Accutane (isotretinoin) is a vitamin A derivative (13-cis-retinoic acid) that is administered orally in pill form with a meal that contains an adequate amount of fat,1 normally for 15-20 weeks (3.5-4.5 months),2although it is also sometimes prescribed at lower dosages for up to six months or longer. It was originally recommended for people with severe acne that did not respond to other treatments,3 but has gained in popularity in the past 25 years and is prescribed more and more frequently for less severe acne.4-6 This practice is controversial because Accutane is a systemic medication that affects every bodily system and can cause lifelong side effects to the user. Accutane need not be paired with other medications.
accutane side effects
Accutane is used to treat serious cases of acne, but it also comes with serious side effects like irritable bowel syndrome, depression and liver damage. The most common side effects of Accutane are:
dry skin, itching, rash, dry nose, nosebleeds, cracks in the corners of the mouth, dry mouth, dry lips, cracking or peeling skin, inflammation of the whites of the eyes, dry eyes, joint pain, back pain, dizziness,drowsiness and nervousness.
The usual starting daily dose is 0.5 mg per kilogram of body weight taken daily for a period of 2 to 4 weeks. Based on body weight, severity of acne, and your response to the medication, your doctor will then adjust your dose. Isotretinoin should be taken as a single dose or in 2 divided doses during the day.
Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
Your acne may get worse temporarily, before it gets better. Your doctor will adjust your daily dose after the initial treatment to between 0.1 mg and 1 mg per kilogram of body weight depending on your response to the medication.
Food increases the amount of medication available to the body. It also helps to reduce upset stomach. For these reasons, isotretinoin medication should be taken with food
The first signs of healing usually occur after 2 to 3 weeks of treatment, however, it may take 1 or 2 months before you see beneficial effects. The complete course of treatment usually lasts 12 to 16 weeks. Most people with severe acne notice a marked improvement after 1 or 2 courses of treatment. You may continue to see even more improvement in your acne condition for several months after you have stopped taking the medication.
If any of your side effects do not clear up in a few weeks after you stop taking your medication, speak to your doctor. Be sure to read the patient information that comes with each package of medication.
It is important that this medication be taken exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Store this medication at room temperature, in the original package, protect it from light and moisture, and keep it out of the reach of children.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Who should NOT take this medication?
Do not take isotretinoin if you:
- are allergic to isotretinoin or any ingredients of the medication
- are breast-feeding
- are pregnant
- are taking tetracycline antibiotics (e.g., tetracycline, doxycycline, minocycline)
- have excessively high blood cholesterol levels
- have excessively high levels of vitamin A
- have reduced kidney or liver function
Isotretinoin should not be taken by women who may become pregnant unless all of the following conditions apply:
- You have severe disfiguring nodular or inflammatory acne, acne conglobata, or recalcitrant acne that has not responded to standard therapy, including systemic antibiotics.
- You are reliable in understanding and carrying out instructions.
- You are able to comply with the mandatory birth control measures for at least one month before, during, and at least one month after treatment.
- You have received, and acknowledged understanding of, a careful oral and printed explanation of the hazards of fetal exposure to isotretinoin, and the risk of possible birth control failure.
- You have been informed and understand the need to quickly consult your doctor if there is a risk that you may be pregnant.
- You understand the need for monthly follow-up.
- You use effective birth control without any interruption for one month before, during, and for one month after stopping isotretinoin. You are aware that 2 reliable forms of birth control should be used at the same time.
- You have had a blood or urine pregnancy test with a negative result, performed in a licensed laboratory, within 2 weeks prior to initiating therapy. You have had 2 or 3 days of your next normal menstrual period before isotretinoin therapy is initiated.
- If you require additional treatment with isotretinoin in the future, you must also follow the same requirement for birth control before, during and after taking isotretinoin.
accutane and alcohol
Accutane can have certain effects on the liver which, combined with alcohol, can become dangerous. Accutane alone can, in certain cases, damage the liver, so combining it with alcohol can increase that damage. Also a combination of alcohol and Accutane can cause major alterations in the lipids in one’s blood. In some individuals, Accutane has been shown to cause elevations in blood cholesterol and triglycerides, a blood fat. Alcohol could increase those levels further. However most patients see a decrease of those lipids to normal levels after the course of Accutane is completed.