Dercutane 20 mg soft capsules

Package leaflet: Information for the user

Introduction

Package leaflet: information for the user

Dercutane 20 mg soft capsules

Isotretinoin

Read the entire leaflet carefully before starting to take this medicine, as it contains important information for you.

• Keep this leaflet, as you may need to read it again.
• If you have any questions, consult your doctor, pharmacist, or nurse.
• This medicine has been prescribed for you only, and you should not give it to others, even if they have the same symptoms as you, because it could harm them.
• If you experience any adverse effects, consult your doctor or pharmacist, even if they are adverse effects not listed in this leaflet. See section 4.

Contents of the leaflet

1. What Dercutane 20 mg soft capsules is and what it is used for
2. What you need to know before taking Dercutane 20 mg soft capsules
3. How to take Dercutane 20 mg soft capsules
4. Possible adverse effects
5. Storage of Dercutane 20 mg soft capsules
6. Contents of the pack and other information

1. What Dercutane 20 mg soft capsules are and what they are used for

Isotretinoin belongs to a group of medicines called systemic anti-acne preparations, which work by suppressing the activity of the sebaceous (fat-producing) glands and reducing the size of these glands. In addition, an anti-inflammatory effect of isotretinoin at the skin level has been described.

Dercutane 20 mg is indicated for the treatment of severe forms of acne (for example, nodular or conglobata acne, or acne with risk of permanent scarring) that do not respond to conventional treatment with other medicines (antibacterials).

2. What you need to know before starting Dercutane 20 mg soft capsules

Do not take Dercutane 20 mg:

• If you are pregnant or breastfeeding.
• If there is any possibility you could become pregnant, you must follow the precautions outlined in the "Pregnancy Prevention Programme", see the section "Warnings and precautions".
• If you have liver problems.
• If you have very high levels of lipids (cholesterol, triglycerides) in your blood.
• If you have very high levels of vitamin A in your body (hypervitaminosis A).
• If you are taking tetracyclines (a type of antibiotic).
• If you are allergic to isotretinoin or to any of the other ingredients of this medicine (listed in section 6).
• This medicine contains soya oil. Do not use this medicine if you are allergic to peanuts or soya.

Warnings and precautions

Treatment with isotretinoin must be supervised by a doctor experienced in the treatment of severe acne and familiar with all the risks associated with isotretinoin therapy, including the risk of fetal malformations (teratogenicity).

Pregnancy Prevention Programme

Pregnant women must not take Dercutane 20 mg

This medicine can seriously harm the unborn baby (the medicine is considered "teratogenic" and may cause severe abnormalities in the baby's brain, face, ears, eyes, heart, and certain glands – thymus and parathyroid). It also increases the risk of spontaneous abortion. This can occur even if Dercutane 20 mg is taken for only a short time during pregnancy.

• Do not take Dercutane 20 mg if you are pregnant or think you might be pregnant.
• Do not take Dercutane 20 mg if you are breastfeeding. The medicine is likely to pass into your breast milk and may harm your baby.
• Do not take Dercutane 20 mg if you could become pregnant during treatment.
• Do not become pregnant within one month after stopping treatment, as the medicine may still remain in your body.

Women who could become pregnant must only be prescribed Dercutane 20 mg under strict conditions due to the risk of serious harm to the unborn baby.

These conditions are:

• Your doctor must explain to you the risk of harm to the unborn baby, and you must understand why you must not become pregnant and what steps you need to take to avoid pregnancy.
• You must have discussed contraception (birth control) with your doctor. Your doctor will provide information on how to avoid pregnancy and may refer you to a specialist for contraceptive advice.
• Before starting treatment, your doctor will require you to take a pregnancy test. The test must confirm that you are not pregnant when starting Dercutane 20 mg treatment.

Women must use effective contraception before, during, and after taking Dercutane 20 mg

• You must agree to use at least one highly reliable method of contraception (e.g., an intrauterine device or contraceptive implant) or two effective methods that work in different ways (e.g., a hormonal contraceptive pill and a condom). Discuss with your doctor which methods are suitable for you.
• You must use contraception for one month before starting Dercutane 20 mg, throughout treatment, and for one month after stopping treatment.
• You must use contraception even if you are not having menstrual periods or are not sexually active (unless your doctor decides it is not necessary).

