Has weight loss been reported during treatment with Roaccutan?/nA 30-year-old woman (weight 59 kg)

Fråga: Has weight loss been reported during treatment with Roaccutan?

A 30-year-old woman (weight 59 kg) with cystic acne has been treated with Roaccutan (isotretinoin) 20 mg three times daily since July 1, this year. During the treatment period (3.5 months), she has lost weight, approximately 3 kg.

Sammanfattning: Weight loss may occasionally be seen during treatment with isotretinoin. However, this adverse effect usually appears in combination with other gastrointestinal symptoms.

Svar: Roaccutan (isotretinoin) is a 13-cis-retinoic acid, a vitamin A derivative. Influence on body weight is not mentioned among the most frequent adverse effects seen during treatment with isotretinoin. However, in the text from PDR (Physicians Desk Reference), weight loss is mentioned among other adverse effects appearing in less than one per cent of treated patients but may bear no relationship to therapy (1).

Anorexia has been reported during treatment with isotretinoin, however, the manufacturer claims that there is no relation to weight loss during treatment with isotretinoin, especially if there are no other gastrointestinal symptoms (2).

A search in the databases Drugline, Medline and Embase revealed one article (3) describing a 16-year-old patient who experienced weight loss after isotretinoin 80 mg daily for four weeks. However, this patient also had other symptoms such as fever, fatigue, polyarthralgia and myalgia.

The Swedish Adverse Drug Reactions Advisory Committee (SADRAC) has received one report of weight loss and weight gain respectively in connection to treatment with isotretinoin.

The WHO centre in Uppsala has received 90 reports of weight decrease during treatment with isotretinoin. However, it is not known whether other gastrointestinal symptoms were present or whether other drugs had been used in these cases.

We recommend that this case be reported to the regional centre of SADRAC.