Isotretinoin (By Mouth)

Isotretinoin (eye-soe-TRET-i-noyn)

Treats severe acne. This medicine is related to vitamin A.

Brand Name(s):

Accutane, Amnesteem, Sotret, Claravis
There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

You should not use this medicine if you have had an allergic reaction to isotretinoin or parabens (a preservative). You should not use this medicine if you are pregnant or plan to become pregnant during your treatment, or if you cannot follow all of the instructions in the Medication Guide.

How to Use This Medicine:

Capsule

• Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to. It is best to take this medicine with food or milk. Swallow the capsule whole. Do not break, crush, or chew it.
• This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions. Your doctor will ask you to sign some forms to show that you understand this information.

If a dose is missed:

• If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine:

• Store the medicine at room temperature, away from heat, moisture, and direct light. Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are also using a tetracycline antibiotic, phenytoin (Dilantin®), St. John's wort, any kind of vitamin A supplement, or a steroid (such as prednisone, Azmacort®, Pediapred®, Flonase®, Flovent®, Nasonex®, Vancenase®).
• Do not drink alcohol while using this medicine. Avoid skin treatments or wax hair removal while you are using this medicine and for at least 6 months after your last dose.

Warnings While Using This Medicine:

• Using this medicine while you are pregnant can cause very serious birth defects. Use two forms of birth control for 1 month before starting this medicine and for 1 month after your last dose. If you are using birth control pills, ask your doctor if your pills are a good kind to use. Some kinds of birth control pills ("minipills") may not work as well. You will be required to have a pregnancy test every month during treatment. If you think you have become pregnant while using the medicine, tell your doctor right away.
• Some people who have used this medicine have become very depressed or angry. Tell your doctor right away if you think this medicine is causing mental changes for you. Some signs of this may be feeling very sad, getting upset easily, thinking about hurting yourself or someone else, feeling nervous, eating more, eating less, gaining weight, losing weight, or having trouble thinking.
• Make sure your doctor knows if you are breastfeeding, or if you have digestion problems, diabetes, heart disease, asthma, or liver disease. Tell your doctor if you or anyone in your family has had anorexia or any other kind of mental illness, or a bone problem such as osteoporosis (thinning bones).
• This medicine may cause problems with bones or muscles. You may get hurt more easily during rough sports. You may heal more slowly. If this medicine is for your child, tell the doctor if you think your child is not growing properly.
• Your skin problems may get worse for a short time before they start to improve. Your acne may continue to get better even after you stop using this medicine. Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to keep all appointments.
• Do not donate blood while using this medicine or for 1 month after your last dose.
• This medicine may make your skin more sensitive to sunlight. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Hearing problems or ringing in your ears
• Severe diarrhea, nausea, vomiting, stomach pain, or bleeding from your rectum
• Severe headache, blurred vision, dizziness
• Yellow skin or eyes, dark-colored urine or pale stools

If you notice these less serious side effects, talk with your doctor:

• Dry, itching, or peeling skin, dry eyes, or dry, cracked lips, mouth, or nose
• Muscle, back, or joint pain or aching (more likely in children)
• Trouble seeing in dim light or darkness
• Trouble wearing contact lenses

If you notice other side effects that you think are caused by this medicine, tell your doctor.