going to take the Accutane I am currently taking Isotretinoin accutanebut I m supposed to be having a LeFort I Maxillofacial surgery in a month.
No one mentioned that I need to stop taking accutanebut everything I m My baseline liver test was ALT and AST pre accutane and after one month the went to after two months on accutane. How bad is this? I ve tried Accutanebut had such severe mood swings, I took myself off it. Looking for alternative to Accutanewhich is supposed to clear acne up permanently, but without mood swings Coronavirus Doctor Consultation Are you a Doctor?
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Please write your question below. Doctors waiting to answer your question. Premium Questions What are the side effects of long term intake of Accutane? View answer Answered by : Dr. Panagiotis Zografakis Internal Medicine Specialist. Is it safe to concieve after twenty months of last dose of accutane? Taking accutane. Test showed elevated alkaline phosphatase level. Should I stop taking medicine? Tanusree Biswas Dermatologist. What causes unexplained swollen lips? Took accutane, tried to masturbate and had erection problem.
Side effect? Anjana Rao Kavoor Psychiatrist. Read More About to start the drug Accutane 20mg. Should I take antibiotics to kill the bacteria in pours first? Neera Kataria Dermatologist. Can accutane be taken along with Maxillofacial surgery in mouth? Mahesh Kumar T S Dentist. What causes less platelet count while taking Accutane? How dangerous is this?
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localhost › comments › bmt › sore_. Sore ribs? Hello all, I'm on day 10 of 30 mg and for about days now I've had a lot of soreness in my rib cage. Discover short videos related to accutane rib pain on TikTok. Explore the latest videos from hashtags: #accutane, #accutespinalpain, #acutanepain, #ribpain. Sore ribs? Hello all, I'm on day 10 of 30 mg and for about days now I've had a lot of soreness in my rib cage. Bone marrow edema consistent with sacroiliitis was detected by sacroiliac MRI in 11 patients with inflammatory back pain. The median total. All participants were firstly assessed by a dermatologist. Taking 40 mg accutane for 2 months Alkaline phophatase normal 17 yr old male Other readings normal Should I continue or reduce dose or stop taking accutane Accepted : 18 September Forgot Password? Table 4 The results of linear regression analysis between the age, sex, cumulative dose of isotretinoin, duration of treatment and musculoskeletal side effects Full size table.Metrics details. Acne vulgaris is a chronic inflammatory disease affecting the pilosebaceous unit. Isotretinoin is an effective treatment option for severe acne.
The aim of this study was to evaluate musculoskeletal side effects of systemic isotretinoin treatment. Ninety-four patients with acne vulgaris and sex- and age-matched controls were enrolled in this study.
Only the patients who had musculoskeletal symptoms were evaluated in this study. All participants were firstly assessed by a dermatologist. The patients were asked whether they had any musculoskeletal symptoms after isotretinoin treatment, if so, the feature and duration of the symptoms were recorded. The dosage of the drug, treatment duration, incidence of arthralgia, myalgia, low back pain, sacroiliitis and tendinopathy and laboratory test results were noted.
The severity of pain was assessed by visual analog scale VAS. Of the 94 patients, 71 were female and 23 were male. Bone marrow edema consistent with sacroiliitis was detected by sacroiliac MRI in 11 patients with inflammatory back pain. Low back pain is one of the very common complications of isotretinoin. It can be mostly mechanical or inflammatory. Isotretinoin-induced low back pain is dose-related, and inflammatory back pain without sacroiliitis is also frequent.
The clinicians should be aware of the back pain may be a reflective of sacroiliitis during isotretinoin usage. Peer Review reports. Acne vulgaris is a chronic inflammatory disease affecting the pilosebaceous unit with multifactorial etiology [ 1 ]. Isotretinoin is an effective treatment option for severe acne vulgaris. Isotretinoin has a wide spectrum of side effects, including multiorgan systems such as reproductive, mucocutaneous, ocular, neurological, musculoskeletal and hepatic systems.
