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The first part of the treatment process entails scheduling a consultation with Dr. Michele Green in her private New York City office. You will discuss your current skin condition and assess if Accutane is the best course of medication for you. A thorough medical history review includes any hormonal changes or family history of acne or other skin issues. It is also essential to discuss any history of diabetes, obesity, mental health disorders, liver disease, bone loss conditions like osteoporosis, and eating disorders like anorexia. Dr. Green will order a complete metabolic profile and other blood tests, including hormonal tests, to ensure no liver abnormalities, hormonal irregularities, or anemia.
Patients must sign up for the iPLEDGE program to receive their medication directly from the pharmacy. Women must have two negative pregnancy tests before they are allowed to begin treatment. In addition, women are asked to use two forms of birth control (i.e., birth control pills and male latex condoms) or abstain from sex during the course of treatment. It is also suggested that patients discontinue the herbal supplement St. John’s Wort while taking Accutane, as it may make hormonal contraceptives less effective.
Accutane dosages are calculated by weight and are generally between one to two milligrams per kilogram per day. Depending on the dosage, Accutane should be taken once or twice a day with food. While on Accutane, monthly visits and blood tests are required to monitor any side effects, liver enzymes, white blood cell count (WBC), and red blood cell (RBC) counts. Women are additionally required to have monthly negative pregnancy tests via blood tests. As Accutane is controlled through the government-run iPLEDGE program, all blood test results and birth control methods must be documented and updated monthly in the iPLEDGE® system before the Accutane prescription can be sent. The complete course of Accutane is typically twenty weeks. Many patients notice immediate improvement within the very first month of taking Accutane, while a small subset of patients notice increased acne breakouts during this first month. Over 95% of patients respond to Accutane and suffer no further acne breakouts after completing their five-month course of medication.
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