- 1 About Olcare Laboratories (India)
- 2 Clinical Research on Isotretinoin
- 3 How Isotretinoin Works on Acne
- 4 Isotretinoin Effects for Acne and Scars
- 5 Recommended Doses and Duration of Therapy
- 6 Side effects and Warnings
- 7 Drug Interactions
- 8 Customer Reviews
- 9 Price, Available Forms, and Dosage
- 10 Reference List
- 11 Editor's Rating
Acnezac is a product which contains Isotretinoin, the active pharmaceutical ingredient (API) which is proven effective in treating acne conditions, especially the most severe ones. It is an oral treatment which contains either 10 mg or 20 mg of the API per pill. The product is made by Olcare/Olski Laboratories which is located in India.
Isotretinoin is the treatment recommended for severe forms of acne, as it is able to eliminate acne in patients who are unresponsive to conventional treatment. Through the years, it had been proven as an effective and safe acne therapy, which is able to produce long-term results (“Isotretinoin for acne vulgaris—10 years later; a safe and successful treatment” by Layton et.al. in 1993) .
Since the product’s effectiveness is implied, it has been a popular treatment for acne worldwide prescribed by physicians but the dose is varied depending on the weight of the patients being treated (“Isotretinoin therapy for acne: results of a multicenter dose-response study” by Layton et.al.) . There is no uniform dose, although there are studies considering the use of low doses of Isotretinoin (10-20 mg) as opposed to the per-bodyweight dosing of the Isotretinoin drugs (“Low-dose isotretinoin in severe acne” by Bellosta et.al.) .
Unfortunately for Acnezac, the only form available is the capsule form, as its manufacturer does not make any form of the product aside from the capsule.
About Olcare Laboratories (India)
India is known for its pharmaceutical manufacturing as there are a large number of local and international brands with their plants and facilities found in the country. One of the companies in the country is Olcare Laboratories or Olsky, which is the manufacturer of the product in the limelight (Acnezac).
Olcare Laboratories is established in 1987 but became a fully functioning manufacturing plant only in 1990. Since then, the company has evolved into a large-scale manufacturer, and to date, it has over 1000 formulations for its drugs .
The company aims to supply medications in various medical fields related to gynecology, cardiology, diabetes, dental, pediatrics, dermatology, and general medicine for the full patient age spectrum . As for Olcare’s accreditations, it has received its ISO 9001:2000 and Schedule M in 2007, and its ISO 9001:2008 in 2010. Aside from those, Olcare is also WHO-cGMP certified which makes it reliable when it comes to product quality.
Clinical Research on Isotretinoin
Acne is experienced by almost everyone in their puberty or adolescent stage, but the degree which acne affects an individual varies depending on the risk factors for the patient. Some people are affected by acne severely than others and since that is the case, treatment for acne patients is most of the time required to restore the normal skin integrity, and also heal the psychosocial damages created by the disease in the patients. Oral Isotretinoin has shown efficacy in the treatment of severe acne and to date has helped a great number of patients treat their acne conditions. But, there are some side effects brought by acne in patients not only physically, but psychologically too. Isotretinoin use has been linked to depression in patients, and there had been studies aimed at the discovery of the link of Isotretinoin use with depression symptoms in patients. One such study is “Isotretinoin Therapy and Mood Changes in Adolescents With Moderate to Severe Acne: A Cohort Study” by Chia et.al. in 2005, which aimed to see whether Isotretinoin use causes depression in patients . The research, however, failed to establish a statistically significant relationship between Isotretinoin intake and depression, and on the contrary, patients exhibited a decrease in their depressive symptoms instead of showing an increase in the symptoms relating to depression in Isotretinoin users .
The results of another study coincide with the result of Chia’s study ; “Reduced anxiety and depression in cystic acne patients after successful treatment with oral isotretinoin” by Rubinow et.al. . Patients diagnosed with cystic acne were also found to have depressive symptoms before treatment. After they were treated with Isotretinoin, it was found out that there was a significant mitigation of the depressive and anxiety symptoms in the patients . This is actually good, as it was generally perceived that Isotretinoin treatment causes depression in some patients.
Isotretinoin is almost the last line of defense for the treatment of acne. It is prescribed by physicians to those patients who are unresponsive to initial acne treatments. According to the study by Layton et.al., “Guidelines for optimal use of isotretinoin in acne” in 1992, patients who are unresponsive to former treatment modalities for acne typically responds to Isotretinoin doses from 0.5 to 1 mg per kg per day . According to Layton , patients treated with Isotretinoin respond 61% of the time during the first bout, and only 39% require follow-up treatment with a repeat Isotretinoin dose or antibiotics . The authors noted that today, incidences of moderate acne are getting harder to treat with the normal interventions, as moderate acne is becoming treatment-resistant . Isotretinoin, according to the authors, is a good consideration for the treatment of moderate to severe acne in patients .
How Isotretinoin Works on Acne
Isotretinoin is related to the shrinking of sebaceous cells in acne patients. Since the drug almost turns off the glands which produce oil (responsible for acne proliferation), the multiplication of acne lesions stop. Isotretinoin is also involved in cell apoptosis (cell death) of the oil-producing cells, and it also lessens the inflammation on the acne lesions found in patients. Since there is not much oil production, the pathogens (P.acnes) have nowhere to multiply on. Also since Isotretinoin dries up the pores, it helps them close and prevents the blockage of pores.