It may also cause several musculoskeletal side effects such as arthralgia, myalgia, back pain, spondyloarthropathy-related symptoms and sacroiliitis [ 1 , 2 , 3 ]. Other uncommon musculoskeletal disorders related with isotretinoin are hyperostosis, extraspinal calcifications, enthesitis, arthritis, costochondritis, osteoporosis, growth retardation, premature epiphyseal closure in children and as well as gout [ 3 , 6 , 7 , 8 ].
In the literature, there are only a few original studies investigating the musculoskeletal side effects of isotretinoin [ 1 , 2 , 9 , 10 ]. Furthermore, there are many case reports or case series indicating the musculoskeletal side effects of isotretinoin [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ].
The majority of the recently performed studies are the case studies regarding with isotretinoin-induced sacroiliitis [ 11 , 13 , 16 , 18 , 20 ]. To the best our knowledge, there is no controlled study investigating the presence of isotretinoin-related musculoskeletal side effects with a wide spectrum such as arthralgia, myalgia, low back pain, sacroiliitis, tendinopathy and enthesopathy. In previous studies, the incidence of sacroiliitis and back pain were the most detected parameters [ 1 , 2 , 10 ].
The primary aim of this study was to evaluate and emphasize the musculoskeletal side effects of systemic isotretinoin treatment in patients with acne vulgaris and to compare them with healthy controls. The second aim was to elucidate clinicians regarding with isotretinoin-induced musculoskeletal symptoms.
A total of 94 patients with moderate to severe acne vulgaris treated with systemic isotretinoin and sex- and age-matched controls who were admitted to Ankara Training and Research Hospital, Department of Dermatology, between September and April were enrolled in this cross-sectional study.
The local ethics committee approved the study. All participants were informed about the study and their written consent form was obtained. Isotretinoin group included the patients under isotretinoin treatment for acne vulgaris, but had no history of rheumatologic syndromes.
The control group was selected from among health professionals who had received a routine medical checkup in the hospital. Exclusion criteria for this study were the presence of any chronic rheumatological, dermatological diseases or any patients with a history of mechanical back pain, inflammatory back pain, sacroiliitis, enthesitis, before starting isotretinoin, history suggestive of spondyloarthropathies reactive arthritis, ankylosing spondylitis, inflammatory bowel disease, and psoriasis , or systemic autoimmune disorders.
Also, the patients with depression or similar psychiatric diseases, had renal and liver function disorders, those who were pregnant or using any systemic drugs for other diseases, were not included. All participants were firstly evaluated by a dermatologist and questioned carefully about the musculoskeletal symptoms. Only the patients who had musculoskeletal symptoms such as myalgia, arthralgia, back pain were determined and enrolled in the study.
They were referred to the physical medicine and rehabilitation department and examined by a specialist. Sociodemographic information, including age, sex, history of drug use dose and duration , history of chronic diseases were recorded. A detailed anamnesis was obtained and a careful dermatological and physical examination was performed by both of the specialists.
It was queried that whether myalgia, arthralgia and low back pain occurred after starting isotretinoin treatment. Data were recorded on a standardized pre-prepared evaluation form. The pain severity of the participants was evaluated by visual analog scale VAS based on a chart numbered from 0 no symptom to 10 maximum severity. According to GAGS, the body was divided into six regions -forehead, nose, each cheek, chin and back.
In each region, each type of lesion is given a number: zero for no lesion, one for comedones, two for papules, three for pustules and four for nodules. It was investigated that whether there was a enthesitis by a detailed clinical examination. The following entheses were examined for tenderness and swelling bilaterally: common extensor tendon insertion on the lateral epicondyle of the humerus, quadriceps tendon, patellar tendon, tibial tuberosity, knee medial collateral ligament, Achilles tendon, and plantar fascia insertion on the calcaneus [ 23 ].
If there was a swelling and erythema, it was considered as inflammatory enthesitis. The absence of swelling or erythema was considered to be mechanical enthesitis. The ASAS criteria consist of commencement under the age of 40, insidious onset, relief with exercise, no relief with rest and nocturnal pain improving with rising up from bed. These 4 items are essential in diagnosing inflammatory low back pain. The various imaging modalities, including conventional radiography, computed tomography CT , magnetic resonance imaging MRI and bone scintigraphy are used for investigation of inflammatory changes at the sacroiliac joints.
