Description
About Tretiva 40 mg Soft Capsule
Tretiva 40 mg is a prescription soft capsule containing 40 mg of isotretinoin, made by Intas Pharmaceuticals, used to treat severe, scarring or treatment-resistant acne. It is the highest strength in the Tretiva range and is generally used by heavier adults once they have reached a full weight-based dose, often after starting on a lower strength.
Who is 40 mg for?
For an 80 kg adult, 0.5 mg/kg a day is 40 mg, and 1 mg/kg a day is 80 mg, which could be two 40 mg capsules taken with two meals. Lighter patients rarely need this strength. Doses above 1 mg/kg a day are uncommon and only used by specialists. Because side effects rise with dose, many dermatologists begin lower and increase once the first few weeks have gone smoothly.
How does isotretinoin work?
Isotretinoin reduces sebum production by shrinking the oil glands, normalizes the shedding of cells inside pores and reduces inflammation. Its benefits outlast the course, and many people remain free of severe acne afterwards.
How to take Tretiva 40 mg
- Swallow whole with a meal; do not chew, crush or open the capsule.
- Take it once daily or in two divided doses as prescribed.
- A typical course runs 16–24 weeks at 0.5–1 mg/kg a day.
- If you forget a dose, leave it out and take the next one as usual.
Coping with side effects at higher doses
- Lips and skin: use a thick balm constantly and a fragrance-free moisturizer twice daily.
- Nose: a thin smear of petroleum jelly inside the nostrils reduces nosebleeds.
- Eyes: lubricating drops help; glasses may be more comfortable than contact lenses, and night vision can be reduced, so take care driving in the dark.
- Muscles: scale back very intense exercise if you ache, and tell your doctor about severe pain or weakness.
- Sun: wear SPF 30 or higher and avoid sunbeds.
Pregnancy: strict precautions
Isotretinoin carries a very high risk of serious birth defects. Anyone able to become pregnant must be on a pregnancy prevention program (UK Pregnancy Prevention Program; iPLEDGE in the US). This requires two effective contraceptive methods for a month before, during and for a month after treatment, and negative pregnancy tests before starting, monthly and at the end. Breastfeeding is not allowed during treatment.
Serious effects to watch for
Report any low mood, anxiety, aggression or suicidal thoughts at once, and ask family to tell you if they notice a change. Seek urgent care for a severe headache with vomiting or blurred vision, severe abdominal or back pain, dark urine or yellow eyes, or a blistering rash. Blood tests check lipids and liver function before and during the course.
Interactions and precautions
Never combine isotretinoin with tetracycline antibiotics or vitamin A supplements. Limit alcohol. Do not donate blood during treatment or for one month after. Wait six months after the course before waxing, laser or dermabrasion.
Pack sizes
Strips of 10 capsules, sold in packs of 30, 60 or 90, from $80. Store in a cool, dry, dark place.
Frequently asked questions
Should I start on 40 mg?
Often not. Many courses start lower, for example with Tretiva 20 mg or Tretiva 30 mg.
Do higher doses clear acne faster?
They may reach the target total dose sooner, but with more side effects. Your dermatologist balances the two.
Where can I see other acne medicines?
Browse our acne category.
General information only. Tretiva 40 mg is a prescription medicine for specialist use; do not take isotretinoin without medical supervision.