Isotretinoin 5 mg (Oratane; Authority Required Streamlined) has been added to the PBS from 1 July 2019 as an additional dose option for people with severe cystic acne.
The 5mg isotretinoin was recommended by the PBAC to allow for dose optimisation in patients who require a lower dose of isotretinoin than the currently available 10 mg, 20 mg and 40 mg.
The PBAC said the 5 mg capsule would likely be used in combination with the higher dose capsules as well as directly replacing daily or irregular dosing of the 10 mg strength capsule in some patients.
Melbourne dermatologist and All About Acne spokesperson Dr Mei Tam said the low dose would be useful for adults who were extremely sensitive to the drug.
“The lower the dose, the lesser side effects but the results will take longer,” she said.
It would also be useful for smaller people including babies or children with infantile cystic acne.
Dr Tam said isotretinoin remained the most effective treatment for severe cystic acne.
However novel strategies under investigation included changing the balance in the skin microbiome to fight Cutibacterium acnes and vaccinating against it and its toxins to minimise the pro-inflammatory fermentation metabolites of C. acnes.