A-Cnotren 10mg/20mg Caps Pharmathen is an Isotretinoin containing medicine produced by Pharmathen from Greece. The main ingredient of Isotretinoin is 13-cis-retinoic acid. It is administered in the systemic way to treat severe acne, scarring acne, conglobate acne, and nodulo-cystic. Systemic Isotretinoin is available in form of capsule and tablet. A-Cnotren is prescribed as 10mg and 20 mg tablets by the doctors depending upon the grade of acne. This drug acts better if it is used with anti-bacterial agents like erythromycin, tetracycline, and chloramphenicol. The effect of A-Cnotren is noticed within 1-2 months after using it regularly. It cures not only the skin of affected patients but also it assists in removing the wrinkles by stretching the skin.
The dose of the medication varies between patients. The general doses used by the doctors are 0.5-2mg/KG.
Though the medication is so good for female acne patients, it has some limitations for using. This medication can’t be used for the woman who are pregnant or who are planning a pregnancy. Physicians strictly forbid usage of this medication for patients who are breastfeeding.
At first, patients may feel burning sensation inside acne, but this is temporary. The common side effects can be divided into two parts:
a- only skin reaction;
b- side effects in the whole body.
The skin reaction includes irritation, redness, a noticeable increase in the skin being sensitive to sunlight, and skin peeling. Dizziness, drowsiness, joint pain, nervousness are the adverse effects on the whole body.
Pharmathen, the manufacturer of A-Cnotren is a Greek private pharmaceutical company based in Athens, Greece . The company was inaugurated in 1969 and has branches all over the world including Europe, United States of America and Canada.
The main goal of the company is developing generic medications and marketing. Now, they have 2 manufacturing units and 3 states of art research laboratories. There are more than 900 workers who provide their service toward the development, research of generic medication, manufacture and distribution of medicine to the world. At present days, the drugs produced by this company are marketed in more than 80 countries in this world. According to the official website of the company, they are approved by FDA and all European Union market. By 2013, the sale of their products reached almost €178 million. The vision of the company is elevating the aspect of human life by providing affordable quality medication.
Clinical Research on Isotretinoin
Isotretinoin is a 13-cis-retinoic acid containing medicine, so scientists were keen to detect if the medication Isotretinoin has effects on night blindness. In order to find the answer a research named “Inhibition of the visual cycle in vivo by 13-cis retinoic acid protects from light damage and provides a mechanism for night blindness in isotretinoin therapy ” by Thaddeus P. Dryja, Harvard Medical School, United States of America. Rod cells in the eyes are the responsible for night vision or low light. They introduced Isotretinoin to the rats to know if night blindness is the consequence of the death of rod cell or from dysfunction of it. Isotretinoin was used for 60 days in high dose which caused toxicity of systems. It did not impact on histological problems of rod cells inside the eye. The amplitudes of electroretinogram caused by rod cells were absolutely normal even after adaptation in the dark place for a long time. The additional research was done to find that every single dose of this medication decreased the rate of recovery of rod cell in an exposure to bright light.The regeneration of rhodopsin also slowed down. After using the mild dose of the medication, the function of rod cell started to become normal within several days. Rod cells and cone cells both undergo for a short recovery process. It was found that isotretinoin protects visual receptors of rat from damage by light. It prevents some kinds of macular and reticular degeneration.
Isotretinoin is considered as one of the trusted medicine for acne but physicians were in doubt if oral isotretinoin can treat difficult acne or not. In the scientific study named “Oral Isotretinoin: Do Our Patients Fully Benefit? ” by Leyden J.J. tried to find the answer of it. The dose used for Isotretinoin was 120 mg/kg. Isotretinoin is found to clear nodule- cystic acne completely followed by preventing remission of acne for a long time. Even some patients became free of acne. Some patients observed to have a relapse in high or poor rate were classified into 4 groups. Relapse of acne was found in high rate in young teen and pre-teenagers. They needed to use the medication for several courses to stop relapsing of acne. This kind of poor response was found in 14 among 20 patients under age of twelve years. Patients with linear, lesions consist of epithelium showed partial cure for Acne. Those individuals had either personal or family history of disease ‘sinus tract’ including hidradenitis and pilonidal sinuses. Acne in female patients suffering from ovarian syndrome or adrenal syndrome relapsed within 8-12 months after stopping the usage of Isotretinoin medication.
Mechanism of Action and Description of Isotretinoin
Isotretinoin is considered as one of the most known inhibitors which can stop production of sebum. The exact way of the mechanism of Isotretinoin is still unknown. It was shown in several researches that Isotretinoin increases the rate of cell death also known as apoptosis in cells of the human body. Apoptosis may be induced in hypothalamic cells, meibomian glands, and hippocampal cells. It has a very low attraction for retinoid receptor, and retinoic acid receptors so it converts metabolites who work as an antagonist of retinoid X receptors, retinoic acid receptor, and nuclear receptors. There are several modes of action for the medication Isotretinoin including the process of normalization of the structure of keratinization inside the follicle of sebaceous gland. It also inhibits the inflammation and reduces the growth of acne in a second manner. Treatment for severe nodulocystic acne and prevention of acne scarring is done by the expression of tissue metalloproteinase and its inhibitor inside Isotretinoin.
A-Cnotren 10mg/20mg Effects for Acne and Its Scars
Isotretinoin has a great impact on acne by reducing the secretion of oil from sebaceous glands to stop the formation of acne. It also helps to open the skin pores leading the bad products stored in affected pores to come from the pores. This process allows the affected pores to undergo a natural healing process before curing the wrinkles.
