Trevissage: Contraindications, Properties And Benefits

It is a pill indicated to treat severe acne, be it nodular acne or nodulocystic acne; This type of acne has unique characteristics due to its measurements and shapes that define it. Also other types of stubborn acne that leave scars and are resistant to other treatments with strong drugs and antibiotics.

It is also indicated for the treatments of severe rosacea (skin affection with strong reddish pigmentation), gram negative folliculitis (severe inflammation that occurs in the part of the hair growth), or other types of chronic diseases that are resistant to hidradenitis suppurativa. that affects the sweat glands and with a high tendency to appear abscesses and nodules.

Likewise, it is a drug to counteract other diseases or disorders presented in the skin such as keratinization, since it affects the cells present in the epidermis, causing premature aging of the skin due to the acceleration of the process of fluid loss. on the skin. Some cases are more severe than others but they are still of care.

What is its active principle and mode of action?

The active principle  is Isotretinoin, it inhibits the activity of the sebaceous glands and reduces the size of these glands, therefore it also reduces the metabolism and the nutrients that keep acne active. This compound also has properties to act in an anti-inflammatory way and as an anti-rattle.

In addition, this active principle, such as Isotretinoin, goes through a process where the crystals of this drug are subjected to micronization, which allows to reduce the size of the particles to the maximum, and in this way to ensure, in addition to guaranteeing physical stability according to pharmacological requirements.

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Trevissage Presentations

There are two presentations in the pharmaceutical market in which the concentration of the active principle varies (Isotretinoin) and they come in soft capsules (soluble coating that contains the dose), this capsule form is the second most used in the pharmaceutical industry to supply a medicine. and it is a leader among the types of tablet presentations.

• Trevissage 20: Contains 20 mg (milligrams) of Isotretinoin plus Excipients qs Each box has 30 softgels.
• Trevissage 10: Contains 10 mg (milligrams) of Isotretinoin plus Excipients qs Each box has 30 softgels.

Types of Trevissage

It can also be found in other presentations or trademarks that contain the same active ingredient, that is, they must have Isotretinoin in the same amounts of said compound in their active ingredients.

To find Trevissage in its other commercial and non-generic presentations, it appears with the names of: Derccutane, Accutane, Acnotin, Isoface, Tretinex, Reytrin, among other names.

On the other hand, Isotretinoin is a compound that has a group of drugs that are related to the retinoids of vitamin A, whose administration is carried out when acne cases are very severe.

It is commonly used to treat, eliminate and improve severe acne completely. It can be used to treat other skin conditions such as rosacea.

Treatment with this drug and all its derivatives achieves very positive results , since it not only manages to treat acne, but also manages to eradicate it and eliminate it completely, without running the risk of reappearing at the end of the treatment.

Through studies it was possible to determine that the rates of falls or relapses in the disease are only 15% to 20%, otherwise, most of the patients treated are satisfied with the results of this treatment.

Look here Severe Acne: Treatments, Pathologies, Symptoms and Causes.

The Trevissage and its contraindications

In the case of contraindications, there are many factors to take into account for this type of medication since the effects it has on the fetus are proven, so that the treatment should not be used in cases of pregnancy and when it is in the period of pregnancy. lactation. Likewise, if there is hypersensitivity to it

It is also contraindicated in patients who are diagnosed with hyperlipidemia, since it is a disease that does not manifest itself with symptoms, but does present high levels of lipids (fats) in the bloodstream. Also, for those patients who have hypervitaminosis A (high excess of vitamin A) and liver or kidney failure.

Therefore, it is advisable for patients using this drug to periodically undergo medical tests that assess liver function and its good activity, to evaluate the entire liver system.