In early and acute stages of sacroiliitis the diagnosis can be difficult because conventional radiographs may be normal.
Inflammatory back pain is not a specific indicator of sacroiliitis. Therefore, there is need for valuable imaging methods. Scintigraphy lacks specificity. CT is a very good method for visualization of established bony destruction or ossification.
MRI can identify both inflammation and structural changes, localise different degrees of inflammation and bone marrow edema, and differentiate a possible septic sacroiliitis. MRI is the most sensitive and specific modality for sacroiliitis by directly imaging changes in the synovium, articular cartilage, and subchondral bone [ 26 , 27 , 28 ].
In our study, the patients meeting ASAS criteria for inflammatory back pain were evaluated in detail and requested both sacroiliac radiography and sacroiliac MRI.
Sacroiliac MRI was performed on 1. At least 12 slices of coronal oblique T1-weighted turbo spin-echo and short tau inversion recovery STIR sequences of the sacroiliac joints were acquired. This images were interpreted by the same reader who had received standardized training and were blinded with regard to the study groups.
In addition, laboratory blood tests including rheumatoid factor RF , erythrocyte sedimentation rate ESR and c-reactive protein CRP values were requested. Anti-nuclear antibody ANA was ordered to rule out other connective tissue diseases.
Data were analyzed using SPSS software version The normality of the data was tested by Kolmogorov-Smirnov test. For the comparison of the paired groups, the independent samples t-test normal distribution and the Mann-Whitney U test non-normal distribution were used for the quantitative data.
Chi-squared test was used to evaluate whether there was a difference in terms of musculoskeletal symptoms between the study groups. This case-control study included 94 71 women, 23 men patients with acne vulgaris receiving isotretinoin and 74 women, 26 men age- and sex-matched controls. The age and sex distributions of the study and control groups are presented in Table 1. All of the tendinopathies were mechanical feature, swelling or erythema was not observed.
The flow chart of the participants was presented in Fig. The median duration of treatment was 3 min. There was a total of 66 patients The clinical characteristics of both isotretinoin group and healthy controls can be seen in Table 2. The median duration of treatment was 3 IQR: 3, min.
The comparison of the patients who had musculoskeletal symptoms or not in isotretinoin group regarding as total cumulative dose of drug were given in Table 3.
The results of linear regression analysis between the age, sex, duration of treatment and cumulative dose of drug with musculoskeletal side effects were shown in Table 4. The sacroiliac radiography was normal in all of the patients with inflammatory back pain. In sacroiliac MRI, sacroiliitis was observed in 11 Semicoronal short tau inversion recovery STIR images show hyperintense lesions arrows consistent with bone marrow edema in bilateral sacroiliac joints.
Semicoronal T1-weighted spin-echo image shows signal loss arrows in sacroiliac joints consistent with sacroiliitis. The patients who developed rheumatologic symptoms during isotretinoin usage were called to follow-ups by monthly. They were evaluated by a specialist and physical examination was performed at each time they came to control. VAS scores of the patients were also assessed at each follow-up.
In addition, routine biochemical blood tests were acquired from all of the patients in isotretinoin group. The patients who developed musculoskeletal symptoms such as mechanical back pain, arthralgia, myalgia or tendinopathy, except for sacroiliitis were initiated a nonsteroidal antiinflammatory drugs NSAID and continued a lower dose of isotretinoin. In patients who were diagnosed as sacroiliitis, the drug was discontinued immediately and a NSAID was prescribed.
We observed that the complaints of these patients were resolved within a month after cessation of the drug and VAS scores were also decreased dramatically. The symptoms were mostly disappeared by the third month. All the patients with sacroiliitis were completely symptom free at the sixth month of the discontinuation of the drug. Isotretinoin, or cis retinoic acid, is a vitamin A derivative used for severe recalcitrant acne since Although isotretinoin is a very effective drug, it may have many side effects.
It is essential that the clinician should be careful about the various side effects of the drug [ 30 ]. In this study, we focused on the musculoskeletal side effects of isotretinoin. Ninety-four patients treated with isotretinoin suffering from musculoskeletal pain were included. The patients were then examined in detail.
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