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Pharmacology: Pharmacokinetics: The exact mechanism of action of isotretinoin is not known. However, isotretinoin reduces sebaceous gland size and inhibits sebaceous gland activity, thereby decreasing sebum secretion. In addition, isotretinoin has been shown to have anti-keratinizing and anti-inflammatory actions. The exact role of these actions in clinical improvement of cystic acne is not known, especially with respect to prolonged remissions.
Rapidly absorbed from the gastrointestinal tract, taking isotretinoin with food increases bioavailability relative to fasting conditions. This is probably as a result of easier absorption of this highly lipophilic medication.
Isotretinoin is metabolized in liver and possibly in the gut wall. The major identified metabolite in the blood and urine is 4-oxo-isotretinoin, other identified metabolites are tretinoin and 4-oxo-tretinoin.
Isotretinoin appears to be eliminated almost exclusively by hepatic metabolism and biliary excretion.
