Isotretinoin
Indications
Isotretinoin capsules are used for severe acne, such as nodular or cystic acne, and for acne that leaves scars or has not improved with other treatments, including antibiotics taken by mouth. Treatment is started and supervised by a skin specialist (dermatologist).
How It Works
Isotretinoin is a form of vitamin A. It shrinks the oil glands in the skin so they make much less oil (sebum), reduces blocking of the pores, and lowers the growth of acne bacteria and inflammation. Many people stay clear of acne for a long time after one full course.
Dosage and Administration
As prescribed. The dose is worked out by the specialist from body weight and response, usually starting low and adjusted over a course of several months. Take the capsules with food, swallowed whole with water. Do not share your capsules with anyone.
Interactions
- Tetracycline antibiotics (such as Doxycycline and Minocycline) must not be taken at the same time, as together they can raise pressure inside the skull.
- Do not take vitamin A supplements or other retinoid medicines, as side effects add up.
- Avoid harsh skin products such as peeling agents and strong acne creams unless the doctor advises them.
- Alcohol can add to the effect on the liver and blood fats.
Contraindications
- Pregnancy, or a chance of becoming pregnant without reliable contraception.
- Breastfeeding.
- Liver disease, very high blood fats, or too much vitamin A in the body.
- Taking tetracycline antibiotics.
- Allergy to isotretinoin or any ingredient of the product (some capsules contain soya or peanut oil).
Side Effects
Common: dry and cracked lips, dry skin, dry eyes, nosebleeds, itching, skin that burns easily in the sun, muscle and joint aches, headache, and raised blood fats or liver tests. Acne may get worse for the first few weeks before it improves.
Get urgent medical help if you have: a severe headache with blurred vision, nausea or vomiting; severe stomach pain, or bloody diarrhoea; yellow skin or eyes or dark urine; a severe skin reaction with blisters or peeling; or low mood, depression, anxiety, aggressive behaviour or any thoughts of harming yourself. Tell the doctor about any change in mood straight away.
Pregnancy and Lactation
Isotretinoin causes serious birth defects even after a short time of use. Women who can become pregnant must have a negative pregnancy test before starting, use reliable contraception from one month before, during, and for at least one month after treatment, and have regular pregnancy tests as the doctor arranges. If pregnancy happens, stop the medicine and contact the doctor at once. Do not breastfeed while taking it.
Precautions and Warnings
- The doctor will check blood fats and liver tests before and during treatment.
- Do not donate blood during treatment and for one month after stopping.
- Use a lip balm and moisturiser, and protect your skin from strong sun.
- Avoid waxing, laser and other skin procedures during treatment and for at least six months after.
- Night vision may get worse; take care when driving at night. Contact lenses may feel uncomfortable.
- Limit very heavy exercise, as muscle pain is common.
- People with a history of depression, diabetes or high blood fats need closer monitoring.
Overdose
Taking too much may cause headache, vomiting, flushing, stomach pain, dizziness and unsteadiness. Seek medical advice promptly. A woman who may be pregnant must tell the doctor straight away.
Therapeutic Class
Retinoid (vitamin A derivative) for acne, taken by mouth.
Storage
Store below 30°C in a dry place, away from light and out of the reach of children. Keep the capsules in the original pack.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.
All brands of Isotretinoin