What are the differences between Tazorac and isotretinoin?
- Tazorac (tazarotene) and isotretinoin are medications used to treat acne. Tazorac is also used to treat psoriasis.
- A difference is that Tazorac is a topical medication (applied to the skin) and isotretinoin is taken orally.
- Tazorac was withdrawn from the U.S. market, but it is available on a very limited basis for restricted use.
- Brand names for isotretinoin include Claravis, Amnesteem, Absorica, Myorisan, Zenatane, Sotret, and Accutane.
- Side effects of Tazorac and isotretinoin that are similar include dry skin and itching.
- Side effects of Tazorac that are different from isotretinoin include redness, stinging and burning, irritation, skin peeling, and sun sensitivity.
- Side effects of isotretinoin that are different from Tazorac include dry nose, nosebleeds, cracks in the corners of the mouth, dry mouth, inflammation of the whites of the eyes, joint aches, and increase blood cholesterol and triglycerides.
What are Tazorac and isotretinoin?
Tazorac (tazarotene) is a topical acne and psoriasis medication. When applied to the skin, it affects the growth of skin cells and thereby reduces the formation of pimples and psoriasis plaques. It may affect growth of skin cells by affecting the action of genes that control production of skin cells. It also reduces inflammation. Tazorac was withdrawn from the U.S. market, but it is available on a very limited basis for restricted use. Patients who would like to be considered for this medication should contact their doctor for an evaluation.
Isotretinoin is an oral drug used for the treatment and prevention of severe acne. Severe acne causes permanent scarring of the skin. The inflammation is caused in part by an increased secretion of sebum (oily substance) from glands in the skin (sebaceous glands). The sebum provokes inflammation, and the inflammation resolves (heals) with the formation of a scar (keratinization). The exact mechanism of action of isotretinoin is not known. It may reduce acne by reducing the secretion of sebum. If less sebum is secreted it is likely that there will be less inflammation and keratinization.
What are the side effects of Tazorac and isotretinoin?
Tazorac
Side effects of Tazarotene are:
Isotretinoin
The most common side effects of isotretinoin are:
- Dry skin,
- Itching,
- Dry nose,
- Nosebleeds (epistaxis),
- Cracks in the corners of the mouth (chilitis),
- Dry mouth,
- Inflammation of the whites of the eyes.
Joint aches also are common. Patients may develop an increase in blood cholesterol and triglycerides. Psychiatric problems such as depression, hallucinations and suicidal behavior have been reported.
Other side effects include:
- Joint aches
- Increased cholesterol
- Increased triglycerides
- Increased glucose
- Headache
- Ringing in the ears
- Insomnia
- Abnormal periods
- Edema
Serious side effects include:
- Skin infections
- Peeling
- Sun-sensitivity to drugs
- Hearing impairment
- Hepatitis
Rarely, isotretinoin can cause brain swelling (pseudotumor cerebri or intracranial hypertension), which produces nausea, vomiting, headache, and changes in vision.
Erythema multiforme and severe skin reactions (for example, Stevens-Johnson syndrome, toxic epidermal necrolysis) have been associated with isotretinoin use. These events may be serious and result in life-threatening events or death, hospitalization, or disability. Patients should be monitored closely for severe skin reactions, and isotretinoin discontinued if necessary.
What is the dosage for Tazorac vs. isotretinoin?
Tazorac
- Plaque psoriasis: Apply a thin film and cover the affected areas once daily in the evening. Start with 0.05% and may increase to 0.1% cream or gel if tolerated.
- Acne vulgaris: Cleanse the skin gently. After the skin is dry, apply 0.1% cream or gel to acne lesions once daily in the evening.
Isotretinoin
- The recommended dose of isotretinoin is 0.5 to 2 mg per kg of body weight daily.
- The daily dose usually is administered in two divided doses for 15-20 weeks.
- Isotretinoin should be taken with food in order to improve its absorption.
What drugs interact with Tazorac and isotretinoin?
Tazorac
- Do not combine tazarotene with medications or cosmetics that have a strong drying effect on the skin.
Isotretinoin
- Isotretinoin is closely related to vitamin A. Therefore, the use of both vitamin A and isotretinoin at the same time may lead to vitamin A side effects.
- Treatment with tetracycline (Achromycin) and isotretinoin should not be given at the same time since the combination has been associated with brain swelling. (See side effects below.)
Are Tazorac and isotretinoin safe to take while pregnant or breastfeeding?
Tazorac
- Tazorac should not be used by pregnant or breastfeeding women, or women who may become pregnant.
Isotretinoin
- Isotretinoin is harmful to the fetus and therefore should not be used during pregnancy. Women of childbearing age must have two negative pregnancy test results before therapy is started, and a pregnancy test must be conducted during each month of therapy. Two effective forms of birth control must be used during therapy, and pregnancy should be avoided one month before, during, and at least one month after stopping isotretinoin.
- It is not known whether isotretinoin is secreted in breast milk, but because of its potentially serious side effects, it should not be used by nursing mothers.