Accutane® (isotretinoin)

Isotretinoin has been approved for acne since 1982.  It was first marketed by Hoffman-LaRoche as Accutane®, and that is still the name by which it is commonly known.  It is used to treat severe, cystic, or disfiguring nodular acne.  It is an oral medication with potential adverse effects, and for this reason, it should only be used after other acne medicines have been tried.  Isotretinoin may occasionally be used to treat other skin conditions such as gram-negative folliculitis, hidradenitis suppurativa, rosacea, and lamellar ichthyosis.  

The brand Accutane® has been discontinued in the United States, primarily due to business and financial reasons.  It is still available as Roaccutane® in other countries.  In the United States, isotretinoin is available as several other brands, including Absorica®, Claravis®, Sotret®, and Amnesteem®.  

Isotretinoin causes birth defects in humans, and as such, it must not be used during pregnancy.  The medicine is only available under a registered distribution program known as the iPLEDGE™ program.  Women of child-bearing potential must be familiar with the pregnancy warnings and requirements of this program before being prescribed isotretinoin.  Your dermatologist will review these requirements with you and counsel you on whether isotretinoin is appropriate for you.  

A typical course of isotretinoin lasts 5-6 months.  During that time, you will be asked to return monthly for an office visit and lab work to monitor your blood counts, lipids, and liver function tests.  In addition, women of child-bearing potential will be required to prevent pregnancy in 2 different ways and to have a monthly pregnancy test.

Other potential side effects need to be discussed and reviewed by your dermatologist.  It is important to note that patients with a history of depression or other mood disorders must use extreme caution when on isotretinoin.  Some studies have supported the idea that isotretinoin can cause mood changes, irritability, and depression symptoms, while other studies have supported improvement in psychosocial symptoms while undergoing therapy.  It is important to discuss this with your dermatologist.

If you would like to discuss whether isotretinoin is appropriate for you, call us to make an appointment today.