Effects of other diseases with the Trevissage

It should be noted that it is essential to consider both the risks and the benefits obtained when using it in treatments where medical problems arise, for which, together with the doctor, you should study its pros and cons when ingesting these capsules. Let’s look at the following medical benefits and drawbacks to consider due to the reaction to Trevissage:

• Problems that induce hypertriglyceridemia. As its name implies, it is a high increase in triglyceride levels in the blood, which is why it is linked to people who are overweight or have a history, high alcohol consumption, a history of high triglycerides or other conditions related to triglycerides. This drug tends to raise those levels more triglycerides in their plasma concentration and to a lesser extent total cholesterol, it can also minimize the production of good cholesterol levels, so that in very long treatments it affects the risk of suffering cardiovascular problems.

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• Problems with type diabetes mellitus. This type of diabetes is mainly related to problems with high insulin in the blood. Therefore, Isotretinoin  can increase sugar and its concentration in the blood. But it should be noted that to treat severe acne problems, Trevissage does not influence insulin problems when used for a long time, but it does have to consider blood sugar levels.

• Retinoid conditions. Retinoids chemically act with vitamin A (it is a fat-soluble one housed in the liver), which influences epithelial cells, which are responsible for skin tissues and other functions. Therefore, it can alter and sensitize vitamin A levels.
• Effects on pregnancy. Highly harmful for pregnant women or when they are breastfeeding, since its active principle such as Isotretinoin is a teratogenic agent which puts the development of the embryo at risk and can cause malformations in the fetus.

Precautions when taking Trevissage

Before starting to consume this drug, it is important to take a series of precautions that undoubtedly can help us avoid a series of adverse reactions in our body and even more so, if we have any additional pathology. Among the precautions to take we have.

• Alteration and sensitivity to the component of this drug: it  can be sensitive in patients suffering from severe acne, but with a cross effect in the alteration of vitamin A and its derivatives such as tretinoin (acid derivative of this vitamin) as well as acitretin.
• Evidence of cancer or tumor: This type of compound such as Isotretinoin has been studied in animals and presented adverse results with a low incidence of the formation of hepatic adenomas (benign tumor in the epithelial tissue in glands) and angiomas (benign type of tumor). , as well as reported incidences of leukemia.

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• Fertility studies: According to the studies carried out in male patients with severe acne, there is no risk of presenting infertility under this treatment, since there were no significant changes in their ejaculation, in the volume and production of sperm, as well as in the quality. of their sperm. Maintaining the fertility of man invariable.
• Cellular genetics: In the dosage of Trevissage (Isotretinoin) in the treatment of nodular or cystic acne, they do not present risks in terms of the alteration of genes or chromosomes, for which there is no evidence of modifying or mutating the genetic material of cells.
• During pregnancy: Extreme caution in its consumption since Isotretinoin has been classified as a teratogenic (a substance that produces a genetic alteration causing malformations), so it is careful to use this medicine and have a sexually active life.

That is why it is necessary to take the precautions with the doctor for its use and the contraceptive methods used orally. It is necessary to take a pregnancy test within two (2) weeks before starting treatment to verify that you are not pregnant, to avoid risks after starting treatment.

Likewise, before starting treatment you must have at least one (1) month of applying a contraceptive method that is 100% effective, either combined with pills and the use of condoms in sexual intercourse in order to safely attack the skin conditions.

It is also recommended to start taking the treatment on the third (3) or fourth (4) day of the menstrual cycle. Similarly, be careful with contraception to get pregnant for two continuous months after stopping acne treatment.

The latent and high risk with the use of Trevissage has been proven, they cause a deformation and affectation in the fetus when pregnancy occurs using this drug, even for short periods of taking the drug in the minimum dose.

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The abnormalities in the fetuses can vary, but absolutely all the documented cases are related to the use of this drug; Cases ranging from brain malformation, hydrocephalus, microcephaly, external ear and eye abnormalities, severe heart disease, thyroid gland insufficiency, and other malformations.

Pregnancy can only be avoided when using Trevissage by being aware of the care to be taken with this class of drug, as well as being informed and using the safest methods to avoid getting pregnant during and after treatment.

