Curakne 20 mg is a product specially produced by the French manufacturer, Pierre Fabre for its clients located in Switzerland. The product contains Isotretinoin (20 mg), which is used for the cure of stubborn acne and scarring acne in patients. Curakne is produced in Switzerland and it is exclusively distributed in the country. The medication is available in 20 mg and 40 mg formulations and in soft capsule form only.
Curakne, like other Isotretinoin products, is indicated for acne cases which are very hard to treat, and it requires a doctor’s prescription to use . Acne is actually a prevalent condition in the society and it is always associated with self-image and confidence. Since physical appearance seem important in individuals, having dermatological conditions affect the psychosocial state of an individual, and in most cases, acne causes social anxiety in patients (“Effects of isotretinoin on social anxiety and quality of life in patients with acne vulgaris: a prospective trial” by Yesilova et.al. in 2012) . Patients associate their having an acne condition to being socially ostracized or stigmatized due to their appearance, especially patients with severe acne conditions.
Due to the prevalence of acne worldwide, treatment is imperative for the acne patient population, not only because acne cases (especially the severe ones) disfigure the patients physically, but acne also scars them psychologically and socially. There are cultures which strongly associate dermatological defects with hygienic practices, and sometimes society dictates that the appearance of acne is due also to poor self-care (“A systematic review of the evidence for ‘myths and misconceptions’ in acne management: diet, face-washing and sunlight” by Magin et.al.) , even if the condition has really nothing to do with hygiene and is really caused by numerous factors like heredity and genetics (“Family history, body mass index, selected dietary factors, menstrual history, and risk of moderate to severe acne in adolescents and young adults” by Di Landro et.al.) .
Pierre Fabre Information
Curakne is one of the dermatological products made by the French multinational pharmaceutical company, Laboratoires Pierre Fabre . The company started its operations 1962 in France and has expanded globally to 130 countries . As for its focus, Pierre Fabre has its concentration on research and development and in the harvest and formulation of active pharmaceutical ingredients from plant sources.
According to the company information, Pierre Fabre ranks as the second largest dermo-cosmetics laboratory among all the manufacturers globally and it employs about 13,000 people in its facilities worldwide . It is also the second largest private medical manufacturer in France .
For prescription manufacturing, the company specializes in the area of Oncology, Dermatology, and Neuropsychiatry . In the field of Oncology, Pierre Fabre is National Centre of Excellence certified in the area of cancer research . As for certifications, the company’s manufacturing sites for oncology products are accredited by the US FDA, EU’s EMA and Japan’s PMA . Its Dermatology department produces products for acne, mycosis, psoriasis, atopic dermatitis, alopecia, and products for pediatric dermatology. Its Dermatology and Neuropsychiatry units are also well-accredited by trusted drug-regulating institutions worldwide.
Scientific Studies on Isotretinoin
Since the introduction of Isotretinoin in the market, its effectiveness in the treatment of acne cases has been well established, although along with the drug’s capability to eliminate acne is its side effects and adverse reactions. The effectiveness of the drug is not only tested in the USA, but researchers and physicians from Saudi Arabia also tested Isotretinoin’s effectiveness in the treatment of patients in Riyadh (“Isotretinoin for acne vulgaris” by al-Khawajah in 1996) . Acne patients were treated with 0.60 to 0.75 mg Isotretinoin per kg/day for 16 to 35 weeks. The results were encouraging as 90.4% of the patients (156) responded well to therapy, and only 3.8% had less than optimal response to Isotretinoin treatment, although there were side effects observed in 99% of the cases . This research is significant as it is the first study documenting patient response to Isotretinoin therapy in the Middle East. Based on the results, moderate dosing of Isotretinoin proved effective in the management of acne cases in the patient .
Although highly effective, there are still cases where Isotretinoin treatment does not seem effective in patients. The drug works most of the time, but there is still a small percentage of patients who are not respondent to Isotretinoin therapy. Studies are conducted to determine the factors which affect the effectiveness of Isotretinoin treatment in patients. The study “Predictive factors for failure of isotretinoin treatment in acne patients: results from a cohort of 237 patients” by Lehucher-Ceyrac et.al. is one of the studies which aimed to identify factors affecting Isotretinoin treatment failures in patients . The study determined that the only predictive factor for Isotretinoin treatment failure (resistance) is closed comedonal acne and its risk for relapse is almost 50% in 5 years . The study concluded, however, that MDD (mean daily dose), TCD (total cumulative dose), hyperandrogenism, and closed comedonal acne had really no predictive value for relapse and does not actually affect treatment failure in patients .
