accutane

[Kilburn]

how bad is it to take 20mg of accutane every day and combine it with orals?

i've been taking 1 cap, 20mg accutane ED now for about 60 days and i dont plan to stop. it is really helping keep everything under control. at the end of my last cycle i was pretty broken out, especially on my arms. the tanning just wasn't covering it up anymore so i hit the accutane. i think i'm just going to take 20mg indefently.

well, now i'm starting cycle #3. how bad is it to use accutane along with oral steroids?

[theslime]

how bad is it to take 20mg of accutane every day and combine it with orals?

i've been taking 1 cap, 20mg accutane ED now for about 60 days and i dont plan to stop. it is really helping keep everything under control. at the end of my last cycle i was pretty broken out, especially on my arms. the tanning just wasn't covering it up anymore so i hit the accutane. i think i'm just going to take 20mg indefently.

well, now i'm starting cycle #3. how bad is it to use accutane along with oral steroids?

Personally, I dont see why you would absolutely need an oral steroid. Oral steroids are liver toxic, accutane is also liver toxic. They also both have a very negative impact on blood lipids. Just use injectables, its only common sense to me. Ive been in the same situation by the way, and i didnt think twice. Used accutane for 7 months for extreme cystic acne, under md care, and never had to take it again. No offense though, its your body, and you probably get good results with orals.

[Bowlcut]

Your liver is already under stress from accutane. I say wait awhile before you run another cycle or chose substances that don't make you break out, but accutane and dbol mix like booze and driving.

[JonnyO]

What the cycle look like?

[Kilburn]

third cycle:

800mg test e 1-12
450mg EQ 1-14
200mg tren e 1-10
20mg accutane ed
30mg superdrol ed 1-4

[Kilburn]

opinions? pct is 5000units of hcg and nolva.

[AlbertaBeef]

I've run accutane on cycle but never with orals. Know of a couple of guys who ran it with orals but at least had blood work done and cholesterol was off the charts.

I wouldn't run hcg for pct but that is not agreed by everyone. I beleive it still shuts down your hpta and doesn't allow LH hormone to activate but some would argue that. If I did run it it would be for only first week of pct at 5000mcg and still have a regular clomid/nova protocol.

[IronRobi]

As it's already been said, your liver is stressed as it is. Testosterone has low liver toxicity and when taken in a high dose it adds up. Add to that Tren is known for being toxic on the liver. Then you have superdrol, which is basically methylated masteron that is fully processed and released into your body through your liver which is very toxic as well.... Put those together, you should be being very careful with your liver just from your cycle alone!

Then comes the accutane, which on it's own is toxic enough to cause severe liver damage. It is recommended that accutane users are monitored very closely for liver damage. And this is just with the accutane on it's own!!

In my opinion, you're taking a pedal bike and playing chicken with a transport truck hoping you can win in the head on colission. For your safety I would drop it, wear a shirt for 12 weeks, then hit the accutane after you've had blood tests done and your liver levels are back within normal range.

[jjmac]

Drop the Drol for sure that's the hardest oral, I'd go with some prop to kick it off instead with accutane and I'd run the test e at least as long as the EQ usually a week or two past.

Prop 1-5
Test E 1-14
tren 1-10
EQ 1-13

And the injectables still go through your liver, orals go through twice so they're harsher but the injects will still affect it too.

[simon85]

I agree Kill. Drop the orals

Injectables only is the healthiest way to go.

This is a kickass cycle:

1-4 Suspension 2X50mg/day
1-15 Tren-E 400-600mg/week
1-15 Test-e 1000mg/week
1-15 EQ 450-600mg/week

[Houstonbc]

that looks like an awesome cycle im just trying to figure out my next one and its gonna look somethin like that!

[Kilburn]

what if i stop taking the accutane for the 4 weeks i'm on the orals?

i dont have any prop unfortunetly and i have a shitload of orals to use up.

[IronRobi]

what if i stop taking the accutane for the 4 weeks i'm on the orals?

i dont have any prop unfortunetly and i have a shitload of orals to use up.

It wouldn't be AS bad, but keep in mind Tren is still liver toxic, and EQ and Test still have an effect on the liver as well. I still say drop it while youre on cycle. However, if you do pick it back up after your orals are done, just be sure you get your levels checked regularly to be safe!

[waderow]

can a guy buy Accutane anywhere, or is it tricky to get? Illegal?

[Bowlcut]

can a guy buy Accutane anywhere, or is it tricky to get? Illegal?

It is only legal to purchase it with a prescription from a doc. Nobody would buy it illegally here.

[phatkid77]

expert is back!

http://dermatology.jwatch.org/cgi/co...ull/2006/425/1

'Microdose' isotretinoin
R.A. Palmer S. Sidhu P.G. Goodwin
S ir, It is our experience that some adults with acne vulgaris respond to extremely low doses of isotretinoin. Such low doses, used continuously, may be a good way of treating patients who relapse quickly when they cease taking standard doses of isotretinoin.

