Isotretinoin Capsules

What are isotretinoin capsules?

Isotretinoin is a powerful prescription-only oral retinoid, derived from vitamin A, used to treat severe acne that hasn’t responded to other treatments. It is available under brand names such as Roaccutane, Rizuderm, and Reticutan[1]. 

What are isotretinoin capsules used to treat?

Doctors prescribe isotretinoin for[1]: 

• Severe nodular or cystic acne 

• Acne at risk of permanent scarring 

• Acne that has not improved with antibiotics or topical treatments 

It is not suitable for mild acne and must be prescribed and monitored by a dermatologist. 

How do isotretinoin capsules work?

Isotretinoin treats acne by[1]:

• Reducing oil (sebum) production in the skin 

• Shrinking sebaceous glands 

• Preventing blocked pores 

• Decreasing inflammation and bacterial growth 

Who can take isotretinoin capsules?

It may be prescribed to[1]: 

• Adults and adolescents with severe or treatment-resistant acne 

However, it is not suitable for children under the age of 12 years or before puberty and people who[1]: 

• Are pregnant, trying to get pregnant, or breastfeeding 

• Have liver or kidney disease 

• Have high blood cholesterol or fats 

• Have hypervitaminosis A 

• Are allergic to isotretinoin, peanuts, or soya (capsules contain soya bean oil) 

• Are taking tetracycline antibiotics 

• Have a mental health condition  

• Have sex life problems like erectile dysfunction, low sex drive, vaginal dryness, or difficulty reaching orgasm 

• Have an inflammatory bowel disease like Crohn’s disease or ulcerative colitis 

Please tell your doctor or pharmacist about any conditions you may have or medication you take before you start treatment, and always follow the instructions in the Patient Information Leaflet[2].

What is the typical dosage of isotretinoin capsules?

Isotretinoin comes as 10mg or 20mg soft capsules. Your dermatologist will calculate your dose based on body weight[1]:

• Usual starting dose is 0.5mg per kg per day (e.g. 30mg/day for a 60kg person) 

• A full course lasts 16 to 24 weeks 

• Your doctor may alter your dose if your acne is not getting better or lower your dose if you’re experiencing side effects 

How do you take isotretinoin capsules?

To take isotretinoin properly[1]:

• Swallow the capsules whole with water 

• Take them with food to improve absorption 

• Do not chew or crush them 

• Take once or twice daily as instructed 

• Use moisturiser and lip balm to manage dryness 

Can you stop taking isotretinoin capsules?

Yes, but only under medical guidance. Stopping early can reduce its effectiveness. Your dermatologist will advise you based on your progress[1]. 

What do you do if you take too many isotretinoin capsules?

Seek emergency medical help by calling NHS 111 or going to A&E. Symptoms may include[1]:

• Headache 

• Nausea or vomiting 

• Blurred vision or other visual changes 

What do you do if you forget to take isotretinoin capsules?

If you forget to take a capsule[1]:

• Take it as soon as you remember 

• If it’s close to your next dose, skip the missed one 

• Do not take two capsules together  

How should I store isotretinoin capsules?

To ensure safety and effectiveness[1]:

• Store below 25°C 

• Keep in the original packaging 

• Keep out of reach of children 

• Do not use after the expiry date 

What medicines can’t you take with isotretinoin capsules?

There are no known interactions with systemic Some medications can interact with isotretinoin, increasing the risk of side effects and so should be avoided or used with caution[1]: 

• Tetracycline antibiotics (e.g. doxycycline, lymecycline, oxytetracycline) 

• Vitamin A supplements 

• Alcohol (can worsen liver and cholesterol-related side effects) 

• Other acne treatments, especially those that exfoliate 

Always inform your doctor or pharmacist about all medications and supplements you take before you start a new medicine, and follow the instructions in the Patient Information Leaflet[2]. 

What are the side effects of isotretinoin capsules?

Common side effects include[1]: 

• Dry skin, lips, nose, and eyes 

• Nosebleeds 

• Joint or muscle pain 

• Headaches 

• Mood changes such as low mood or irritability 

• Skin rashes or itching 

• Sexual side effects such as erectile dysfunction, loss of libido, vaginal dryness, loss of genital sensitivity, or difficulty reaching orgasm 

More serious risks include[1]: 

• Liver problems 

• Raised cholesterol or triglyceride levels 

• Vision changes 

• Inflammatory bowel disease 

• Blood clotting disorders 

• Signs of depression or other mental health conditions 

• Hallucinations or psychosis 

• Signs of pancreatitis  

• Blood in your stool 

• Muscle weakness 

• Yellowing of skin or eyes 

• Difficulty peeing 

• Extreme tiredness 

• A long-lasting headache that doesn’t go away 

• Rare cases of long-term sexual dysfunction 

Mental health side effects are possible – tell your doctor if you experience mood changes or suicidal thoughts. 

You should contact your GP if you experience any of these symptoms. In rare cases, the medicine may cause a serious allergic reaction (anaphylaxis). You should call 999 or visit A&E immediately if you believe this is happening[1]. 

Symptoms of anaphylaxis include[1]:  

• Difficulty breathing  

• Tightness in throat and chest  

• Swelling of the tongue or throat  

• Feeling faint or dizzy  

• Blue/grey skin or lips  

• Loss of consciousness 

If you experience any side effects, including those not listed, you are encouraged to report them via the Yellow Card Scheme or contact your doctor, pharmacist, or nurse. This information is intended as a summary for general awareness and does not replace professional medical advice. 

The information provided in the side effects section is not a comprehensive list of all possible side effects associated with this medication. For a complete list of side effects, please refer to the Patient Information Leaflet (PIL) provided with your medication or consult your healthcare professional[2].

Frequently asked questions about isotretinoin capsules

Can I take isotretinoin capsules during pregnancy? 
No, it is strictly contraindicated. Isotretinoin, vitamin A and other medications derived from vitamin A can severely harm the foetus. Tell your prescriber if you become pregnant during treatment. Women of childbearing potential must meet the conditions of the Pregnancy Prevention Programme[1]. 

Can I drink alcohol with isotretinoin capsules? 
It’s best to limit or avoid alcohol[1]. 

Can I wear contact lenses? 
Possibly not – dry eyes may make them uncomfortable. If you wear contacts and require eye drops to help with dry eyes, preservative free preparations should be used[1]. 

Can I go in the sun while taking isotretinoin capsules? 
You should avoid purposefully exposing yourself to excessive sunlight or sunbeds. Use high SPF and limit sun exposure when outside, as your skin will be more sensitive[1]. 

Can I use other acne treatments? 
Avoid exfoliants and peels during treatment[1]. 

Will my acne come back? 
Some people need a second course, but many do not[1]. 

Can I donate blood on isotretinoin capsules? 
Not during treatment and for at least 1 month after finishing[1]. 

Can I exercise on isotretinoin capsules? 
Yes, but joint and muscle pain may occur[1]. 

For the official NHS guide to isotretinoin capsules, visit their website.