What is Accutane?
Accutane (isotretinoin), or Roaccutane as it is known in parts of the world, was discovered in 1979 when it was first given to patients with severe acne, most of whom reacted with dramatic and permanent clearing of their acne symptoms. It is a vitamin A derivative (13-cis-retinoic acid) that is administered orally in pill form with a meal that contains an adequate amount of fat,1 normally for 15-20 weeks (3.5-4.5 months),
although it is also sometimes prescribed at lower dosages for up to six months or longer. It was originally recommended for people with severe acne that did not respond to other treatments, but has gained in popularity in the past 25 years and is prescribed more and more frequently for less severe acne. This practice is controversial because Accutane is a serious medication that can cause severe birth defects as well as potentially long-lasting side effects to the user. Accutane need not be paired with other medications.
How does Accutane work?
Exactly how Accutane works on a cellular level is unknown but we do know that it affects all four ways that acne develops.
It dramatically reduces the size of the skin's oil glands (35%-58%) and even more dramatically reduces the amount of oil these glands produce (around 80%).
Acne bacteria (P. acnes) live in skin oil. Since oil is dramatically reduced, so is the amount of acne bacteria in the skin.
It slows down how fast the skin produces skin cells inside the pore, which helps pores from becoming clogged in the first place.
It has anti-inflammatory properties.
What happens if I miss a dose?
Skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include headache, dizziness, vomiting, stomach pain, warmth or tingling under the skin, swelling of the lips, and loss of balance or coordination.
What should I avoid?
Do not take vitamin supplements containing vitamin A while you are taking Accutane.
Do not donate blood while taking Accutane and for at least 30 days after you stop taking it. Donated blood that is later given to pregnant woman could lead to birth defects in her baby if the blood contains any level of Accutane.
Do not use wax hair removers or have dermabrasion or laser skin treatments while you are taking Accutane and for at least 6 months after you stop taking it. Scarring may result.
Avoid exposure to sunlight or artificial UV rays (sunlamps or tanning beds). Accutane can make your skin more sensitive to sunlight and sunburn may result. Accutane may impair your vision, especially at night. Be careful if you drive or do anything that requires you to see clearly.
Accutane side effects
Get emergency medical help if you have any of these signs of an allergic reaction to Accutane: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using Accutane and call your doctor at once if you have any of these serious side effects:
- depressed mood, trouble concentrating, sleep problems, crying spells, aggression or agitation, changes in behavior, hallucinations, thoughts of suicide or hurting yourself;
- sudden numbness or weakness, especially on one side of the body;
- blurred vision, sudden and severe headache or pain behind your eyes, sometimes with vomiting;
- hearing problems, hearing loss, or ringing in your ears;
- seizure (convulsions);
- severe pain in your upper stomach spreading to your back, nausea and vomiting, fast heart rate;
- loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
- severe diarrhea, rectal bleeding, black, bloody, or tarry stools;
- fever, chills, body aches, flu symptoms, purple spots under your skin, easy bruising or bleeding;
- severe blistering, peeling, and red skin rash; or
- joint stiffness, bone pain or fracture.
Less serious Accutane side effects may include:
- joint pain, back pain;
- feeling dizzy, drowsy, or nervous;
- dryness of the lips, mouth, nose, or skin; or
- cracking or peeling skin, itching, rash, changes in your fingernails or toenails.
- This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect Accutane?
Before taking Accutane, tell your doctor if you are also taking:
- steroids (prednisone and others);
- seizure medication such as phenytoin (Dilantin); or
- a tetracycline antibiotic such as demeclocycline (Declomycin), doxycycline (Doryx, Vibramycin), minocycline (Minocin), or tetracycline (Brodspec, Sumycin, Tetracap).
This list is not complete and other drugs may interact with Accutane. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
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