The dose of isotretinoin used to treat acne vulgaris is often 0·5-1 mg kg 1 d 1, for approximately 4-6 months, to produce a cumulative dose of > 120 mg kg 1. 1 Adult patients with acne tend not to have severe disease and are often successfully treated with relatively low doses, such as 0·25 mg kg 1 d 1, 2 or 0·5 mg kg 1 d 1 taken 1 week in 4 for 6 months. 3 The lowest dose we could find in the literature is 0·1 mg 1 kg 1 d 1· 4 We retrospectively report eight patients with acne vulgaris, controlled by continuous treatment with a single 20 mg tablet, taken once or twice a week; we calculate they are receiving doses of 0·04-0·11 mg kg 1 d 1. Details of their treatment are shown in Table 1.

These patients developed acne between 14 and 32 years ago. Prior to treatment with oral isotretinoin they had acne of moderate severity. Two patients had predominantly truncal acne, which is known to be associated with a relatively high relapse rate after isotretinoin therapy. 5 With treatment (20 or 40 mg d 1), all patients became clear or almost clear of acne. At least six of our eight patients experienced side-effects, such as dry lips, which were severe in some cases.

After stopping treatment they relapsed, often within a few weeks, on several occasions, developing acne of mild severity. Usually, conventional measures of treating relapse (topical therapies and systemic antibiotics) were not used, because their efficacy was perceived by dermatologist and patient to be inferior to oral isotretinoin. Relapse was treated by restarting oral isotretinoin, at successively lower doses. All patients currently have no acne or minimal acne while taking a single 20 mg tablet once or twice per week. They report enormous psychological benefit. Stopping this treatment results in recurrence of mild acne.

Two of our patients have reported mild dry skin or eczema, thought to be due to treatment with 'microdose' isotretinoin; the others have no symptomatic side-effects. Isotretinoin therapy can elevate serum hepatic enzymes and lipids and cause adverse skeletal effects, including diffuse idiopathic skeletal hyperostosis. The latter may be detected with a lateral cervical or lumbar spine radiograph. The patients with the highest cumulative doses were investigated for these side-effects when their cumulative doses were between 174 mg kg 1 and 310 mg kg 1. In the four patients tested, no relevant abnormalities were found. However, a previously reported patient with perforating folliculitis 6 now treated with this regimen has a slightly raised serum cholesterol (5·79 mmol L 1, normal range 3·30-5·20); her pretreatment serum cholesterol is unknown. Treatment is on-going in all patients.

Continuous treatment with 'microdose' isotretinoin has several theoretical advantages over intermittent standard-dose treatment. In the latter type of regime, patients restart treatment when their symptoms return; therefore by definition, they are not continuously free of disease. The incidence and severity of symptomatic side-effects is very low. Continuous treatment with a 20-mg tablet once per week in a 70-kg adult produces a cumulative dose of under 15 mg kg 1 year 1, which is sufficiently low to be unlikely to cause long-term side-effects, but is an unlicensed method of administration. It costs approximately £52 per year, and can produce enormous psychological benefit.

We recommend that dermatologists consider the continuous use of very low doses of isotretinoin, particularly for adult patients who have repeatedly relapsed after stopping

[phatkid77]

San Francisco - Low and ultra-low doses of isotretinoin are an effective therapy for many acne patients. This safer and cheaper solution can even be used continuously.

Gerd Plewig, M.D., believes that the doses of isotretinoin typically used in the United States and Europe are far too high. For many patients, as little as 2.5 mg twice a week, which he describes as "a drop of rain on a dusty road" is adequate.

Dermatologists all over the world already are treating some patients continuously with low doses of isotretinoin, according to Dr. Plewig, director, dermatology and allergy clinic, Ludwig-Maximilian University in Munich.

"When you talk to doctors in this country and other countries of the world, they use 10 mg twice a week or three times a week, which is a low or ultra-low dose. But nobody ever bothered to show and demonstrate that it works," he said. Thus, he and his team performed two clinical trials to assess its efficacy.

Study Spotlights Low Dosing In the first trial, 28 patients with acne conglobata and inflammatory acne took a low dose of isotretinoin: 20 mg/kg, 10 mg/kg, or 0.5 mg/kg body weight daily for six months. In the second study, 11 acne patients took an ultra low dose of isotretinoin: 2.5 mg to 5 mg daily or 2.5 mg twice a week for six months. Both trials involved multiple endpoints, including clinical grading, lesion counts, counts of follicular filaments (believed to be precursors to lesions), bacterial colonization, patients' opinion of seborrhea levels, two objective measurements of sebum levels (Sebutape and Bentonite clay), qualitative assessment of sebum using high power, thin layer chromatography, and biopsies to assess size and configuration of sebaceous glands.

Trials Yield Significant Improvement Results of the first trial in which low doses of isotretinoin were used revealed significant improvements in all parameters tested. Numbers of follicular filaments, and lesions dropped, as did levels of bacteria and sebum. Sebaceous glands shrank, as well.