It is said that acne is not only a physical condition as it affects the psychological aspect of a patient as well. Acne cases have been linked to low self-esteem, low self-worth, and confidence, and also linked to depression and other psychiatric problems. Treating the patients’ acne case seemed a viable solution even for the psychological effects of acne, but there are studies which present that treatments, Isotretinoin, in particular, can exacerbate the depression amongst acne patients. The role of Isotretinoin in depression has long been controversial, so studies were made to determine the actual effect of Isotretinoin in patients. The study, “Changes of psychiatric parameters and their relationships by oral isotretinoin in acne patients” by Hahm et.al. is one of the studies conducted to determine whether Isotretinoin can alter a patient’s psychiatric condition . The cohort study included 38 patients who were evaluated using the Assessment of the Psychological and Social Effects of Acne (APSEA) parameter for quality of life, Beck’s depression inventory (BDI) for depression, Beck’s anxiety inventory (BAI) for anxiety, and Symptomchecklist-90-revised (SCL-90-R) for psychopathology . Using these parameters for evaluation, it was determined that instead of worsening the depressive symptoms and causing psychiatric problems, Isotretinoin was able to alleviate the patients’ depression as it cured the acne symptoms in patients . This study presented evidence that the drug actually works positively on a patient’s psychological well-being as apparently, the clearing of the acne symptoms in patients renders a good effect on the patients’ psychological state.
Description and Mechanism of Action of Isotretinoin
Isotretinoin is a retinoid well-known for the treatment of acne in patients. Clinicians and dermatologists use the drug for the treatment of stubborn acne and consider the drug as the last line of treatment for patients with recalcitrant acne and unresponsive acne (in prior antibiotic therapy).
Isotretinoin’s significant action in the patients treated with it is its capability to suppress the excessive oil production by the sebocytes (or the sebaceous/oil cells) in patients. In order to accomplish that, Isotretinoin purposely induces the death of several sebaceous cells, therefore resulting to the shrinking of the sebaceous glands. Since the cell apoptosis reduces the number of the oil-producing cells, the sebum production is minimized, leading to less oil present in the skin.
Acne, especially the severe cases, is exacerbated by the presence of the bacteria P.acnes, which thrives on sebum. The bacteria cause the inflammation and cause the lesions to multiply. Since Isotretinoin primarily inhibits the production of sebum, it also limits the multiplication of the bacteria by removing the environment which they thrive on. As oil production ceases, the bacteria has no more substrate, and without the bacteria, the inflammation around the lesions heal up. Acne production stops, and the clearing of the skin is achieved.
Curakne Effects for Acne/Scars
A patient benefits from Isotretinoin for acne treatment as it is able to heal up the acne lesions found on the skin. In scarring acne, Isotretinoin is also known to improve acne scars on the skin, as before and after results indicate in most studies.
Patients can expect to have improvements on their acne condition a few weeks during Isotretinoin treatment. The effect of the drug for acne is not instantaneous, however, as the drug takes some time to have its effects on the skin. Almost all of the cases of severe acne in patients are cleared out by Isotretinoin, and that includes the end-stage, worst acne case, Acne Fulminians.
Since Isotretinoin has effects even on acne scars, it is also being studied for other dermatological applications, and its effect is also tested on wrinkles and stretch marks. However, further proof for its beneficial effect on these conditions is needed, as Isotretinoin is a tedious drug to use. There are other alternatives for wrinkles and stretch marks on the market, and for the meantime, patients should stick with the known treatments for these skin conditions.
Recommended Doses and Duration of Therapy
The actual recommended dose for acne treatment in patients is within the range of 0.5 mg to 1 mg of Isotretinoin per kg per day in patients. The exact dosage is to be recommended by the attending dermatologist, and no patient should self-medicate on Isotretinoin, as it is a sensitive drug with a number of known negative side effects.
