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Table of Contents > Drugs >  Isotretinoin
Brand Names
Foreign Brand Names
Therapeutic Categories
What key warnings should I know about before taking this medicine?
Reasons not to take this medicine
What is this medicine used for?
How does it work?
How is it best taken?
What do I do if I miss a dose?
What are the precautions when taking this medicine?
What are the common side effects of this medicine?
What should I monitor?
Reasons to call healthcare provider immediately
How should I store this medicine?
General statements

(eye soe TRET i noyn)

Brand Names

Foreign Brand Names
Isotrex® (Canada)

Therapeutic Categories
Retinoic Acid Derivative

What key warnings should I know about before taking this medicine?

  • Do not use if you are pregnant or could become pregnant. There is an extremely high risk that your baby will be deformed or will die if you are pregnant while taking this medicine. Your healthcare provider will talk about the risk before starting you on the medicine. You must use 2 forms of birth control. There are only two reasons why you would not need to use 2 separate methods of effective birth control (you had your uterus removed by surgery or you commit to complete abstinence). Effective birth control must be started 1 month before the medicine and continue for 1 month after the medicine is stopped. Do not forget your birth control. You will need a pregnancy test each month. If you have sex without using effective birth control or miss your period, stop using this medicine and call your healthcare provider right away.

Reasons not to take this medicine

  • If you have an allergy to parabens, vitamin A, another retinoid, isotretinoin, or any other part of the medicine.
  • If you are pregnant or plan on getting pregnant.
  • If you are female and you do not understand the possible risks, are unwilling to follow all the instructions and sign the patient consent form.

What is this medicine used for?

  • This medicine is used to treat the most severe form of acne. Your acne has not improved with other medicines including antibiotics.
  • Other uses include treatment of some cancers in children. These cancers have not responded to other therapies.

How does it work?

  • Isotretinoin decreases gland size in the skin.
  • It also affects cell growth and reproduction.

How is it best taken?

  • You will get a month's supply at a time.
  • Take with food.
  • Swallow capsule whole. Do not chew, break, or crush.

What do I do if I miss a dose?

  • If you miss a dose, skip that one. Return to your regular schedule.
  • Do not take a double dose or extra doses.

What are the precautions when taking this medicine?

  • Tell healthcare provider if you or anyone in your family has had mental illness. This includes depression, suicidal thoughts or attempts, or loss of contact with reality (psychosis).
  • May have trouble wearing contact lenses. Your eyes may be dry.
  • Limit alcohol intake (includes wine, beer, and liquor).
  • Do not take extra vitamin A, beta-carotene, or a multivitamin containing vitamin A while taking this medicine.
  • Do not donate blood while using this medicine and for 1 month after stopping.
  • Do not take antibiotics like tetracycline or minocycline with this medicine. Increased pressure in the brain can occur.
  • You can get sunburned more easily. Avoid sun, sunlamps and tanning machines. Use sunscreen; wear protective clothing and eyewear.
  • Avoid cosmetic procedures to smooth skin including waxing, dermabrasion, or laser procedures for at least 6 months after stopping medicine.
  • Tell healthcare provider if you are allergic to any medicine. Make sure to tell about the allergy and how it affected you. This includes telling about rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, throat; or any other symptoms involved.
  • There is a high risk of birth defects in babies whose mothers took this medicine while pregnant.
  • As a woman who is able to have children you must talk with healthcare provider about the risks of this medicine to the baby if you were to get pregnant. You will also get a written paper talking about the risks.
  • You must have two pregnancy tests that say you are not pregnant. You need a pregnancy test every month in order to get more medicine.
  • Do not use in pregnancy and do not get pregnant. Use 2 forms of birth control that you can trust. Use 1 month before starting this medicine, during, and for at least 1 month after stopping this medicine.
  • Do not use birth control pills that have a low dose of progesterone (minipills). They may not work well.
  • Do not use if you are breast-feeding. Do not breast-feed for 1 month after stopping medicine.

What are the common side effects of this medicine?

  • Dry skin, itching, nose bleeds, dry mouth and nose, dry eyes.
  • Inflamed lips and irritated eyes.
  • Muscle aches and pains.
  • Nausea, vomiting, belly pain.
  • If you are pregnant this medicine can cause birth defects, premature births, and death in babies.
  • Serious mental problems such as depression.

What should I monitor?

  • If female, make sure that you take both forms of birth control. Do not miss doses.
  • If you have missed doses of your birth control then call healthcare provider right away.
  • Check blood work. Talk with healthcare provider.
  • You will need 2 negative pregnancy tests before starting this medicine. It must be repeated every month.
  • Follow up with healthcare provider. If you are female, follow up must be on a monthly basis.

Reasons to call healthcare provider immediately

  • Signs of a life-threatening reaction. These include wheezing; tightness in the chest; fever; itching; bad cough; blue skin color; fits; swelling of face, lips, tongue, or throat.
  • Feeling depressed, feeling blue, feeling sad, irritable, tired, having trouble concentrating, or loss of appetite.
  • Any thoughts of hurting yourself or of suicide.
  • Severe muscle aches and pains.
  • Severe belly pain, diarrhea, rectal bleeding, yellowing of skin or eyes, dark urine.
  • Pain with physical activity.
  • Any rash.
  • If you are pregnant or think you may be pregnant.

How should I store this medicine?

  • Store in a tight, light-resistant container at room temperature.

General statements

  • Do not share your medicine with others and do not take anyone else's medicine.
  • Keep all medicine out of the reach of children and pets.
  • Keep a list of all your medicines (prescription, herbal/supplements, vitamins, over-the-counter) with you. Give this list to healthcare provider (doctor, nurse, pharmacist, physician assistant).
  • Talk with healthcare provider before starting any new medicine, including over-the-counter or natural products (herbs, vitamins).
  • Read medication guide provided by pharmaceutical company.

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  Interactions with supplements
Carnitine (L-Carnitine)
Vitamin A (Retinol)

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