What isotretinoin is for
Isotretinoin is used to treat severe acne when other prescription medicines have not worked.
It's usually prescribed by a healthcare professional who specialises in treating skin conditions.
How to take isotretinoin
Isotretinoin comes as capsules that you swallow.
How much you need to take and for how long depends on your symptoms. Most people need to take isotretinoin once or twice a day. You'll usually need to take it for around 3 months, but you may need to take it for less time or for longer.
When taking isotretinoin capsules:
- swallow them whole
- try to take them at the same times every day
- take them with food
Always check the packet or leaflet that comes with your medicine. Ask a pharmacist or doctor for advice if you're not sure how to take it or have any problems taking it.
While taking isotretinoin you'll need to have regular check-ups and blood tests. This is to make sure the isotretinoin is working and to check for any side effects.
Your doctor or pharmacist will also give you advice about how to reduce the risk of side effects while you're taking it.
Things to avoid
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do not spend too long in the sun - use sunscreen with a sun protection factor (SPF) of at least 30 when you're out in the sun, and reapply it regularly
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do not use sunbeds or sunlamps
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do not use skincare products containing salicylic acid or benzoyl peroxide, or have skin treatments such as microdermabrasion or chemical peels
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do not use waxing or laser treatments for hair removal
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do not do too much intense exercise (exercise that makes you breathe fast and hard) - it can cause severe joint and muscle pain or kidney failure
Important: Use contraception
You must use contraception while taking isotretinoin if there's a chance you could get pregnant. This is because isotretinoin can cause serious problems with how a baby develops during pregnancy.
You must start using contraception at least 1 month before you start taking isotretinoin. You must continue to use contraception for at least 1 month after you stop taking isotretinoin.
Speak to a doctor or pharmacist for advice about what type of contraception may be the most effective for you.
If you miss a dose of isotretinoin
If you forget to take a dose of isotretinoin, take the next dose when you remember, unless it's nearly time for your next dose.
If it's nearly time for your next dose, skip the dose you missed and take the next dose at the usual time.
Do not take 2 doses to make up for a missed dose.
If you take too much isotretinoin
Taking too much isotretinoin can be dangerous.
Urgent advice: Call NHS 111 if:
- you've taken more than your prescribed dose of isotretinoin
If you're told to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.
Bring the isotretinoin packet or leaflet inside it, any remaining medicine, and any other medicines you take.
Side effects of isotretinoin
Like all medicines, isotretinoin can cause side effects, but not everyone gets them.
Side effects of isotretinoin can include:
- skin problems such as dry or itchy skin, a rash, and skin irritation after being in the sun
- muscle and joint pain
- bruising more easily
- headaches
- sore eyes, nose or throat
- getting infections more often
- problems with sex, such as erectile dysfunction (impotence) and low sex drive (loss of libido)
Isotretinoin will not usually affect your ability to drive, ride a bike or use machinery, but if you feel dizzy after taking it, wait until the dizziness stops.
Non-urgent advice: Speak to a pharmacist or doctor if:
- you have any side effects that bother you or do not go away
They may be able to give you advice about how you can reduce the side effects. Keep taking your medicine unless you're advised to stop.
Find a pharmacySerious side effects
Isotretinoin can sometimes cause serious side effects, although most of them are rare.
Possible serious side effects of isotretinoin can include:
- an allergic reaction (anaphylaxis) - causing symptoms such as a swollen throat or tongue, a raised itchy rash and difficulty breathing
- pancreatitis - causing symptoms such as severe tummy pain and feeling sick (nausea) or being sick (vomiting)
- seizures (fits)
- shortness of breath
- mental health problems including hallucinations, psychosis, or thoughts of suicide or self-harm
Urgent advice: Call NHS 111 if:
- you're taking isotretinoin and think you might be having serious side effects
- you're having thoughts about harming yourself
More about side effects
These are not all the side effects of isotretinoin.
For a full list, see the leaflet that came with your medicine or search for your medicine leaflet on the electronic medicines compendium website.
You can report any side effects you get on the Yellow Card website.
Who can and cannot take isotretinoin
Most adults can take isotretinoin. Sometimes it's suitable for children and young people aged 12 years and over.
But isotretinoin is not suitable for everyone. For example, it may not be suitable if:
- you have problems with your liver
- you've had a previous allergic reaction or serious side effect from isotretinoin
- you have an allergy or sensitivity to soya or peanuts
- you've had mental health problems, such as depression, mood problems, or thoughts about self-harm or suicide
- you have high cholesterol
Before taking isotretinoin, it's important to tell your doctor if you have any medical conditions, or have ever had problems with your mental health.
Breastfeeding and isotretinoin
You must not take isotretinoin when breastfeeding because it can cause your baby to have side effects. Tell your doctor if you're breastfeeding - they will offer you a different treatment.
Pregnancy and isotretinoin
You must not take isotretinoin during pregnancy, or if you're trying to get pregnant. This is because it can cause miscarriage or serious problems with how your baby develops. You need to stop taking it for at least one month before trying to get pregnant.
Tell your doctor if you're pregnant or trying to get pregnant.
Taking isotretinoin with other medicines, food and drink
There are some medicines and supplements that may not mix well with isotretinoin.
This includes:
- certain types of antibiotics, including tetracycline and doxycycline
- vitamin A supplements and supplements that contain vitamin A
- other skin treatments for acne
- certain blood thinning medicines, including enoxaparin and dalteparin
This is not the full list of medicines that may not mix well with isotretinoin. Before taking it, tell your doctor if you're taking any other medicines, herbal remedies, vitamins or supplements.
Food, drink and alcohol with isotretinoin
You can generally eat as normal while taking isotretinoin.
It's best to not drink alcohol while taking isotretinoin because it could cause liver problems.
Find out more about your medicine
To find out more about your medicine, you can:
- check the leaflet that comes with it
- search for your medicine leaflet on the electronic medicines compendium website
- speak to a pharmacist or doctor for advice