Before taking isotretinoin

Before taking isotretinoin make sure your doctor or pharmacist knows:

• If you are pregnant, trying for a baby or breast-feeding.
• If you have kidney or liver problems.
• If you have high levels of fat in your blood, such as cholesterol.
• If you have ever had mental health problems such as depression, psychosis or suicidal thoughts.
• If you have diabetes mellitus.
• If you have ever had an alcohol addiction.
• If you know you have a condition called hypervitaminosis A (too much vitamin A stored in your body).
• If you have ever had an allergic reaction to this or to any other medicine, or if you are allergic to soya or peanuts.
• If you are taking other medicines, including those available to buy without a prescription, herbal or complementary medicines.

How to take isotretinoin

• Before beginning treatment, read the printed information leaflet you have been given.
• Take isotretinoin exactly as you have been told to by your doctor.
• Take isotretinoin with a drink of water, with or after a meal.
• Swallow the capsules whole, do not chew or suck them.
• Isotretinoin is taken once or twice each day. You will have been told which is right for you.
• Your dose may change - follow the instructions given to you by your doctor.
• If you forget to take a dose, take it as soon as you remember unless it is nearly time for your next dose, in which case leave out the missed dose. Do not take two doses together to make up for a missed dose.
• Only one course of isotretinoin is usually needed. A course of treatment usually lasts for 4-6 months.

Getting the most from your treatment

• Isotretinoin will damage an unborn baby or cause a miscarriage. Therefore it is very important that women taking isotretinoin do not get pregnant.
• If you are female, your doctor will explain the dangers of isotretinoin on an unborn baby and will discuss with you the importance of contraception. One or more forms of contraception are needed at least 1 month before starting treatment, during treatment, and for at least 1 month after stopping treatment.
• If you are female, your doctor will do pregnancy tests before your treatment starts, during your treatment, and 5 weeks after you have stopped isotretinoin. If at any time during your treatment and for 1 month following treatment you think you may be pregnant, you must speak with your doctor straight away.
• It is important that you keep your regular appointments with your doctor. You will need to have regular blood tests to check for changes in your blood, cholesterol, glucose and liver function.
• Isotretinoin is likely to make your skin and lips very dry, so use a moisturiser and lip balm regularly.
• Do not take vitamin supplements that contain vitamin A while you are taking isotretinoin.
• Do not donate blood while you are taking isotretinoin, and for one month after stopping treatment.
• Sometimes, acne can get worse at the start of this treatment, but this should resolve in a week or so.
• Your skin will become more sensitive to sunlight and UV light while you are taking isotretinoin. Do not use sunbeds and try to avoid direct sunlight. Use a sunblock and a lip balm with a sun protection factor (SPF) of at least 15.
• Avoid hair removal by waxing, dermabrasion and laser skin treatment during, and for 6 months after isotretinoin.
• You might not see as well at night during your treatment with isotretinoin. If this happens, avoid driving or operating machinery at night.
• Prescriptions for isotretinoin must be dispensed within 7 days. After collecting a new prescription, take it to your pharmacy for dispensing straight away.

Can isotretinoin cause problems?

Along with their useful effects, all medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects become troublesome.

• A severe, itching rash with blisters.
• Mood changes such as feeling depressed, or if you have any thoughts about harming yourself.

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

How to store isotretinoin

• Keep all medicines out of the reach and sight of children.
• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines

References

• Manufacturer's PIL, Roaccutane® 10 mg and 20 mg Soft Capsules, Roche Products Limited, electronic Medicines Compendium. Dated October 2009, accessed September 2010.
• British National Formulary; 60th Edition (September 2010) British Medical Association and Royal Pharmaceutical Society of Great Britain, London (link to current BNF)