• Caution in breastfeeding: This drug should not be indicated if you are breastfeeding, since traces of Trevissage can go through the milk produced by the mother and transmit the effects of this drug in this way. For that reason, the doctor should be informed if you are breastfeeding.
• In the donation of blood: in this case it can also possibly affect the fetuses to pregnant patients who receive a transfusion, since this drug is found in the blood. Therefore, it is advisable not to donate blood while receiving this medicine and the risk also remains after 1 month of stopping treatment.
• Uses in pediatric patients: Drug not studied in children, but because it is a strong drug, it can cause severe damage because it is in the growth and development stage where their entire system is weak.
• Use in geriatrics : It is not commonly indicated in older adults, since severe cases of acne on the skin rarely occur, for which there is no documentation that indicates the use according to age and this drug.
• Oral system: When taking Trevissage capsules you should be careful as it affects the oral cavity, so much so that you may be more prone to dental problems such as cavities, inflammation and infection in the gums, excess salivation or dry mouth.

It is strictly necessary for the patient suffering from nodular or cystic acne to have a control with the dermatologist and dentist , in addition, most acne and other types of diseases that this drug attacks are located on the surface of the face. It is also recommended to keep a record of the symptoms in the mouth and to use stimulants to produce saliva.

Side effects when using Trevissage

They vary according to each patient, so it is important to pay attention to each case , since while this drug is being used it will be related and only until the relationship they may have is completely ruled out, will it be part of the list of reactions adverse events you may have.

It should also be noted that the patients studied when using it and its side effects that they could obtain when using it to combat nodular acne problems, when stopping the treatment its adverse effects were reversed. However, despite this, it usually causes a series of side effects in the body, but it is simply due to its main active compound.

These common effects usually affect the skin directly, making it much weaker and more fragile while we are in the presence of the treatment, since luckily these conditions obtained are reversible without leaving annoying sequelae.

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Very rarely do we find collateral effects present internally in the body or that may affect a specific organ, however, on very rare occasions they occur and require urgent medical attention and in that case, treatment would be suspended.

Here are a series of common and totally normal side effects that occur due to the action of the drug in eliminating excess fat and sebum production in the skin and others in which urgent medical help and assistance is required.

Xerosis or dry skin and mucous membranes

The Trevissage reduces the amount of sebum and oil production in the skin, it has a greater tendency to remain dry or without natural hydration. This effect can be seen with the naked eye in areas such as the lips, mucous membranes or the inside of the nose and the inside of the hands respectively.

As we mentioned earlier, it is a totally reversible effect that heals after the treatment is completely finished and when the body has excreted all the remaining drug from the body.

For this reason, it is often recognized or popularly called “the medicine that makes it look like a lizard” since these reptiles when they shed their skin, it is stripped to give way to a new and regenerated layer of skin.

Photosensitivity

The retinoids of vitamin A contained in this drug favor and help the skin to become red or much more pink in the presence of lights or heat sources with a fairly high intensity.

This condition favors the appearance of burns and mistreatment of the skin when it is in contact with said causative agents or sources, one of them is sunlight and ultraviolet radiation in general.

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As in Xerosis or dry skin and mucous membranes, this is a completely normal symptom in the body and to help prevent it from increasing, you should use sunscreen with a protection screen of at least 30 SPF to go out and be at home you can use a protection of 15 to 20 SPF calmly.

For this reason, in the summer or vacation time, the doses of Trevissage lower since at this time of year the sun’s rays are at their maximum and, therefore, they mistreat the skin more.

It is recommended while taking this treatment not to use artificial solariums and you can not do laser or normal hair removal, because it can cause permanent scars in it.

Hepatoxicity

It is a very rare side effect but it may be likely to occur since, like all drugs, it is metabolized in the liver. For this reason, under no circumstances should alcoholic beverages be consumed while using this treatment , since it can increase transaminases by 15% to 20%.

To prevent the appearance or that it can be detected in time, it will be requested to constantly practice blood tests, to verify that all values ​​are within their normal ranges.

Teratogenesis or fetal malformations

This condition does not affect any person who is not pregnant, so it should not be ingested by any woman who is pregnant or thinks she is, since the risk of congenital malformations is more than half, ranking between 45% to 55%. % in each case.

