Should we be prescribing isotretinoin to patients with peanut allergies?
Citations Over Time
Abstract
Conflict of interest: the authors declare that they have no conflicts of interest. In the UK, two types of isotretinoin are available for prescription: the branded drug Roaccutane®, made by Roche Pharmaceuticals, and a generic form previously produced by Beacon Pharmaceuticals, but now made by Jensen Pharmaceuticals. Peanut oil, also known as arachis oil, is the oil extracted from peanuts, and this was previously an excipient in the capsule shell of Roaccutane®. In theory, this peanut extract could precipitate an anaphylactic reaction in patients with peanut allergy. In 1997, Hourihane et al.1 reported that allergenic peanut proteins may become denatured during the refining of arachis oil. The arachis oil in the capsules of medications such as Roaccutane® is highly refined, and therefore may be less likely to precipitate reactions. The British Association of Dermatologists (BAD) Guidelines for the use of isotretinoin for the treatment of acne vulgaris states: ‘Some brands (of Isotretinoin) contain peanut oil and are contraindicated in patients with peanut allergy.’ However, asking about peanut allergy is not mentioned in the pretreatment checklist for isotretinoin treatment.2
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