Ignoring the elephant in the room—overregulated isotretinoin and unregulated dietary supplements in the United States

Physiological and Psychological Effects of Isotretinoin in the Treatment of Patients with Acne: A Narrative Review

“… 114 Because of the difficulty of accessing ISO, patients may turn to over-The-counter dietary vitamin A supplements. 115 Cook et al 116 proved that at doses of 50,000–300,000 IU daily, vitamin A probably supply a second choice for acne management when ISO is unavailable. However, vitamin A was not considered safe enough to be reused because it was easily available and could not be strictly monitored.…”

“…That means there was a big security risk, the iPledge risk evaluation and mitigation strategy and other programs must actively solve workflow concerns and predict changes that threaten patient access to medication, even in changes. 115 Doctors should also do a better job of advising acne patients on medications to avoid tragedies. Vitamin D can act as an immunomodulator, regulating the proliferation and differentiation of keratinocytes and sebum cells, and https://doi.org/10.2147/CCID.S416267…”

Isotretinoin: 40 years of experience

“…Teratogenost molekula je u prvim godinama obustavila razvoj leka, a kasnije i dovela do opravdane akcije regulatornih tela na upozoravanju i edukaciji pacijentkinja. No, čini se da je ova akcija imala za posledicu i strah pacijenata da uopšte započnu terapiju, a sa druge strane i preteranu upotrebu drugih derivata vitamina A koji se na tržištu nalaze kao suplementi i kao takvi ne podležu istoj regulativi kao lekovi 37 , premda nose slične rizike. Teratogenost jeste ozbiljna i jedina ireverzibilna neželjena posledica uzimanja izotretinoina i svakako zavređuje sve mere upozorenja i aktivnog praćenja, ali nije razlog da se ovaj lek ne uvede kada je to indikovano i u dogovoru sa pacijentom.…”