Before taking Isotretinoin, patients should undergo tedious assessments and blood tests, and females should be tested for pregnancy, as the drug is highly teratogenic. Depending on the advice of the physician and the tolerance of patients for the drug, the dose may be customized according to the need of the patients. Some patients require more than the universally accepted dosage, while some require less than 0.5 mg.
As for the length of treatment, patients are usually given 4 to 6 months to respond to therapy. Others take longer and may have the need for maintenance to prevent relapse. It has been observed that although some require a second round of treatment, most of the patients have sustained effects of Isotretinoin for years and generally do not have relapses.
Side effects and Warnings
Side effects are unavoidable for almost all kinds of medication. Isotretinoin, though effective for acne treatment, has drawbacks in terms of its side effects. Almost all of the patients complain about having headaches in the course of treatment, and the most common complaint about the drug is its effect of extreme dryness on the lips (cheilitis). Side effects like headaches and skin dryness may be managed by using moisturizers and creams, and if intolerable, patients should consult with their doctors for reformulating the dosage for the drug.
Female patients are tested for pregnancy before using Isotretinoin as the product is highly teratogenic and may influence fetal life. Pregnancies are usually terminated by the drug, and the pregnancy termination is linked to its capability to induce apoptosis. If the fetus survives, there is a high chance of congenital anomalies to be contracted by the infant, as Isotretinoin influences cell differentiation in the development of the fetus inside the womb.
There are still a number of considerations for the drug, so patients should follow all their doctors’ instructions regarding the intake of Isotretinoin during their therapy.
Isotretinoin is recommended to be taken with extreme caution as there are medications generally incompatible with its intake. The interaction could be toxic, and for instance, when taken with Vitamin A, the interaction could result to an overdose-like effect for the patients.
Aside from caution when taking Vitamin A medication, patients should exercise care when taking tetracyclines and other antibiotic medication. Isotretinoin is also not advised to be taken with other Isotretinoin medications, if not advised by the doctor. In some cases, though, there are recommendations by the dermatologists of Isotretinoin intake with other topical acne medication. But when not prescribed, patients should not be using anything else for their acne other than the oral Isotretinoin product.
Other drugs interacting with Isotretinoin are progesterone, mini-pills, phenytoin, systemic corticosteroids, and St. John’s wort. These meds should never be taken in conjunction with Isotretinoin to prevent adverse reactions.
Curakne 20 mg did not have client reviews from users who were able to experience its effect. One factor might be due to its exclusive distribution in Switzerland and the absence of the product online. Usually, online buyers are the ones who are writing reviews for products, so since Curakne is not available for international buyers online, there are no reviews available too.
But though the product did not have client feedback for it, the product may still be effective. Isotretinoin is highly effective for the cure of acne regardless of the brand or manufacturer, so Curakne may also be effective in the treatment of stubborn acne in patients. There are also international laws governing the distribution of products to other nations, and it may be that Curakne is not yet approved for international sale.
Curakne 20 mg is also manufactured by Pierre Fabre, the world’s second largest dermo-cosmetics manufacturer with numerous factories worldwide. It may also be that the company makes versions of Isotretinoin made for distribution for other countries, and it just happened that Curakne is the one made exclusively for Switzerland.
Price, Available Forms and Dosage
Curakne 20 mg seems to just be locally sold in Switzerland. It is available online, but in a Swiss online pharmacy only, and there is no delivery information for international clients. The store only caters to Swiss residents and ships orders only locally.
As for the price, Curakne 20 mg costs $42.52 for 30 pieces and the stronger pill, the 40 mg costs $58.90 for 30 pills. Although it is available on Xtrapharm.ch, Curakne is not available for shipping to the USA, Canada, and Australia, as the product is exclusively distributed in Switzerland only.
Conclusion and Rating
There is not much information on the product Curakne 20 mg and there are no product reviews available for reference. Even so, the effectiveness of the drug is not measured by the reviews available for it, as there are other factors affecting the reviews harbored by the products. One of the possible factors is the products’ exclusivity in Switzerland.
Isotretinoin as an active ingredient is proven in the treatment for acne cases, and regardless of brand or manufacturer, with the exception of counterfeit and impure products made by dubious companies. As for my rating, I think the product deserves 3 out of 5 although no client feedback was found for it. The product was made by one of the leading worldwide companies, Pierre Fabre, so the product is sure to be pure and effective.
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