DRUG ALERT
Urgent warning over common acne drug as doctors share side effect that left man, 20, with life-threatening condition
Some people claim the drug causes mental health problems like depression and suicide and are calling for it to be banned
DOCTORS have issued a stark warning to those taking a common anti-acne medicine after a young man suffered a life-threatening side effect.
The 20-year-old was taking isotretinoin, a controversial drug dished out on the NHS, when he was rushed to hospital with severe stomach pain, according to Belgian medics.
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The drug is well known for its potential mental health side effects.
Experts describing the case in the now warn that patients should also be aware of its potentially serious effects on the pancreas.
At the hospital, tests confirmed the man, whose name was not disclosed, had acute pancreatitis, a serious condition that can, in some cases, be deadly.
It occurs when the pancreas, a large gland at the back of the abdomen, becomes inflamed over a short period of time.
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In severe cases, the condition can cause tissue death in the pancreas, which may spread to the bloodstream, lead to organ failure, and even be fatal if not treated quickly.
Typically linked to gallstones or excessive boozing, medics at the time attributed his condition to alcohol, as he had consumed a few beers just days earlier.
The only medication he took was isotretinoin, a 10 mg/day pill, for acne.
Within a few days in the hospital, the man recovered and was sent home.
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But two and a half years later, he landed back in hospital with the same issue.
But this time, he had not touched alcohol, and the only thing linking both cases was isotretinoin.
There are many treatments available on the NHS to help with low mood and depression
Also known by the brand names Roaccutane or Accutane, isotretinoin is taken by 48,000 people in the UK for severe acne.
Specific data on the exact number of people using isotretinoin in Belgium is limited.
It's dished out on the NHS, but only when other options have failed or the person is at risk of scarring.
This is because some people claim it causes mental health problems like depression and are calling for it to be banned.
Tighter controls were placed on the use of the acne drug in 2023, after it was linked to a number of suicides over the past few years.
Other reports also suggest it may increase the risk of irritable bowel disease (IBD).
There is a possibility of sexual side effects including impotence and loss of libido when taking isotretinoin, according to the NHS.
Pancreatitis isn't listed as a main risk, but doctors suspected the acne drug was irritating his pancreas and advised him to stop taking it.
He recovered fully and had no further issues – until he used a cream version of the drug two years later.
Just 15 days after restarting treatment, he suffered yet another pancreatitis attack.
Medics from Centre Hospitalier Universitaire de Liège said this is the first documented case linked to the topical form of the drug.
New safety warnings
They are now calling for the drug to be reclassified so people are aware of its effects on the pancreas.
"Drug-induced pancreatitis is becoming increasingly common," they wrote.
"And it is essential to keep classifications up to date to properly warn patients and clinicians, and assess the benefit/risk balance when introducing a new drug.
"Isotretinoin should definitely be recognised as a Class I pancreaticotoxic drug."
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This would mean it would be officially recognised as a drug with a high potential to harm the pancreas.
"This change would raise clinicians' awareness of this not-so-rare complication," they added.
What is pancreatitis?
Pancreatitis is inflammation of the pancreas.
Inflammation is immune system activity that can cause swelling, pain, and changes in how an organ or tissues work.
The pancreas is a long, flat gland that's tucked behind the stomach. The pancreas helps the body digest food and regulates blood sugars.
Pancreatitis can be an acute condition. This means it appears suddenly and generally lasts a short time.
Chronic pancreatitis is a long-term condition. The damage to the pancreas can get worse over time.
Acute pancreatitis may improve on its own.
More-serious disease requires treatment in a hospital and can cause life-threatening complications.
Symptoms
Symptoms of pancreatitis may vary.
Acute pancreatitis symptoms may include:
- Pain in the upper belly
- Pain in the upper belly that radiates to the back
- Tenderness when touching the belly
- Fever
- Rapid pulse
- Upset stomach
- Vomiting
Chronic pancreatitis signs and symptoms include:
- Pain in the upper belly
- Belly pain that feels worse after eating
- Losing weight without trying
- Oily, smelly stools
Some people with chronic pancreatitis only develop symptoms after they get complications of the disease.
When to see a doctor
Make an appointment with your doctor if you have sudden belly pain or belly pain that doesn't improve.
Seek immediate medical help if your pain is so severe that you can't sit still or find a position that makes you more comfortable.
Causes
The pancreas has two major roles. It produces insulin, which helps the body manage and use sugars.
The pancreas also produces dietary juices, called enzymes, that help with digestion.
The pancreas makes and stores "turned off" versions of the enzymes.
After the pancreas sends the enzymes into the small intestine, they are "turned on" and break down proteins in the small intestine.
If the enzymes are turned on too soon, they can start acting like digestive juices inside the pancreas.
The action can irritate, damage or destroy cells.
This problem, in turn, leads to immune system responses that cause swelling and other events that affect how the pancreas works.
Several conditions can lead to acute pancreatitis, including:
- Blockage in the bile duct caused by gallstones
- Heavy alcohol use
- Certain medicines
- High triglyceride levels in the blood
- High calcium levels in the blood
- Pancreas cancer
- Injuries from trauma or surgery
Conditions that can lead to chronic pancreatitis include:
- Damage from repeated acute pancreatitis
- Heavy alcohol use
- Inherited genes linked to pancreatitis
- High triglyceride levels in the blood
- High calcium levels in the blood
Sometimes, a cause for pancreatitis is never found. This is known as idiopathic pancreatitis.
Source: Mayo Clinic & NHS
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