Women must agree to undergo pregnancy tests before, during, and after taking Dercutane 20 mg

• You must agree to attend regular follow-up visits, ideally every month.
• You must agree to undergo regular pregnancy tests, ideally every month during treatment and one month after stopping Dercutane 20 mg, because the medicine may still remain in your body (unless your doctor decides otherwise in your case).
• You must agree to undergo additional pregnancy tests if requested by your doctor.
• You must not become pregnant during treatment or within one month after stopping treatment, as the medicine may still be present in your body.
• Your doctor will discuss all these points with you using a checklist and will ask you (or a parent/guardian) to sign it. This checklist confirms that you have been informed of the risks and that you will follow the above rules.

If you become pregnant while taking Dercutane 20 mg, stop taking the medicine immediately and consult your doctor. Your doctor may refer you to a specialist for advice.

Additionally, if you become pregnant within one month after stopping Dercutane 20 mg, consult your doctor. Your doctor may refer you to a specialist for advice.

Advice for men

The levels of oral retinoids in semen of men taking Dercutane 20 mg are too low to harm a partner's unborn baby. However, you must never share your medicine with anyone.

Additional precautions

Never give this medicine to another person. Please return any unused capsules to your pharmacist at the end of treatment.

You must not donate blood during treatment with this medicine or for one month after stopping Dercutane 20 mg, because a baby could be harmed if a pregnant woman receives your blood.

Talk to your doctor before starting Dercutane 20 mg:

• If you have ever had any mental health problems, including depression, aggressive tendencies, or mood changes. This also includes thoughts of self-harm or ending your life. This is because your mood may be affected while taking Dercutane 20 mg.

Mental health problems

You may not notice some changes in your mood or behavior, so it is very important to inform your friends and family that you are taking this medicine. They may notice these changes and help you identify any issues that need to be discussed with your doctor.

• If you experience persistent headache, nausea, vomiting, blurred vision, or severe (bloody) diarrhoea; stop treatment immediately and contact your doctor as soon as possible.

• If you have kidney problems; inform your doctor, as you may need to start treatment with a lower dose.

• If you experience allergic reactions (skin redness, itching); inform your doctor, as treatment with Dercutane 20 mg may need to be stopped.

• Acne may worsen during the first few weeks of treatment, but should improve later.

• Your skin may become more sensitive to sunlight. Avoid exposure to sunlight (even on cloudy days) and to ultraviolet (UVA) lamps while taking this medicine. If sun exposure is unavoidable, apply a sunscreen product with a high protection factor (at least SPF 15) before going outdoors.

• Dercutane 20 mg may increase skin fragility. Chemical peels (controlled skin resurfacing to remove acne scars or lesions), laser skin treatments, and wax depilation should be avoided during treatment and for at least 6 months afterwards, as they may cause skin scarring or irritation.

• Avoid using topical keratolytic or exfoliating creams or preparations (to remove thickened skin) that have not been prescribed by your doctor.

• Use a skin moisturizer and lip balm during treatment, as Dercutane 20 mg can dry the skin and lips.

• Treatment with Dercutane 20 mg may cause reduced night vision, which can sometimes appear suddenly (see section "Driving and use of machines"). Other visual disturbances may also occur (e.g., dry eyes). You may develop intolerance to contact lenses, which may require you to wear glasses during treatment with Dercutane 20 mg. Cases of persistent dry eyes that do not resolve after stopping treatment have been reported. Inform your doctor if you experience any of these symptoms. Your doctor may recommend using an eye lubricant or tear replacement therapy. If you wear contact lenses and develop intolerance, you may be advised to wear glasses during treatment. Your doctor may refer you to a specialist if you experience visual difficulties and may ask you to stop taking isotretinoin.

• It is advisable to reduce intense physical activity during treatment with Dercutane 20 mg, as muscle and joint pain have been observed during treatment.

• Talk to your doctor if you experience persistent pain in the lower back or buttocks during treatment with Dercutane 20 mg soft capsules. These symptoms may be signs of sacroiliitis, a type of inflammatory back pain. Your doctor may stop treatment with Dercutane 20 mg soft capsules and refer you to a specialist for management of inflammatory back pain. Additional evaluation, including imaging techniques such as magnetic resonance imaging (MRI), may be required.