To prevent the appearance of this complication, the safest thing is for the doctor to request a monthly pregnancy test, just to confirm that the drug treatment should not be paused or stopped.

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It causes bone malformations and problems in the growth and formation of the fetus regardless of the gestation time at the time, in very serious cases a spontaneous abortion or the appearance of microcephaly and hydrocephalus can occur.

Side reactions that demand medical help:

• More recurrent reactions : these types of incidents where medical attention is necessary since an adverse effect such as burning and strong redness, pain in the joints, intense pain in certain areas that gives the sensation of having a severe burn, inflammation in the eye area, skin infections, etc.
• Uncommon reactions: these occur in fewer patients who consume Trevissage such as: gum conditions presenting inflammation and bleeding, vision problems, intestinal inflammation diseases, depression or psychiatric disorders, severe headaches, nausea, stiffness, pain in the bones, back and muscles.
• Inconclusive reactions: these types of cases are not determined by the exclusive use of the drug in question, such as chest pain, radical acne production, conjunctivitis, aggression problems, slow healing processes and fractures in adolescents, respiratory tract infections, osteopenia, thrombi, heart problems, addictive decline.

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Side reactions that require medical help if they are persistent:

• More recurrent reactions: Excessive pain caused in the back, delayed healing or scabbing, dry eye syndrome, little discharge from the nose and mouth, discomfort in contact lenses, burning sensation on the skin, constant pain in the head, stomach problems, tiredness, scales on hands and feet, hair loss.
• Inconclusive reactions: baldness, unusual menstruation, bone problems, color blindness, arthritis, fatigue and tiredness problems, dizziness, nervousness, constant sleep, increased sebum, skin fragility, skin burns, frequent sweating, hair growth on infrequent areas, voice variation and weight loss.

What recommendations can I take before starting the medication?

• If you have an active sex life, avoid pregnancy within the course of treatment and for two (2) months after finishing treatment because it influences the development of the fetus during pregnancy.
• Have liver and lipid tests done before starting treatment and after one (1) month repeat liver and lipid tests at the end of a treatment period (3 to 4) months.
• If they have a psychiatric or psychological history, pay attention to the changes that may occur in mental health, since there is evidence of psychotic cases or depression, if simultaneous treatment is necessary.
• According to the case of each person who suffers from severe acne, its benefits and risks should be studied, as is the case of possible bone problems with obvious changes.
• Contraceptives that have progestational androgen should be avoided for acne, since acne is an androgen dependent condition, and other derivatives that come from nortestosterone.
• While consuming, alternative rejuvenation, facial care and waxing treatments should be completely avoided ; since they disturb the action of the medicine and there can be irreversible problems in the skin. Only after (5 to 6) months of completion of the treatment can these beauty treatments be used.
• If nodular or cystic acne can be treated in special cases that the Trevissage influences your disease (diabetes, alcoholism, hypertriglyceridemia, lipids), only that it requires more frequent and special control.
• Constantly check blood glucose in diabetic or diabetic patients. Also have permanent controls of sugar in the blood, since cases of diabetes have appeared during the treatment.
• Do not resort to other treatments or therapies that are exfoliating anti-acne, ultraviolet radiation (UV), also avoiding direct contact with the sun. You can only use topical anti-acne drugs with medical authorization.

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• It should not be a medicine that can be acquired by children, since it can be accidentally consumed and cause even the death of the minor, as it is a very strong medicine.

Can it be combined with other treatments?

It can interact with other classes of drugs, depending on the amount of drugs present. In many cases, studies have not been completed that determine with certainty its interaction with the different classes of drugs. The most commonly used will be mentioned:

The Antiepileptics: anticonvulsant drugs can be used with caution when acting with said medicament, as studies have determined the relationship with these drug classes and if can occur cases where the go interaction linked to decreased bone mass , in prolonged uses together with these two drugs.

