Like all medicines, isotretinoin capsules can cause side effects, although not everyone gets them. Side effects will usually go away when you stop treatment.
You'll be given a patient reminder card when you start taking isotretinoin. This card contains important safety information that you need to be aware of before and during your treatment.
Common side effects
These common side effects of isotretinoin capsules happen in more than 1 in 100 people. There are things you can do to help you cope with them:
Dry skin, eyes, nose or lips
Apply a moisturiser cream or ointment and lip balm regularly (speak to a pharmacist or your doctor about the best type to use). Avoid using exfoliating products or anti-acne products. Try applying a thin layer of Vaseline to the inside edges of your nose.
Ask your pharmacist or optician to recommend some eye drops. If you wear contact lenses and these become uncomfortable, you might have to wear glasses instead while you're taking this medicine.
Other skin problems, including rashes, and mild itching
You may notice your skin becoming more fragile and getting redder, and it may be more sensitive to sunlight.
Do not have any cosmetic treatments, including hair removal (waxing), dermabrasion, or laser treatments while you're taking isotretinoin, and for 6 months after you stop taking it.
Stay out of the sun as much as possible and use a high factor sun cream (SPF 15 or above) before you go outside, even on cloudy days. Do not use a sunlamp or sunbeds.
Sore or dry mouth or throat
Gargle with salt water (adults only), drink plenty of water, eat soft food, avoid smoking or smoky places, suck ice cubes or ice lollies. Speak to a pharmacist about other ways to relieve the pain, such as painkillers, medicated lozenges or anaesthetic sprays.
Headaches
Make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller. Talk to your doctor if the headaches last longer than a week or are severe.
Back pain and aches and pains in muscles or joints
Light exercise should not be a problem, but cut down on or avoid intense exercise and physical activity as it may make joint or muscle pain worse, particularly in children and teenagers.
Speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or does not go away.
Sexual side effects
Speak to a doctor if you start having problems with your sex life such as erectile dysfunction (impotence), low sex drive (loss of libido), vaginal dryness, loss of feeling in your genitals or difficulty reaching orgasm. This can last a long time and can sometimes carry on after you stop taking isotretinoin.
Serious side effects
Stop taking isotretinoin capsules and call a doctor or call 111 straight away if:
- you get unexplained bruising, or you bleed more easily – these may be signs of a blood clotting disorder
- you get frequent infections, or have infections for longer than expected, or feel weak or dizzy, possibly with pale skin – these may be signs of a blood disorder
- you become anxious, aggressive or violent, or have changes in your mood – these can be signs of depression or other mental health problems
- you have hallucinations (seeing or hearing things that are not there) or delusions (believing things that are not true) – these may be signs of psychosis
- you have severe pain in your stomach, with or without diarrhoea and feeling or being sick (nausea or vomiting) – these can be signs of a serious problem called pancreatitis
- you have diarrhoea with blood in – this may be a sign of gastrointestinal bleeding
- you have muscle weakness, difficulty moving your arms or legs, and painful, swollen or bruised areas of the body, or dark pee – these can be signs of a rare, serious condition
- the whites of your eyes turn yellow, or your skin turns yellow although this may be less obvious on brown or black skin – these are signs of liver problems
- you have difficulty peeing, or feel very tired – these are signs of kidney problems
- you get a lasting headache that does not go away and makes you feel sick or makes you sick (vomit)
- you get sudden changes in eyesight, including not seeing as well at night
Immediate action required: Call 999 or go to A&E now if:
- you have thoughts about harming yourself or ending your life
Serious allergic reaction
In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to isotretinoin capsules.
Immediate action required: Call 999 now if:
- your lips, mouth, throat or tongue suddenly become swollen
- you're breathing very fast or struggling to breathe (you may become very wheezy or feel like you're choking or gasping for air)
- your throat feels tight or you're struggling to swallow
- your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
- you suddenly become very confused, drowsy or dizzy
- someone faints and cannot be woken up
- a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)
You or the person who's unwell may also have a rash that's swollen, raised, itchy, blistered or peeling.
These can be signs of a serious allergic reaction and may need immediate treatment in hospital.
Other side effects
These are not all the side effects of isotretinoin capsules. For a full list, see the leaflet inside your medicines packet.
More information
You can report any suspected side effect using the Yellow Card safety scheme.