• Your doctor should regularly monitor liver function and blood lipid levels. If you are diabetic, obese, consume alcohol frequently, or have any lipid metabolism disorder, your doctor may need to perform more frequent monitoring. Diabetic patients are also advised to monitor blood glucose levels (blood sugar tests) more frequently.

Other medicines and Dercutane 20 mg

Inform your doctor or pharmacist if you are taking, have recently taken, or might need to take any other medicines.

Do not take vitamin A supplements or tetracyclines during treatment with Dercutane 20 mg. Taking them together increases the risk of adverse effects.

Pregnancy, breastfeeding and fertility

Pregnancy

[End of provided text]

For more information about pregnancy and contraception, see the "Pregnancy Prevention Programme" in the section "Warnings and Precautions".

Breast-feeding

Fertility

There are no data indicating that fertility or offspring in men are affected by taking isotretinoin.

Driving and use of machines

Dercutane 20 mg may in some cases cause a decrease in night vision, which can occur suddenly during treatment. Rarely, these disturbances persist after discontinuation of the medication. If you experience these or other visual effects, or if you feel drowsy or dizzy, you should not drive, operate machinery, or engage in any activity where these symptoms could place you or others at risk.

Dercutane 20 mg contains soybean oil, sorbitol, sodium, and carmine red A.

This medicine contains 11.89 mg of sorbitol (E420) in each capsule.

This medicine may cause allergic reactions because it contains carmine red A (E124). It may provoke asthma, particularly in patients allergic to acetylsalicylic acid.

This medicine contains less than 23 mg of sodium (1 mmol) per capsule; therefore, it is essentially "sodium-free".

3. How to take Dercutane 20 mg soft capsules

Follow exactly the instructions for use of this medicine as given by your doctor. If in doubt, consult your doctor or pharmacist again.

Remember to take your medicine. Your doctor will tell you how long your treatment with Dercutane 20 mg should last. Do not stop treatment early.

Take the capsules with food, once or twice daily. Swallow the capsules whole without chewing or sucking them.

Use in adults, including adolescents and elderly patients:

The usual starting dose is 0.5 mg per kilogram of body weight per day (0.5 mg/kg/day). Your doctor may adjust this dose after a few weeks depending on your response to treatment. In most cases, the dose ranges between 0.5 and 1.0 mg/kg/day.

Before starting treatment with Dercutane 20 mg, please read the "Pregnancy Prevention Programme" in the section "Warnings and Precautions".

Patients with severe renal impairment:

Treatment should be initiated at the lowest dose and increased later if necessary.

Use in children:

Dercutane 20 mg is not indicated for the treatment of acne occurring before puberty or in children under 12 years of age.

The usual course of treatment lasts 16 to 24 weeks. Acne may continue to improve for up to 8 weeks after treatment ends. Most patients require only one course of treatment.

If you think that the effect of Dercutane 20 mg is too strong or too weak, inform your doctor or pharmacist.

If you take more Dercutane 20 mg than you should

If you have taken more Dercutane 20 mg than you should, contact your doctor or pharmacist immediately.

In case of overdose or accidental ingestion, contact your doctor or pharmacist immediately or call the Toxicology Information Service at telephone number 91 562 04 20, stating the medicine and the amount ingested.

If you forget to take Dercutane 20 mg

Do not take a double dose to make up for forgotten doses.

If you miss a dose, take the medicine as soon as possible and continue treatment as prescribed. However, if it is almost time for your next dose, do not take the missed dose and wait until your next scheduled dose.

4. Possible adverse effects

Like all medicines, this medicine can cause adverse effects, although not everyone will experience them.

Serious adverse effects

Mental health problems

Rare (may affect up to 1 in 1,000 people):

• Depression or related disorders. These signs include low or altered mood, anxiety, and feelings of emotional distress.
• Worsening of existing depression.
• Becoming violent or aggressive.

Very rare (may affect up to 1 in 10,000 people):

• Some people have experienced feelings or thoughts about self-harm or ending their lives (suicidal thoughts), have attempted to end their lives (suicide attempt), or have died by suicide. These individuals may not appear depressed.
• Unusual behaviour.
• Signs of psychosis: loss of contact with reality, such as hearing voices or seeing things that are not there.