The bacteria causing Acne (P. acne) lives in the oil inside the pores of the skin. As soon as this medication starts, the amount of secreted oil decreases and the numbers of bacteria too.
The medication Acnotren also has benefits of an anti-inflammatory drug on the skin which helps the skin to repair the scars caused by acne and start the process of regeneration. The before and after results of using this medication can be noted after only after several months.
Duration of Therapy and Recommended Doses
The doses and duration are not the same for the all the patients as they have different kinds of acne with different severity. The doses are advised by the dermatologists. For most of the patients, Acnotren is administered orally for the patients suffering from acne for a long time. For the oral usage, the initial dose is 500mcg/kg every day and the maximum daily dose used for this medication for a limited time is 1mg/kg. The maintenance dose for Acnotren is 0.1-1mg/kg/ each day during the treatment of 16 weeks. The second course for this drug is conducted at intervals of 1 week. The medication is taken after a meal with one or more than one receptions.
Side effects and Warnings
Unfortunately, there are several side effects of A-Cnotren, systemic medicine for curing acne. The dermatological adverse effects are skin rashes, dry mucous membranes, pruritus, dermatitis, sweating, chelates, erythema on the face, paronychia and desquamation of palmar-plantar and dystrophy of nails. This drug also increases the proliferation process of granulation cell inside affected skin causing vacuities, extra photosensitivity and thinning of the hair. In some cases, it also affects peripheral nervous and central nervous system the by making following syndromes: photophobia, intracranial hypertension, depression, and headache.
It has a very fatal side effect on the liver if the medication is being used for a long period of time.
This medication is restricted to be used by the pregnant woman or who is planning to be pregnant. Physicians strictly advise avoiding this medication for patients who are breastfeeding.
This drug interacts with a wide range of antibiotics. In most of the cases, isotretinoin interacts with erythromycin and tetracycline. It increases the efficiency of the isotretinoin medication. The application of Aminoglycoside antibiotics develops intracranial hypertension.
The action of isotretinoin can be reduced by the application of hormonal therapy in the females like progesterone in mild dose.
The administration of Vitamin A medication simultaneously with isotretinoin increases the risk of toxicity in the human body.
The patients are extremely disappointed with the use of oral A-Cnotren. The first customer complained that she is using this medication for two months without any positive effect. She is even searching for the alternative medicine quoting “what can I use instead which more effective and less dangerous”
The second customer is using this drug for the last three months. She didn’t find any noticeable change. Her scars of acne didn’t disappear yet. So, she quoted “I just want to know if it’s normal to still have acne?”
The third customer also claimed that her acne was in better condition than after administration of the drug. She quoted that” I can make sure that my face looks better than before starting this medication”.
A-Cnotren 10mg/20mg Price, Available Forms and Dosage
Nexxtec.net lists 30 capsules of 20 mg A-cnotren for $48. The site didn’t mention any shipping cost.
Аccording to the internet shop galaxypharm.info, the shipping charge is $12.74 for regular airmail and $16.98 for registered airmail which includes all over the world. They have also Express and Registered Airmail service only for Europe costing $16.98 and $23.35 respectively.
According to the site hippocampus.me, the price for A-cnotren is $35.00. This site didn’t mention the quantity of medicine. The cost of shipping is described below – Regular shipping $15.00, Trackable Shipping – $20.00, Express Shipping- $55.00, including the USA, Australia, and Canada.
Conclusion and Rating
Acne seems to be a great problem especially for the women who pay a lot of attention to keep their skin beautiful. Sometimes suffering from acne is linked to a lot of psychological issues. The medication A-Cnotren 10mg/20mg can give these patients a new quality of life. Unfortunately, there is a price to pay in exchange for this quality. The brand worsens the condition of the skin by increasing the amount of acne and related scars increase. More than that, this medication offers very dangerous side effects on the human body including liver and another system.
Keeping all these facts in mind, I can’t give more than 2 out of 5 rating for A-Cnotren 10mg/20mg.
A-Cnotren Wiki Facts
- Brand: A-Cnotren
- Active Ingredient: Isotretinoin
- Treatment: Acne
- Manufacturer: Pharmathen
- Country of Manufacture: Greece
- Availability: Greece, Russia, Finland, UK, Canada and USA
- Information about Pharmathen Pharmaceutical Company. Accessed from:
- Sieving PA, Chaudhry P, Kondo M, Provenzano M, Wu D, Carlson TJ, Bush RA, Thompson DA. Inhibition of the visual cycle in vivo by 13-cis retinoic acid protects from light damage and provides a mechanism for night blindness in isotretinoin therapy. Proceedings of the National Academy of Sciences. 2001 Feb 13;98(4):1835-40.Accessed from:
- Cunliffe, Saurat, Newton, Layton, Meigel, Leyden, Ortonne. Oral Isotretinoin: Do Our Patients Fully Benefit? F. Hoffmann-La Roche Ltd Satellite Symposium held during the 19th World Congress of Dermatology-Questions and answers. Accessed from:
- Wikipedia. Isotretinoin. Accessed from:
- Isotretinoin-Medscape Reference. Accessed from:
- Isotretinoin: Mediline Plus Drug Information. Accessed from:
- Isotretinoin: Treatment for severe acne. Accessed from:
- Low dose isotretinoin for acne? -BPJ 56 November 2013. Accessed from: