Isotretinoin Complete Guide: Benefits, Dosages, Protocols

 »  »  Isotretinoin Complete Guide: Benefits, Dosages, Protocols


  1. What is Isotretinoin?
  2. How Does Isotretinoin Work?
  3. Who Uses Isotretinoin?
  4. Isotretinoin for the Body
  5. Benefits of Isotretinoin
  6. Side Effects of Isotretinoin
  7. Dosage & Protocols
  8. FAQ (Frequently Asked Questions)
  9. Conclusion

Isotretinoin is a prescription medication used to treat severe acne that has not responded to other treatments. It may also be prescribed for other purposes, such as other skin problems and certain types of cancer.

Because this medication is a vitamin A derivative (retinoid), your body reacts to it in the same way that it does to vitamin A. Because vitamin A can accumulate in your tissues, it can become a problem quickly. When taking isotretinoin, you should avoid taking vitamin A supplements.

It can help clear up your skin, but there are some potential side effects. Most of these go away within a few weeks of stopping the medication. Continue reading to learn more about the effects of isotretinoin on the body!

What is Isotretinoin?

Isotretinoin (eye-soh-tret-in-OH-in) is a prescription acne medication. Deep, painful cysts and nodules the size of a pencil eraser or larger are caused by this type of acne. Scars are common as this acne clears. Severe acne can be challenging to treat. Isotretinoin may be an option if other treatments have failed to clear the skin. Isotretinoin treatment frequently results in prolonged acne clearance, which can be permanent in some patients.

Isotretinoin was first licensed for the treatment of moderate to severe acne under the trade name Accutane. The manufacturer of Accutane, Hoffmann-La Roche, stopped selling it a few years ago, but isotretinoin is still accessible under other brand names, including Absorica, Amnesteem, Claravis, Myorisan, Sotret, and Zenatane. These oral drugs should only be used by people who have long-term moderate to severe acne or scarring acne that hasn’t responded to prior treatments. Isotretinoin should not be used to treat moderate acne. It’s critical to understand and discuss the benefits and dangers of isotretinoin with your doctor before beginning treatment for acne. This includes possible isotretinoin side effects.

Absorica®, Amnesteem®, Claravis®, Myorisan®, and ZenataneTM are some brand names for isotretinoin. Accutane® is a brand name for this medication. This is an isotretinoin brand that is no longer available.

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How Does Isotretinoin Work?

Isotretinoin, like retinol, is a retinoid. Vitamin A derivatives are known as retinoids. They can aid in the treatment of a variety of skin disorders, including acne. The drug works by reducing the size of the sebaceous glands, which secrete an oily material known as sebum. Acne can be aggravated by sebum.

Isotretinoin treatment usually takes 4 to 5 months to work, although you can take it for a shorter or longer period of time. The length of time you take it is determined by how your skin responds to treatment and whether or not you experience any adverse effects. According to studies, approximately half of patients who use isotretinoin for acne see their skin clear up and stay clear, while acne can appear to worsen during the first week to 14 days of treatment. Others may see some improvement or may not see any improvement at all, yet their acne reappears. Treatment might be repeated for additional 4 to 6 months in this scenario.

Who Uses Isotretinoin?

Isotretinoin should be considered for people who have moderate or severe inflammatory acne that has not responded to topical or oral antibiotics (Accutane). Note that Accutane is also known by other names such as Absorica, Accutane, Amnesteem, Claravis, Myorisan, Sotret, and Zenatane.

Isotretinoin for the Body

When taking isotretinoin, women must be especially cautious. The medicine is known to cause birth malformations and should not be used by a pregnant or sexually active woman who is not using effective birth control. Your doctor will discuss the iPledge risk management program with you. This computer-based application is required to lower the likelihood of isotretinoin-treated women becoming pregnant. Isotretinoin prescribers must have their patients register with iPledge. Women who are potentially pregnant are required to take a pregnancy test every month, and the results are put into iPledge along with information about the two types of contraception they are using. The pharmacist will then be able to fill and distribute the medication.

Isotretinoin may cause depression, psychosis, suicidal thoughts, suicide attempts, and deviant or aggressive behavior, according to the prescribing advice. This is based on adverse events reported to the US Food and Drug Administration. The Food and Drug Administration, as well as other studies, were examined in the literature.

However, studies demonstrate no obvious cause-and-effect association between isotretinoin use and depression in teenagers and young adults compared to acne patients who did not use it. Some studies show no statistical difference, while others show that those with acne who use isotretinoin have a decreased risk of depression than those who don’t. To completely understand the effect of isotretinoin on mood and behavior in all age groups prescribed the treatment, a large, randomized research of acne patients with and without the drug would be required. The iPledge risk program may be able to shed insight on the link between isotretinoin and depression.

Prescribers should inquire patients about a family or personal history of the psychiatric disorder before prescribing isotretinoin, and follow up with them throughout and after therapy until the science proves otherwise (including repeat treatment courses).

Benefits of Isotretinoin

  • Isotretinoin (Accutane) is a prescription oral medication that must be taken for a minimum of 20 weeks.
  • It shrinks the oil glands, resulting in decreased oil production. As a result, bacterial growth is slowed, inflammation is reduced, and acne activity is reduced. Yes, you read that correctly – we’ve come to a halt.
  • The only acne medication that has a long-term positive effect on the skin is isotretinoin (Accutane).
  • According to statistics, 70% of people who are treated with isotretinoin will have clear skin for the rest of their lives. The remaining 30% may develop acne again, although it will be less severe than previously. When a modest dose of isotretinoin (Accutane) is used for a longer period of time, it can give a true long-term “cure” for acne sufferers with few side effects.
  • Accutane and blue light acne phototherapy have been demonstrated to work together to reduce the likelihood of acne flare-ups while on Accutane treatment.
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Side Effects

Side effects that are more common

Isotretinoin has a number of minor adverse effects, including:

  • skin that is parched
  • lips that are chapped
  • eyes that are dry
  • nosebleeds caused by a dry nose

It’s possible that these adverse effects will go away on their own. Call your doctor if they don’t go away or become a concern.

Serious negative consequences

Isotretinoin’s more extreme side effects can have long-term or permanent consequences. Apart from an increase in cholesterol and joint and muscle problems, all of these side effects are uncommon.

  • Cholesterol elevation- Isotretinoin can raise fat and cholesterol levels in your blood. Regular blood tests to assess your fat and cholesterol levels may be recommended by your doctor during your treatment. You’re more likely to have these issues if you: suffer from diabetes, are overweight or obese, are afflicted with metabolic syndrome, or drink alcohol.
  • Muscle and joint problems- If you plan to engage in strenuous physical activity while taking isotretinoin, tell your doctor. Pain in the bones, joints, muscles, and ligaments can be caused by isotretinoin. It can also prevent youth from growing lengthy bones, which can have long-term consequences. Call your doctor straight away if you develop any of the following symptoms: new backache, new joint discomfort, or a fractured bone. If you break a bone, make sure all of your healthcare providers are aware that you are taking isotretinoin. Stop taking isotretinoin and contact your doctor straight away if you experience muscle weakness, discomfort, or both. Muscular weakness is a symptom of severe muscle injury and can have a long-term impact.

Dosage & Protocols

Adult Acne Typical Dose:

0.25 to 0.5 mg/kg orally twice a day as a maintenance dose

Maximum daily dose: 2 mg/kg

Therapy might last up to 20 weeks.

  • Some of this drug’s formulations should be taken with food.
  • Before raising the dose, patients should be questioned about their treatment compliance (e.g., taking this drug with food).
  • Patients with severe acne, scarring, or main trunk symptoms may require a dose of 2 mg/kg/day.
  • Any patient requesting refills will need a new prescription as well as a new iPLEDGE authorization.
  • Because the safety and efficacy of a once-daily dose have not been demonstrated, it is not recommended.

Acne Typical Pediatric Dose:

12 years and up:

Maintenance dose: 0.25 to 0.5 mg/kg twice a day orally

Maximum daily dose: 2 mg/kg

Therapeutic period: up to 20 weeks

  • Some of this drug’s formulations should be taken with food.
  • Before raising the dose, patients should be questioned about their treatment compliance (e.g., taking this drug with food).
  • Patients with severe acne, scarring, or main trunk symptoms may require a dose of 2 mg/kg/day.
  • Any patient requesting refills will need a new prescription as well as a new iPLEDGE authorization.
  • Because the safety and efficacy of a once-daily dose has not been demonstrated, it is not recommended.


Is isotretinoin going to help me? 

Isotretinoin treatment often results in long-term acne clearance, which in some cases can be permanent. A therapy course usually lasts about 4 to 5 months. It can be as short as a few minutes or as long as a few hours. If a patient’s condition does not improve after one round of treatment, a second session of treatment may be necessary. This has been shown in studies to help some patients achieve clear skin. Between treatments, you should wait at least 8 weeks. After patients stop taking the drug, their skin usually clears up for a while.

What is the best way to take isotretinoin?

This drug is taken as a tablet. As directed by your dermatologist, you will take one or two pills every day. Your dermatologist will enroll you in the iPLEDGE® REMS risk-management program before you start taking isotretinoin. The United States of America designed it. This program, run by the Food and Drug Administration (FDA), ensures that patients: If you’re pregnant, don’t start taking isotretinoin. If you’re taking isotretinoin, don’t get pregnant. All patients must be enrolled in iPLEDGE REMS before taking isotretinoin since it educates them about potential possible side effects.

Is it true that I’ll have to take isotretinoin for the rest of my life?

A typical treatment course lasts roughly 4 to 5 months. It’s possible that you’ll need a shorter or longer treatment period.

What is the mechanism of action of isotretinoin?

This is the only acne treatment that targets all four causes of acne: excessive oil production, clogged pores, P. acnes overgrowth, and inflammation. Isotretinoin is quite effective as a result of this.

Are there any precautions I should take when taking isotretinoin?

Yes. Before you decide whether or not to take isotretinoin, you should understand the possible adverse effects. Your dermatologist will enroll you in a risk-management program if you and your dermatologist believe that this medicine is good for you. You must do the following while taking isotretinoin: See your dermatologist for a follow-up appointment every 30 days, either in person or via telemedicine. Any suspected negative effect should be reported to your dermatologist at once. Avoid using a tanning bed, sun lamp, or other indoor tanning devices to protect your skin from the sun. Do not donate blood while taking isotretinoin and for 30 days after you take your last pill. Patients who can get pregnant also need to take the following precautions: Take the required pregnancy tests. Use two approved forms of birth control or do not have sex or any sexual contact.

Is waxing hair removal safe when taking isotretinoin?

Please, no waxing. Isotretinoin users should avoid waxing because it might leave lasting scars. You should not wax while using isotretinoin or for six months after stopping it to avoid scarring. This is true for both hot and cold wax.


Isotretinoin can be learned more about from your doctor or pharmacist. Remember to keep this and all other medicines out of the reach of children, never share your medicines with others, and only use this medication as directed. Always check with your healthcare practitioner to make sure the information on this page pertains to your specific situation.

Isotretinoin can be an effective remedy for persons who have persistent moderate to severe or scarring acne. The most important thing is to balance the benefits against the possible side effects and recognized hazards, taking into account your overall health and medical history. Understanding the benefits and drawbacks and discussing them with your doctor will help you have a safe and successful treatment plan.

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The information provided above is not intended to substitute professional medical advice, diagnosis, or treatment. Always seek your physician’s advice or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have seen or read. We bear no responsibility or liability for your use of any compound.