Isotretinoin

Please note: these are basic guidelines, refer to your doctor for a professional medical opinion.

Popular brand names:

Acnetane, Isotrex Gel, Oratane, Roaccutane

Drug group:

Drug for acne

Prescription needed?

Yes

What does it do?

Isotretinoin is prescribed for the treatment of:

• Severe acne – especially cases that have failed to respond to other treatments (a 16-week course of treatment usually clears the acne)
• Ichthyosis - a condition characterised by abnormal thickening of the skin

How does it work?

• Isotretinoin is chemically related to vitamin A
• It reduces production of sebum (oil) and keratin (protein) in the outer layers of the skin

How should it be used?

• Capsules should be taken with food or milk
• Women should use a combined oral contraceptive PLUS an alternative method of contraception, for one month before, during, and one month after treatment
• Do not donate blood during or for at least a month after using oral isotretinoin

What is the typical dosage?

Your doctor will recommend a dosage tailored to your need, but typically:

Capsules/gel, used 1–2 x daily, dose determined individually

How quickly will it start to work?

Capsules 2–4 weeks, gel 6–8 weeks.

NOTE: Acne sometimes worsens initially, but then usually improves in 7–10 days.
                                   

How long will the effects last?

Effects continue for several weeks after stopping the drug.

When should I stop using it?

For best results complete the course of treatment as prescribed.

Is it safe for prolonged use?

Prolonged use can result in: raised blood fat (cholesterol) levels, increased risk of heart/blood vessel disease, bone changes, liver damage and bowel inflammation. You will need blood tests for liver function and cholesterol levels before and during treatment.                    

What are the possible side effects?

Side effects usually improve as treatment continues. The following have been reported:

• More common: dry nose/mouth/eyes, inflamed lips, nosebleeds, dry/flaking/itchy skin
• Less common: mood changes, skin pigmentation changes, muscle/joint pain, temporary loss/increase of hair, headache, nausea
• Report to your doctor before taking your next dose if you experience: vomiting, abdominal pain, diarrhoea, blood in the faeces, visual impairment, rash, unusual bruising

What other considerations are important?

Dosage may be adjusted by your doctor under certain conditions.

• Certain health problems: liver/kidney problems, arthritis, gout, diabetes, depression, fructose intolerance, high blood fat levels, contact lens use, current or planned pregnancy
• Other medicines: tetracycline antibiotics, skin-drying preparations, vitamin A supplements, progestogen-only contraceptives
• Pregnancy and breast-feeding: NOT safe in pregnancy, the drug causes abnormalities in the developing baby. Isotretinoin may pass into breast milk and affect the breast-fed baby.
• Children: Not prescribed
• Over 60: Not usually prescribed
• Driving and hazardous work: Caution, can cause vision problems in dim light or darkness
• Alcohol: Avoid regular heavy drinking as this may raise blood fat levels
• Sunlight and sunbeds: Avoid, always use a sunscreen or sunblock