Contact your doctor immediately if you experience any signs of these mental health problems. Your doctor may advise you to stop taking Dercutane 20 mg. This may not be sufficient to stop the effects: you may need further help, which your doctor can manage.

It is very important that you inform your doctor if you have previously suffered from conditions such as depression, suicidal behaviour, or psychosis, and if you are taking any medication for the treatment of these conditions.

Other serious adverse effects

Rare (may affect up to 1 in 1,000 people):

Allergic reactions: severe allergic reaction with chest tightness or difficulty breathing (especially if you have asthma), skin rash, and itching. If you experience an allergic reaction, treatment must be stopped immediately and you should consult your doctor.

Very rare (may affect up to 1 in 10,000 people):

Increased intracranial pressure (in the brain): very rarely, when isotretinoin is taken together with certain antibiotics (tetracyclines), increased intracranial pressure, seizures, and drowsiness have been observed. If you experience a persistent headache with nausea, vomiting, and blurred vision, this may indicate benign intracranial hypertension. Stop taking isotretinoin as soon as possible and consult your doctor.

Gastrointestinal disorders: pancreatitis (inflammation of the pancreas), gastrointestinal bleeding (blood in stools), colitis, ileitis (intestinal inflammation), and inflammatory bowel disease. If you experience severe abdominal pain with or without severe bloody diarrhoea and vomiting, stop taking isotretinoin immediately and consult your doctor.

Liver disorders: hepatitis. If your skin or eyes become yellow and you feel tired, stop taking your medication immediately and consult your doctor.

Kidney disorders: glomerulonephritis (inflammation of the kidneys). You may feel excessively tired, have reduced or no urine output, and have swollen, puffy eyelids. If this occurs while you are taking your medicine, stop treatment with this medicine and consult your doctor.

Frequency not known (cannot be estimated from available data):

Skin disorders: severe skin rash (erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis) which may be life-threatening and requires immediate medical attention. These initially appear as circular spots, often with a central blister, usually on arms and hands or legs and feet; more severe rashes may also include blisters on the chest and back. Additionally, symptoms such as eye infection (conjunctivitis) or ulcers in the mouth, throat, or nose may occur. More severe forms of rash may lead to widespread skin peeling, which can be life-threatening. These types of skin rashes may often be preceded by headache, fever, and body aches (flu-like symptoms). If you develop any of these skin symptoms, stop taking this medicine and contact your doctor immediately.

Non-serious adverse effects

Very common (may affect more than 1 in 10 people):

Skin and eye disorders: dry skin, lips, and face. You may experience throat or skin inflammation, cracked skin or lips, rash, mild itching, and slight peeling. This dryness can be reduced by regularly using a good moisturiser from the start of treatment.

You may experience eye irritation or conjunctivitis, itching, and redness. You may also notice swollen eyelids. These adverse effects are usually reversible once treatment is stopped.

Musculoskeletal and connective tissue disorders: back pain (lumbago), muscle pain, and joint pain. These effects are reversible once you stop treatment. You should try to reduce intense physical activity during treatment with isotretinoin.

Blood and urine laboratory test abnormalities: decreased haemoglobin in blood (anaemia), decreased or increased platelets, increased liver enzymes (transaminases), increased blood triglycerides, and decreased levels of certain fats (high-density lipoproteins).

Common (may affect up to 1 in 10 people):

Blood and urine laboratory test abnormalities: decreased white blood cells, which may make you more susceptible to infections; increased blood cholesterol; increased blood sugar; detection of protein or blood in urine.

Nervous system disorders: headache.

Respiratory disorders: nosebleeds, dry nose, or inflammation of the nose and throat.

Rare (may affect up to 1 in 1,000 people):

Hair loss (your hair will return to normal after treatment ends).

Skin allergic reactions such as rash, itching, or swelling.

