Common uses

Due to the possibly significant negative side effects of Accutane, the drug is normally used as a last resort when other forms of acne treatment including the use of over the counter products or prescription antibiotics have not been successful in treating the acne.

Before using

Accutane is a naturally occurring derivative of vitamin A and is detectable in the bloodstream of all people. Vitamin A in large doses has the same effects as Accutane, both good and bad, but quickly becomes harmful since it builds up in the tissue. (Important: Don't take any vitamin A while on Accutane). Accutane is formed naturally in the body from the Vitamin A present in the bloodstream. This is why large amounts of Vitamin A taken during pregnancy cause the same birth defects that Accutane does. Fortunately, because it is a naturally occurring product, the body is able to quickly remove Accutane from the bloodstream. It is gone from the blood within nine days and has no lasting effect on future pregnancies.
Do not start or stop any medicine without doctor or pharmacist approval. Contact your doctor or pharmacist if you have any questions or concerns about taking this medicine.

Directions

Follow the directions for using this medicine provided by your doctor. This medicine is usually taken two times a day with a meal, unless your doctor tells you otherwise. Swallow the capsule. Don't suck or chew it. Take it with a full glass of water, milk, or other nonalcoholic liquid. Follow your doctor's instructions carefully.
Depending on your reaction to Accutane, your doctor may need to adjust the dosage upward or downward. If you respond quickly and very well, your doctor may take you off Accutane even before the 15 or 20 weeks are up.
After you finish taking Accutane, there should be at least a 2-month "rest period" during which you are off the drug. This is because your acne may continue to get better even though you are no longer taking the medication. Once the 2 months are up, if your acne is still severe, your doctor may want to give you a second course of Accutane. If you are still growing, your doctor may recommend a longer "rest period."
The recommended dosage range for Accutane is 0.5 to 1 milligram per 2.2 pounds of body weight, divided into 2 doses daily, for 15 to 20 weeks. For very severe cases, the doctor may increase the daily dose to as much as 2 milligrams per 2.2 pounds.
If after a period of 2 months or more off therapy, severe cystic acne persists, your doctor may prescribe a second course of therapy


Cautions

Accutane is a potentially dangerous prescription medicine that should only be taken under the close supervision of your healthcare professional and pharmacist. If you are pregnant or may get pregnant, accutane can cause birth defects, miscarriage, premature births, and death in babies.
Avoid consumption of alcoholic beverages.
Read the patient information leaflet available with the product.
Do not crush the capsules.
Do not share Accutane with anyone because of the risk of birth defects and other serious side effects.

Possible side effects

Unfortunately, side effects depend on the dose as well. At the lowest doses, there are almost no side effects at all. At the highest, everyone get rather nasty side effects, which are related on the drying effects on the oil glands. The dose needs to be adjusted to strike a balance between effectiveness and side effects.

Side effects are listed here. Abnormal hair growth or loss, allergic reaction, bleeding gums, blood in urine, bowel inflammation and pain, bruising, changes in blood sugar or cholesterol levels, changes in skin pigmentation, chest pain, decreased night vision, decreased tolerance to contact lenses, delay in wound healing, depression, difficulty sleeping, dizziness, drowsiness, dry or fragile skin, dry or cracked lips, dry mouth, dry nose, fatigue, flushing, headache, hearing problems, heartbeat irregularities, herpes, inflammation or sores in the esophagus, itching, joint pain, liver disorders, menstrual changes, muscle wasting, nail disorders, nausea, nervousness, nosebleeds, peeling palms or soles, pinkeye, rash, skin infections, stomach and intestinal discomfort, stroke, sudden drop in blood pressure (causing unconsciousness), sunburn-sensitive skin, suppression of growth, sweating, swelling due to fluid retention, tendon and ligament problems, urinary discomfort, vision problems, vomiting, weakness, weight loss

Accutane may increase the level of blood fats, sometimes to risky levels. This reverts back to normal when the drug is stopped. Occasionally it may affect the liver. That's why regular blood tests are necessary during Accutane treatment. There is little risk of any damage if these precautions are followed.

The most damaging side effect of Accutane is serious birth defects if taken during pregnancy. It is critically important for women not to take Accutane while pregnant, and not to become pregnant while taking it. Women who are, or might be, sexually active while taking Accutane must use an effective method of birth control, of which the birth control pill is the most effective. Birth control pills do rarely fail, so an additional method of birth control such as a condom for the male partner or a spermicidal foam or sponge is also needed. Because the birth defects caused by Accutane are so serious, it's important not to share the pills with others.

If you take too much

Any medication taken in excess can have serious consequences. If you suspect an overdose of Accutane, seek medical attention immediately.
• Overdosage of Accutane, like overdosage of vitamin A, can cause:
Abdominal pain, dizziness, dry or cracked lips, facial flushing, incoordination and clumsiness, headache, vomiting

Additional information

While taking Accutane, do not take vitamin supplements containing vitamin A. Accutane and vitamin A are chemically related; taking them together is like taking an overdose of vitamin A.
Remember, too, that Accutane should not be combined with tetracycline antibiotics such as Doryx, Minocin, and Vibramycin.

Drug interactions

The concurrent use of Accutane with tetracycline antibiotics or vitamin A supplementation is not recommended. Concurrent use of isotretinoin with tetracyclines significantly increases the risk of idiopathic intracranial hypertension. Concurrent intake of Vitamin A supplementation increases the risk of vitamin A toxicity.
Concurrent use of isotretinoin with methotrexate increases the risk of hepatotoxicity and may increase methotrexate levels. The combination is used with caution and close monitoring of adverse effects and liver function tests.