Without a Prescription
Isotretinoin, a chemical cousin of vitamin A, is prescribed for the treatment of severe, disfiguring cystic acne that has not cleared up in response to milder medications such as antibiotics.
Because Isotretinoin can cause severe birth defects, including mental retardation and physical malformations, a woman must not become pregnant while taking it.
Before starting Isotretinoin therapy, women of childbearing age will be asked to read a pamphlet, watch a video, and sign a detailed consent form regarding the danger of birth defects.
Each prescription for Isotretinoin must bear a yellow qualification sticker signifying that you meet these requirements.
If you accidentally become pregnant while taking Isotretinoin, you should immediately consult your doctor.
In addition, you must use 2 forms of birth control during Isotretinoin therapy, and for 1 month before and after.
It works on the oil glands within the skin, shrinking them and diminishing their output.
Scientists have not ruled out the possibility that hormone-based contraceptives (birth control pills and implants) may be less reliable when taken with Isotretinoin, so a second form of birth control should always be prescribed while taking this drug.
The antiacne effect can last even after you have finished your course of medication.
You must have two negative pregnancy tests before beginning Isotretinoin therapy, and must take monthly pregnancy tests while using this drug.
You take Isotretinoin by mouth every day for several months, then stop.
Isotretinoin side effects that you should report to your health care professional or doctor as soon as possible:
Side effects may include:
- Weight loss;
- Vision problems;
- Urinary discomfort;
- Tendon and ligament problems;
- Swelling due to fluid retention;
- Suppression of growth;
- Sunburn-sensitive skin;
- Sudden drop in blood pressure (causing unconsciousness);
- Stomach and intestinal discomfort;
- Skin infections;
- Peeling palms or soles;
- Nail disorders;
- Muscle wasting;
- Menstrual changes;
- Liver disorders;
- Joint pain;
- Inflammation or sores in the esophagus;
- Heartbeat irregularities;
- Hearing problems;
- Dry or fragile skin;
- Dry or cracked lips;
- Dry nose;
- Dry mouth;
- Difficulty sleeping;
- Delay in wound healing;
- Decreased tolerance to contact lenses;
- Decreased night vision;
- Chest pain;
- Changes in skin pigmentation;
- Changes in blood sugar or cholesterol levels;
- Bowel inflammation and pain;
- Blood in urine;
- Bleeding gums;
- Allergic reaction;
- Abnormal hair growth or loss;
Isotretinoin is contraindicated if you have any of the following conditions:
- If Isotretinoin gives you an allergic reaction;
- If you are a woman of childbearing age and you are considering taking Isotretinoin, you will be given both spoken and written warnings about the importance of avoiding pregnancy during the treatment;
- If you are a woman of childbearing age;
- If you are pregnant;
- If you are unable to keep coming back to the doctor for monthly checkups, including pregnancy testing;
- If you begin to feel depressed or become troubled by suicidal thoughts;
- If you think there is a possibility you might get pregnant during the treatment;
You will be asked to sign a second consent form noting that:
- Isotretinoin affects the body's processing of fats and sugars. it should be prescribed cautiously by people with diabetes, excess weight, high triglyceride or cholesterol levels, or a tendency to drink too much alcohol. if you have any of these conditions, your doctor will monitor you closely during Isotretinoin therapy;
- Be careful driving at night. some people have experienced a sudden decrease in night vision;
- If you become pregnant, you must immediately stop taking Isotretinoin and see your doctor;
- If you get pregnant while taking Isotretinoin, your baby will be at high risk for birth defects;
- If you take Isotretinoin, you must use 2 effective forms of birth control from 1 month before the start of treatment through 1 month after the end of treatment;
- Some people taking Isotretinoin develop vision or hearing problems. if you notice changes in your vision or hearing, stop taking this drug and contact your doctor;
- Some people taking Isotretinoin, including some who simultaneously took tetracycline, have experienced headache, nausea, and visual disturbances caused by increased pressure within the skull. avoid taking tetracycline while using Isotretinoin. see a doctor immediately if you have these symptoms; if the doctor finds swelling of the optic nerve at the back of your eye, you must stop taking Isotretinoin at once and see a neurologist for further care;
- You have been invited to participate in a survey of women being treated with Isotretinoin;
- You have read and understood the Isotretinoin patient brochure and asked your doctor any questions you had;
- You may become more sensitive to light while taking this drug. try to stay out of the sun as much as possible;
- You may not be able to tolerate your contact lenses during and after your therapy with Isotretinoin;
- You may participate in a program that includes an initial free pregnancy test and birth control counseling session;
- You must have 2 negative pregnancy tests (one just before starting Isotretinoin therapy), and must be tested every month during therapy;
- You must not take Isotretinoin if you are pregnant or may become pregnant during treatment;
- You should not donate blood during your therapy with Isotretinoin and for a month after you stop taking it;
- You should not use wax hair removal treatments or skin resurfacing procedures (dermabrasion, laser treatments) while taking Isotretinoin or for 6 months after completing therapy;
- You should stop taking Isotretinoin immediately if you have abdominal pain, bleeding from the rectum, or severe diarrhea. you may have an inflammatory disease of the bowel;
Do not take Isotretinoin with any of the following drugs:
- Isotretinoin and vitamin a are chemically related; taking them together is like taking an overdose of vitamin a;
- Remember, too, that Isotretinoin should not be combined with tetracycline antibiotics such as doryx, minocin, and vibramycin;
- While taking Isotretinoin, do not take vitamin supplements containing vitamin a;
The recommended dosage range for Isotretinoin is 0.5 to 1 milligram per 2.2 pounds of body weight, divided into 2 doses daily, for 15 to 20 weeks.
If after a period of 2 months or more off therapy, severe cystic acne persists, your doctor may prescribe a second course of therapy.
For very severe cases, the doctor may increase the daily dose to as much as 2 milligrams per 2.2 pounds.
Overdosage of Isotretinoin, like overdosage of vitamin A, can cause:
- Incoordination and clumsiness;
- Facial flushing;
- Dry or cracked lips;
- Abdominal pain;