Isotretinoin: Serious side effects

Isotretinoin is an active ingredient used to treat acne. However, he is only approved for the treatment of severe acne. This is because the drug can have significant side effects. These include rash and inflammation of the skin, eye and mouth. Since ingestion can lead to malformations of the fetus, ingestion during pregnancy is not permitted. Learn more about the effects, side effects and dosage of isotretinoin.

Effect of isotretinoin

Isotretinoin belongs to the group of acne agents - more specifically to the retinoids. These are substances that are related to vitamin A (retinol). By using the remedy, the sebaceous glands become smaller and less sebum is produced. In addition, isotretinoin is anti-inflammatory and normalizes the growth of (mucosal) cells. This can effectively alleviate acne.

The active substance can be used both topically and systemically. In a topical application, the agent acts only locally at the diseased site. In a systemic therapy, the active ingredient is taken in the form of tablets and thus unfolds its effect throughout the body.

Because of its significant side effects isotretinoin is usually used only in severe disease. In addition, the active ingredient is usually used only if previously another treatment - such as a local acne or antibiotic therapy - has not struck.

Side effects of isotretinoin

Whether and, if so, what side effects occur when treated with isotretinoin depends greatly on how the drug is used. In a local application are usually less side effects than if the drug can be distributed throughout the body. Especially in this case, the drug shows a number of side effects.

Very common side effects on the skin during use include: inflammation, scaling, rash, increased skin integrity and itching. The skin becomes drier and it can lead to mucous membrane inflammation and nosebleeds. In addition, the skin is more sensitive to the sun. This should be noted especially in the summer.

In addition, the following side effects occur very frequently during treatment: Reduction in the number of red blood cells (and less frequently also white blood cells), changes in the number of platelets, dry mucous membranes and inflammations in the eyes and mouth, back pain, muscle and joint pain and increase in blood lipid levels. It can also lead to headaches, hair loss and an increase in blood sugar levels.

Effects on the psyche

Presumably, isotretinoin also affects the psyche of some patients. In rare cases side effects such as mood swings, anxiety and increased aggressiveness have been observed. In addition, depression may occur or existing depression may be exacerbated.

Very rarely it can come in the treated patients also to suicidal thoughts and in the worst case to suicide attempts. Therefore, patients should be closely monitored next to the attending physician by relatives or friends. This is especially important at the beginning of treatment.

For a detailed list of all side effects, please refer to the package insert of your medication.

Dosage of isotretinoin

Isotretinoin is a prescription drug that can only be purchased with a doctor's prescription at the pharmacy. The acne is not available without prescription. In principle, the active ingredient is available for local use in the form of ointment, creams or gels. For internal use there are tablets. These usually contain 10 or 20 milligrams of the active ingredient.

Isotretinoin tablets should be taken once or twice daily with some liquid at meal times. Depending on the dose, treatment usually takes 16 to 24 weeks. At baseline, adults and children over the age of 12 should receive 0.5 milligrams of isotretinoin per kilogram of body weight. Later, the dose can be increased to as much as 1 milligram as needed. In case of impaired renal function, the dose must be correspondingly lower.

Overdose of the acne

If you take too high an dose of isotretinoin, contact your doctor immediately or go to the nearest hospital. On the other hand, if you have forgotten a dose, get it as soon as possible. However, stop taking it when it is already time for the next dose. So do not take double cans!

Without good reason, you should not stop or stop treatment with isotretinoin without consulting your doctor. An exception is the possibility of pregnancy. In this case, you must not continue to use the active substance. You should also stop taking it immediately if you experience any of the following symptoms:

  • Nausea and vomiting coupled with upper abdominal pain
  • Nausea and vomiting combined with headache and / or blurred vision
  • Strong abdominal pain and bloody diarrhea

Even with an allergic reaction, the intake must be stopped immediately. This can be manifested by skin rashes, itching, respiratory problems, swelling or circulatory disorders.


Products containing isotretinoin should not be used if hypersensitivity to the active substance is present. In addition, the active ingredient is also contraindicated in the following diseases:

  • Increased blood lipid levels
  • Limited liver function
  • Increased vitamin A concentration in the body

In addition, the drug for certain disorders, depression, renal dysfunction, diabetes, obesity, increased intracranial pressure and inflammatory bowel disease should be used with particular caution. When applied topically to the skin, do not treat skin areas affected by acute eczema, perioral dermatitis or rosacea.

pregnancy and breast feeding period

Isotretionin should not be used during pregnancy and lactation. Women of childbearing potential must be sure to use contraception and have a pregnancy test before beginning treatment. As a rule, pregnancy tests are also carried out during treatment at regular intervals.

Contraception must be started four weeks prior to treatment and continued until four weeks after treatment. Stop treatment immediately if you are likely to be pregnant. Otherwise it can lead to severe malformations of the unborn child or a miscarriage.

Because of the dangerous side effects, women of childbearing age should only receive prescriptions that range from the prescribed amount for 30 days. The recipe must also be redeemed until seven days after the exhibition - otherwise it will expire.


If you take other medicines besides isotretinoin, they may interact. Therefore, be sure to tell your doctor about medications that you use regularly. During treatment with the acne agent, no antibiotics that end in cyclin should be taken. Likewise, no vitamin A supplements may be added to the body.

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