TAM (Treatments and Medicines) NHS HighlandImportant: Therapy notes
Oral preparations for acne (Formulary)
Refer to guidelines and notes on Management of acne and National Patient Pathways.
Important: Therapy notes
MHRA advice: Erythromycin: caution required due to cardiac risks (QT interval prolongation); drug interaction with rivaroxaban (December 2020) (www.gov.uk).
Important: Therapy notes
MHRA advice: Cyproterone acetate: new advice to minimise risk of meningioma (June 2020) (www.gov.uk).
- Co-cyprindiol carries an increased risk for venous thromboembolism. The risk increases with increasing BMI; avoid co-cyprindiol in patients with a BMI above 35kg/m2. See CSM advice in BNF and https://www.fsrh.org/documents/cec-ceu-statement-dianette-jun-2013/.
- Co-cyprindiol provides effective contraception. An additional hormonal contraceptive should not be used in combination with co-cyprindiol.
Important: Formulation and dosage details
Formulation:
Tablets (cyproterone acetate 2mg, ethinylestradiol 35 micrograms)
Dosage:
1 tablet daily for 21 days starting on the first day of the menstrual cycle and repeated after a 7-day interval, usually for several months; withdraw treatment 2 menstrual cycles after acne has resolved (repeat courses may be given if recurrence).
Important: Therapy notes
MHRA advice: Isotretinoin (Roaccutane): introduction of new safety measures, including additional oversight of the initiation of treatment for patients under 18 years of age (October 2023) (www.gov.uk).
MHRA advice: New safety measures to be introduced in the coming months, including additional oversight on initiation of treatment for patients under 18 years (April 2023) (www.gov.uk).
MHRA advice: Temporary advice for management of oral retinoid medicines during the COVID-19 pandemic (June 2021) (www.gov.uk).
MHRA advice: Isotretinoin (Roaccutane): reminder of important risks and precautions (August 2020) (www.gov.uk).
MHRA advice: Oral retinoid medicines: revised and simplified pregnancy prevention educational materials for healthcare professionals and women (June 2019) (www.gov.uk).
- Isotretinoin should only be prescribed by or under supervision of Physicians with expertise in the use of systemic retinoids for the treatment of severe acne and a full understanding of the risk of isotretinoin therapy and monitoring requirements.