Isotretinoin Effects for Acne and Scars
Any Isotretinoin-containing medication is effective in treating acne in patients and has benefits for acne management, as the active ingredient has been well-proven in acting to resolve acne issues in patients. Acnezac is able to treat patients suffering from acne breakouts as the Isotretinoin content of the medication inhibits the production of sebum, lessens inflammation, deals with the pathogens existing on the acne lesions, and it lessens the appearance of lesions in patients.
Patients can expect good before and after results from Isotretinoin products for acne conditions if they follow through the treatment religiously or if they do not mess with the prescribed doses. Acne scars are also improved along with the healing of lesions, so Isotretinoin products are also studied for its effect on fibers found in the skin. For this reason, the product is also being studied for anti-aging treatments for wrinkles, other scars, and stretch marks.
Recommended Doses and Duration of Therapy
There is no fixed dose recommended for Isotretinoin treatment in patients, although the product is prescribed based on the patient’s body weight. In most cases, the patients are prescribed 0.5 mg to 1 mg per kg per day  but patients may be prescribed up to 2 mg/kg/day of Isotretinoin when needed, depending on the case.
As for the duration, the patients may be required an initial 4-month treatment length but some can take up to 10 months or more  depending on the patient case.
Side effects and Warnings
The commonly observed Isotretinoin side effects in patients involve general dryness of the skin like chapping of the lips, dry eyes, dry mucosa, dry genitals, and other body parts. There are also cases where patients experience hair loss, impetigo, brittle nails, and increased sweating .
These side effects are treated by decreasing the dose to 5 to 10 mg of Isotretinoin only per day and by using products for the relief of the dryness of the affected areas . For some cases, though, like impetigo, patients may be given antibiotics to treat the condition .
Isotretinoin has actually no drug contraindications, but the product is known for interacting with several medications, so care is advised when taking the medication with contraindicated drugs. Isotretinoin will interact with retinoic acid (Vitamin A), although beta-carotene or provitamin A is allowed . Antibiotics like Tetracyclines, when taken with Isotretinoin may be the cause of headaches, vision changes, and increased intracranial pressure .
There were no consumer reviews found for Acnezac from previous clients. It may be due to the product being unpopular or poorly marketed in the country. One of the factors affecting this lack of reviews is the fact that the product is not even sold online. Acnezac might just be locally available in India, so there is no chance of reviewing the product online on Internet stores.
Another factor may also be that the product might have been discontinued due to adverse effects. There is actually no way of knowing for sure, but it is a loss that there are no feedbacks available for the product. The effectiveness of Isotretinoin products is unparalleled still, so it is possible that Acnezac is effective in acne treatment. It is recommendable that Indian locals try it, though, as they are the only ones who have access to the drug.
Price, Available Forms, and Dosage
Mims India’s preview of Acnezac pricing is actually surprising, as the price for Acnezac is low. The 10 mg variant (sold in 10s) may be bought for only $1.17 and the 20 mg variant in 10s is also sold for as low as $2.21 only for the pack. These are astoundingly low prices for Isotretinoin medication and are good for patients who are not able to afford the more expensive treatments.
However, though Acnezac is super cheap, patients from other countries are not able to avail the drug as it is only sold in India. Currently, there are no online stores offering Acnezac, so clients from other parts of the world like the USA, Canada, and Australia may obtain the drug. Although that is the case, there are numerous versions of Isotretinoin existing in the pharmaceutical market, and every country has its own native version available.
- Layton AM, Knaggs H, Taylor J, Cunliffe WJ. Isotretinoin for acne vulgaris—10 years later; a safe and successful treatment. British Journal of Dermatology. 1993 Sep 1;129(3):292-6. Available from: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2133.1993.tb11849.x/abstract
- Strauss JS, Rapini RP, Shalita AR, Konecky E, Pochi PE, Comite H, Exner JH. Isotretinoin therapy for acne: results of a multicenter dose-response study. Journal of the American Academy of Dermatology. 1984 Dec 31;10(3):490-6. Available from: http://www.sciencedirect.com/science/article/pii/S0190962284801000
- Bellosta M, Vignini M, Miori L, Rabbiosi G. Low-dose isotretinoin in severe acne. International journal of tissue reactions. 1986 Dec;9(5):443-6. Available from: http://europepmc.org/abstract/med/2959631
- The Company. Available from: http://olcarelab.com/the-company/
- Chia CY, Lane W, Chibnall J, Allen A, Siegfried E. Isotretinoin therapy and mood changes in adolescents with moderate to severe acne: a cohort study. Archives of dermatology. 2005 May 1;141(5):557-60. Available from: http://jamanetwork.com/journals/jamadermatology/fullarticle/394824
- Rubinow DR, Peck GL, Squillace KM, Gantt GG. Reduced anxiety and depression in cystic acne patients after successful treatment with oral isotretinoin. Journal of the American Academy of Dermatology. 1987 Jul 31;17(1):25-32. Available from: http://www.sciencedirect.com/science/article/pii/S0190962287701662
- Layton AM, Cunliffe WJ. Guidelines for optimal use of isotretinoin in acne. Journal of the American Academy of Dermatology. 1992 Dec 31;27(6):S2-7. Available from: http://www.sciencedirect.com/science/article/pii/S0190962208802526
- Cutaneous and mucocutaneous side effects. Available from: http://www.dermnetnz.org/topics/isotretinoin/
- Drug interactions with isotretinoin. Available from: http://www.dermnetnz.org/topics/isotretinoin/