Take isotretinoin capsules with a meal or after a snack.
It is very important that you keep your regular check-ups with your doctor.
Isotretinoin will harm an unborn baby. It is very important that women taking isotretinoin do not get pregnant.
Do not donate blood while you are on isotretinoin, and for one month after stopping treatment.
|Type of medicine||An oral retinoid|
|Used for||Severe forms of acne in adults and young people over 12 years of age|
Acne is the common cause of spots. Most people with acne are aged between 12 and 25, but some older and younger people are affected too. Small sebaceous glands lie just under your skin surface and make an oil (sebum) that keeps your skin supple and smooth. Tiny pores on your skin allow the sebum to come on to the surface of your skin. In acne, some of these pores become blocked, causing inflamed spots.
Isotretinoin belongs to a group of medicines known as retinoids, which are substances related to vitamin A. It is used to treat acne which is severe, or which has not got better with other treatments such as oral antibiotics or skin treatments. It works by reducing the production of your skin's natural oil. It is also thought to reduce inflammation. Isotretinoin capsules will be prescribed for you by a specialist skin doctor.
Isotretinoin is also available as a topical (rub-on) skin treatment. There is more information about topical isotretinoin in a separate leaflet called Isotretinoin gel for acne.
Before taking isotretinoin
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking isotretinoin it is important that your doctor or pharmacist knows:
- If you are pregnant, trying for a baby or breast-feeding. This is very important because isotretinoin is harmful to babies.
- If you have diabetes.
- If you have a dry eye condition.
- If you have kidney or liver problems.
- If you have been told you have high levels of lipids (fats) in your blood.
- If you have ever had a mental health problem such as a depressive illness, or if you have ever had suicidal thoughts.
- If you know you have a condition called hypervitaminosis A (too much vitamin A stored in your body).
- If you have ever had an allergic reaction to a medicine, or if you are allergic to soya or peanuts.
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines. It is particularly important that your doctor knows if you are taking a tetracycline antibiotic, or a vitamin supplement.
How to take isotretinoin
- Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack and any other printed information you are given. The manufacturer's leaflet will give you more information about isotretinoin and a full list of the side-effects which you can experience from taking it.
- The capsules are for you - it is very important that you do not share isotretinoin with anyone else.
- Take isotretinoin exactly as your doctor tells you to. Your dose will be calculated from how much you weigh. Isotretinoin is taken once or twice each day - your doctor will tell you which is right for you and your dose will also be printed on the label of the pack to remind you.
- Take the capsules after you've eaten some food, or a meal. It is best to swallow them with a drink of water. Do not open or chew the capsules.
- If your doctor thinks it necessary, your dose may be adjusted during the course of treatment. If this happens, make sure you follow carefully the instructions that your doctor gives to you.
- You will be prescribed a course of treatment that lasts for 4-6 months. Only one course of treatment is usually needed.
- If you forget to take a dose, take it as soon as you remember unless your next dose is due. If when you remember, your next dose is due then take the dose that is due and leave out the forgotten dose. Do not take two doses together to make up.
Getting the most from your treatment
- It is important that you keep your regular appointments with your doctor. This is so your doctor can check on your progress. You will need to have some tests before and during the treatment. The tests will check a number of things: that your liver and blood remain healthy, that the amount of fat in your blood stays within normal amounts, and (in women) that you are not pregnant.
- Your doctor will explain to you the dangers of isotretinoin on an unborn baby. If you are a woman, you will be given advice on which types of contraception are suitable for you. One or more forms of contraception are needed at least one month before you start taking isotretinoin, during the course of the treatment, and for at least one month after you stop taking isotretinoin capsules. If at any time during treatment, and for one month afterwards, you think you may be pregnant, you must speak with your doctor straightaway.
- Some people find that their acne gets worse when they first start taking isotretinoin. This can happen, but it usually resolves quickly within a week or so.
- Isotretinoin is likely to make your skin feel very dry. Many people find that using a moisturiser and a lip balm regularly helps to reduce this.
- You may find that your eyes feel drier than normal. Ask a pharmacist or optician to recommend some suitable lubricating eye drops for you to use. If you normally wear contact lenses, you may prefer to wear glasses instead for a while.
- Your skin will become more sensitive to sunlight and UV light while you are on isotretinoin. Do not use sunbeds and try to avoid direct sunlight. It is recommended that you use a sunblock and a lip balm with a sun protection factor (SPF) of at least 15.
- Do not use treatments such as hair removal waxing, chemical dermabrasion, or laser treatments. You should wait for at least six months after you've finished isotretinoin before having any of these types of treatments.
- Prescriptions for isotretinoin must be dispensed within seven days of being prescribed by a doctor. Wherever possible, it should be on the same day. Each time you are given a new prescription, please take it to your pharmacy to be dispensed straightaway.
- Do not take any vitamin supplements which contain vitamin A while you are on isotretinoin. If you buy any over-the-counter medicines or vitamin supplements, check with a pharmacist that they are suitable for you to take. Also, do not use or take any other anti-acne treatments.
- If you are a blood donor, do not donate blood while you are taking isotretinoin or for at least one month after your treatment has stopped.
- Rarely, some people taking isotretinoin have become depressed and have experienced some mood changes. It is important that you let your doctor know straightaway if this happens to you.
Can isotretinoin cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with isotretinoin. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Common isotretinoin side-effects||What can I do if I experience this?|
|Headache, joint and muscle pain, back pain||Ask your pharmacist to recommend a suitable painkiller. If it continues or is severe, speak with your doctor|
|Dry skin and lips||Apply a moisturiser and lip balm regularly. If you develop a rash or if your skin becomes irritated and fragile, let your doctor know|
|Dry eyes, eye irritation||Ask your pharmacist or optician to recommend some suitable eye drops. If your vision is affected, let your doctor know as soon as possible|
|Dry mouth||Try sucking sugar-free gum or sugar-free sweets|
|Dry nose and nosebleeds||Try applying a thin layer of petroleum jelly (Vaseline®) to the inside edges of your nose|
|Changes to blood tests||Your doctor will do regular blood tests to check for these|
If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.
How to store isotretinoin
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
- Do not keep out-of-date or unwanted capsules. Return them to your local pharmacy which will dispose of them for you.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
If you have any questions about this medicine ask your pharmacist.
Further reading & references
- Manufacturer's PIL, Roaccutane® 10 mg and 20 mg Soft Capsules; Roche Products Limited, The electronic Medicines Compendium. Dated January 2012.
- British National Formulary; 66th Edition (September 2013) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr John Cox