At the end of the second study, which investigated ultra-low doses of isotretinoin, efficacy was maintained on many of the parameters. There were significant reductions in numbers of active lesions and follicular filaments as well as objective measures of sebum levels. Patients' ratings of seborrhea improved, and levels of P. acnes on the skin diminished.

"The endpoint or the lowest point of a retinoid being effective for the treatment of seborrhea, persistent low grade acne, or maintenance therapy for patients with bad acne probably is around 2.5 mg or 2 mg, or maybe even 1.5 mg," Dr. Plewig said.

The best candidates for low and ultra-low doses isotretinoin therapy, Dr. Plewig said, include patients with severe acne who were controlled with higher doses and require a lower-dose maintenance therapy, individuals whose facial acne has persisted from adolescence into adulthood, and people with sebaceous gland hyperplasia. "Some patients come only because of their oiliness. ... For these patients, I think the low or ultra-low dose is very good, and it's cheap, too," he said.

Severe Patients Still Receive Low Doses Dr. Plewig keeps doses of isotretinoin relatively low in patients with severe acne. "I pretreat patients with severe inflammatory acne with systemic corticosteroids to begin with...about 1 mg/kg body weight for about seven to 14 days, taper it off, and then give an antibiotic, usually an erythromycin, a macrolide," he said. "And then I start with the isotretinoin [0.2 mg/kg to 0.4 mg/kg body weight]. It is so much better. We used to start immediately with isotretinoin or tried antibiotics, but often it takes too long, the patients are miserable, and it is so much better for them because you can have a faster final result, a better final result with cooling down the skin first, then adding your active treatment."

Continuous Use Offers Versatility A great benefit of using lower doses of isotretinoin is that it can be used continuously. There are other important advantages, as well. "In terms of pharmacoeconomics, it is cheaper to use lower doses, it is better tolerated by patients, has fewer side effects, fewer laboratory abnormalities, and of course the patients like it when they have continuous elegant treatment," Dr. Plewig said.

Despite the safer side-effect profile with low-dose isotretinoin, Dr. Plewig emphasized that, at any dose, the drug should still be considered teratogenic and be used with great caution in women of childbearing age

[Gettin'r'round]

Like I posted elsewhere I did low dose for the first 2 weeks of a cycle then used the oilyness as my skin as a guide to take another dose for a day or so. Also no orals, no vit-a (multi-vitamins/fish oils), no tanning, no booze/tylenol (i don't use anyhow but is liver toxic), liver protectants(nac/r-ala,milk thistle). Also as someone else said you can't do this during summer.

[td1111]

I think the reason for the common high-dose protocols is to have a lasting effect and change in the skin. 2 years after I used Accutane at 80mg/day, I still have dry skin, dry lips, less oil, less acne. The changes seem quite permanent.

[Bret Hart]

yes usually changes are fairly permanent after 1-2 treatment cycles

[tony_canuck]

you either do a full on hardcore treatment of accutane or a little to keep away the acne. I've run acne on cycles with no probs but I use WAY less than you're using. Its very strong drug and for me 1 20mg per week was enough to keep away all my cysts (yea I got those big red nasty ****ers, but no more!)

if you want to use it, try a low dose of 1 cap per week and move up. it take a week or two to get into your system, thats what I found a bit of a delay for it to work. i'd be willing to bet at most you would need only 2 doses a week. I would start before you get the acne, it'll keep it at bay.

and yea, drop the orals, no need for them.

[bmorlock]

accutane is serious stuff i would try not to use it if possible

[Kilburn]

accutane is serious stuff i would try not to use it if possible

i've been using 20 mg a day for about 2 and a half months now and i still have black heads. no big cysts or anything but blackheads are still disgusting and if you dont get rid of them i hear they will eventually turn into scars.

i would rather die than go through having acne like i did in highschool and i dont think 1 or 2 20mg caps per week would do **** all to be honest with you.

but ya, i'm going to stick with injectable only to be safe.

[purelife]

do you guys use some liver protection like milk thisle or liv52 while on accutane??
just wondering

[Houstonbc]

you can, im going to just waiting for my liv52 to get here

[bmorlock]

u have to run acutane for like 6 months i forget exactly but my ex girlfriend used it , its like 3 month on then a short break and then 3 more months or something the doc prescribed her 40 mg tabs he bumped her up to 50 mgs and she couldnt handle the sides she got kidney pain and joint pain like crazy , you also have to avoid lots of sun exposure she went to cuba and swelled up real bad and was bed ridden for 2 days , he never prescribed her any kidney protectant but made her come in and get blood work to check em , also really bad chappped dry lips

[Kilburn]

really? it makes you swell up? that's wierd cause ive been hitting the tanning bed regularly without any issues so far.

got any more info on that?

[phatkid77]

ive done 4 FOUR.... full courses last one at like 100mg day...still comes back, ive got the persistant stuff

[tony_canuck]

accutane is serious stuff, so I wouldn't mess with it unless you have to. In fact I would recommend going to a doc and getting him to check your blood levels if you're going to do a full accutane. I was using only 1 20mg a week and had blood work done and I was fine, but anymore and I would make sure you had yourself checked, the sides can be very serious