isotretinoin at a glance
Medicine class
Oral retinoid related to vitamin A
Usual role
Severe, treatment-resistant acne or acne at risk of permanent scarring
Administration
Swallow capsules whole with food
Key safety requirement
Pregnancy must be prevented; mental health and sexual function require monitoring
What is isotretinoin used for?
Licensed use represented by the selected product:
Severe acne, including nodular or conglobate acne or acne at risk of permanent scarring, when adequate standard systemic antibacterial and topical treatments have not worked.
How does isotretinoin work?
It suppresses sebaceous-gland activity and reduces gland size and sebum production. This makes follicles less prone to blockage and reduces conditions promoting acne-related inflammation.
isotretinoin preparations and strengths
Capsule
Route: Oral
Strengths: 5 mg, 10 mg, 20 mg
How to take isotretinoin
Follow the specialist’s directions and the leaflet supplied with the product.
Take capsules with food and swallow them whole.
Do not share isotretinoin.
Return unused capsules to a pharmacy.
isotretinoin side effects
Common or expected effects
- Dry, cracked or inflamed lips and dry or fragile skin
- Dry or irritated eyes, conjunctivitis or reduced contact-lens tolerance
- Dry nose, nosebleeds or sore throat
- Back, muscle or joint pain
- Headache
- Changes in liver enzymes, blood fats or blood-cell measurements
- Increased sensitivity to sunlight
Get urgent medical advice
- New or worsening depression, marked mood or behaviour changes, psychosis or thoughts of self-harm
- New sexual-function problems, including those occurring after treatment
- Severe headache with nausea, vomiting or visual disturbance
- Severe abdominal pain, particularly with vomiting
- Bloody diarrhoea
- Serious allergic or severe skin reaction
- Sudden or significant visual changes
isotretinoin in pregnancy
Isotretinoin must not be used during pregnancy because it can cause miscarriage and severe birth defects. Anyone who could become pregnant must meet Pregnancy Prevention Programme requirements, including contraception and pregnancy testing. If pregnancy occurs or is suspected during treatment or within one month after stopping, stop isotretinoin and contact the specialist immediately.
isotretinoin while breastfeeding
Do not take isotretinoin while breastfeeding. It may pass into breast milk and potentially harm the baby; discuss an alternative with the prescriber.
isotretinoin interactions
Tell the specialist or pharmacist about all medicines, vitamins, supplements and skin treatments.
Tetracycline antibiotics, including doxycycline
Do not combine them with isotretinoin because this increases the risk of raised pressure around the brain.
Vitamin A supplements
Avoid them because additive vitamin A toxicity may occur.
Common questions about isotretinoin
Answers are fully visible for fast scanning and source review.
Why must isotretinoin be prescribed by a specialist?
It requires careful selection, counselling and monitoring because of major pregnancy risks and possible psychiatric, sexual, metabolic and other adverse effects.
Can acne worsen at first?
Acne can temporarily flare early in treatment. Contact the dermatology team if worsening is severe or concerning.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.