With oral contraceptives: in studies carried out in postmenopausal women, they concluded that there are no significant clinical changes between using Trevissage and the anticipatory ones with active compounds such as Ethinyl Estradiol and Norethindrone. But until now it has not been studied in depth that Isotretinoin influences the effectiveness of contraceptives.

Progestins in oral contraceptives : In this case the contraceptive effect can be reduced with the combination of Trevissage treatments with this type of contraceptive. Therefore, it is extremely careful, since this type of contraceptive is less effective and a second or more radical form of protection must be sought, such as sexual abstinence.

Retinoids: The different types of retinoids, whether systematic or topical, can put the patient at risk due to an action of toxicity due to excess vitamin A, since their continued use can provide more vitamin A than is required by the body, forming this mode a rejection of this vitamin.

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Antimicrobial antibiotics: From the tetracycline family, its combination with Trivegessan (Isotretinoin) is highly harmful, since studies have shown a type of cranial hypertension . Therefore, it is recommended not to combine these two drugs.

Sulfonamide or photosensitive drugs: when the compositions of these drugs interact, a type of sensitivity of patients can be caused and in cases where there are several months of this sensitivity, the simple rays of the sun can cause burns, because they are affected the layers of the skin.

What should be done if there is an overdose of Trivegessan?

In cases of an overdose, either intentionally or unintentionally, absorption should be avoided and minimized, through stomach lavage in the first two (2) hours after the overdose.

Also monitor the pressure in the skull as it can be affected. And in the same way keep track of the concentrations that can be had in the blood since this influences other functions of the body.

Trevissage dosage

• Its administration is orally.

In adolescents and adults its doses:

• For severe nodular and rosaceous acne: Take between 0.05mg / kg to 1mg / kg daily, as it is advisable to take it in divided doses when eating food. In a period of 15 to 20 weeks. There may be an adjustment to require more Trivegessan medication and as it is tolerated by the body.
• For keratinization, dosage from up to 4mg / kg per day. For a period of 4 months, depending on the type of keratinization.
• It is important to note that this type of medicine should only be taken with meals. Only the treating physician can indicate exactly what concentration to take of Trivegessan.

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How is Trevissage ingested?

It can be ingested in two doses a day for all those patients who have a mass weight greater than 60 kilograms, since they are already higher doses to consume them in the same dose.

This drug is recommended to be ingested on an empty stomach, in the morning , since its absorption is carried out in the small intestine and it is better if it is without any trace of food.

In general, this drug is preferable to ingest only with water without any additional food or drinks , because its effectiveness would be reduced and that is what is not wanted, on the other hand, there are also a series of foods that remove or reduce its effectiveness.

Now, among these foods we find dairy, but mainly milk, of course it is only if the pill is ingested with the milk as if it were water. Juices are also contraindicated to ingest in the company of this drug.

However, the hour or time in which it is ingested is not very important because the important thing is the constancy that one has when taking the medicine and strictly following the doctor’s instructions.

Response to Trevissage treatment

It stimulates the skin to expel and eliminate excess oil from the sebaceous glands of the skin. That is why at the beginning of the treatment you can notice that the acne has increased a little but after 2 or 3 weeks you will begin to notice indescribable and permanent improvements in your condition.

In cases of very severe acne, this aggravation can form ulcers on the skin . That is why the dermatologist can medicate the use of corticosteroids for 2 or 4 weeks before starting treatment, just to avoid and prevent this pathology.

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After the first month of treatment, a period where an aggravation can be observed, the Trevissage begins to show its positive effects . The vast majority of patients show excellent results throughout the entire treatment, with effects that will last until the end of the treatment.

Most of the patients present a total healing and effectiveness of 40% to 50% without the need to take another round of medication, the rest of the percentage will need to take another round to be able to notice the absolute improvements , of course, if the case of acne is very severe and warrants it.

The cases of incidence in acne months after having finished the treatment can also be treated with Trevissage . In general, you must wait an interval of 5 months to start the treatment again, almost always the recurrences of acne are because the body did not manage to accumulate at least 7200 mg of the compound in the entire treatment.