Very rare (may affect up to 1 in 10,000 people):

Other adverse effects that may occur include:

• Sudden chest tightness and possible difficulty breathing (bronchospasm), particularly in patients with asthma
• Dry throat, which may cause hoarseness
• Mild hearing loss
• Kidney inflammation: difficulty urinating or even inability to urinate, along with swollen eyelids and severe fatigue
• Excessive thirst and frequent need to urinate, indicative of increased blood sugar levels, which may suggest diabetes. Your doctor may monitor your blood sugar levels more frequently during treatment
• Increased blood uric acid levels
• Increased blood creatine phosphokinase levels
• Swelling of lymph glands
• Your acne may worsen at the beginning of treatment. However, it will improve as treatment continues
• Increased skin pigmentation
• Skin that is inflamed, more swollen, and darker than normal, especially on the face
• Increased sensitivity to sunlight during treatment
• Increased sweating
• Bacterial infections at the base of the nails, with swelling, redness, and pus
• Changes in nails
• Increased body hair
• Changes in hair texture, hair thickening. Your hair will return to normal after treatment ends
• Reduced night vision. This may occur suddenly.
• Changes in colour vision
• Severe eye irritation, swelling of the cornea (keratitis), and cataracts
• Irritation when using contact lenses
• Abnormal sensitivity to light. You may need sunglasses to protect your eyes from glare
• Redness, pain, swelling of blood vessels
• Seizures or epilepsy, dizziness, or increased sleepiness
• Blurred vision, vision difficulties, headaches, or even vision loss
• Severe acne
• Rash or abnormal redness of the face
• Generalised rash
• Arthritis, bone changes (e.g., growth delay, changes in bone density, abnormal bone growth)
• Swelling of tendons and ligaments. Symptoms include stiffness, swelling, pain, and discomfort in joints

Frequency not known (cannot be estimated from available data):

• Problems achieving or maintaining an erection
• Decreased libido
• Breast swelling with or without tenderness in men
• Vaginal dryness
• Sacroiliitis, a type of inflammatory low back pain causing pain in the buttocks or lower back
• Urethritis (inflammation of the urethra)

Reporting of adverse effects

If you experience any adverse effect, talk to your doctor or nurse, even if it is a possible adverse effect not listed in this leaflet. You can also report them directly via the Spanish Pharmacovigilance System for Human Medicines at www.notificaram.es. By reporting adverse effects, you can help provide more information on the safety of this medicine.

5. Storage of Dercutane 20 mg soft capsules

Keep this medicine out of the sight and reach of children.

Do not store above 30 °C.

Keep the blisters in the outer packaging to protect them from light and moisture.

Do not use this medicine after the expiry date stated on the carton, after EXP. The expiry date refers to the last day of the month indicated.

Do not use this medicine if you notice any visible signs of deterioration.

Medicines must not be disposed of via wastewater or household waste. Dispose of unused containers and medicines at a SIGRE collection point at your pharmacy. Ask your pharmacist how to dispose of medicines and containers you no longer need. This will help protect the environment.

Return any unused capsules to your pharmacist. Keep them only if your doctor specifically instructs you to do so.

6. Contents of the pack and other information

Composition of Dercutane 20 mg soft capsules

• The active substance is isotretinoin. Each soft capsule contains 20 mg of isotretinoin.
• The other components are: refined soybean oil, DL-alpha-tocopherol, disodium edetate, butylated hydroxyanisole (E320), partially hydrogenated soybean oil, yellow beeswax, and hydrogenated vegetable oil. The capsule shell contains gelatin, glycerol (E422), sorbitol (E420), carmine red A (E124), titanium dioxide (E171), indigo carmine lake (E132), and purified water.

Appearance of the product and contents of the pack

Dercutane 20 mg is presented as soft capsules; each capsule has a garnet-colored coating and contains an opaque yellow/orange viscous liquid. Each pack contains 50 soft capsules.

Marketing authorization holder and manufacturer responsible

Manufacturer

INDUSTRIAL FARMACÉUTICA CANTABRIA, S.A.
C/ Pirita, 9
28850 Torrejón de Ardoz (Madrid)
Spain

or

TOLL MANUFACTURING SERVICES, S.L.
C/ Aragoneses, 2
28108 Alcobendas (Madrid)
Spain

Date of the most recent revision of this leaflet: February 2024

Detailed and up-to-date information on this product is available by scanning the QR code included in the leaflet using a smartphone. The same information is also available at the following link: http://www.aemps.gob.es