Once I decided to go for 150mg/kg cumulative, and it was going to take forever unless I really ramped up the dose, I tried to go up as fast as possible.
As soon as the sides (other than dry lips, which you can only keep using lip balm for) eased off and I felt ok, I'd double.
On average, every two weeks.
At 180mg (2mg/kg, the absolute max) after a week it didn't get better, some SI joint pain, so I dropped down to 160mg which was tolerable.
I was so happy with the results after 3 months, I decided to go for 220mg/kg cumulative, the "magic" number with the highest documented rate of never needing retreatment.
However, the other thing that predicts best long term results beyond cumulative dose, is continuing for 2 months beyond complete clearance (with the added benefit of reducing old acne scars because skin turnover accelerates to an incredibly fast rate).
My shoulders were last to clear, at 3 months, and I was going too fast, because I'd hit 220mg/kg before the 5 month mark.
So I've been easing off, down to 100mg/day. Once I started reducing, there have been zero sides other than dry lips.
Always split dose to twice a day. This makes a big difference in sides. Always eat after food, preferably high fat. Most failures are attributed to lack of absorption by failing to eat high fat meals. Effectiveness is reduced by 80%+ without it. If you can't manage that, you'll need to buy Sotret NF, which doesn't rely on high fats for absorption, but'll be more expensive. For 20,000mg $450-500 vs $200-250. By comparison 20,000mg of the equivalent NF stuff in the US is $18,000.
Stay disciplined, all sides have been temporary (until 180mg). Don't panic when acne returns or worsens. That's a good sign. It happened multiple times, in different body areas as the treatment "reached" those areas. I got (very short term) acne in places I never had it before, like my stomach! Once that happens, the area will clear and be "done".
Stock up early, consistent daily use has proven vital for effective treatment. You don't want to lose ground and go through sides again. Murphys law I had a hell of a time ensuring I didn't run out and came. very close. The larger gelcaps 30-40mg make things a lot cheaper when buying 20,000mg of this stuff, but you need some 10-20mg to have flexibility of dosing.
