How it is administered

Isotretinoin is taken by mouth as a capsule. It is available in various strengths, including 10 mg, 20 mg, 25 mg, 30 mg, 35 mg, and 40 mg. The capsules should be swallowed whole with a full glass of liquid to reduce the risk of esophageal irritation. Depending on the specific product, isotretinoin may be taken with or without food, but some brands recommend taking it with a meal to improve absorption. Always follow your healthcare provider's instructions regarding how to take this medication.

How it works

Isotretinoin is a type of medication called a retinoid, which is related to vitamin A. It works mainly by reducing the size and activity of sebaceous (oil) glands in the skin, leading to decreased production of sebum (skin oil). This effect helps treat severe acne by reducing inflammation and preventing clogged pores.

The exact mechanism by which isotretinoin works is not fully understood, but it is known to inhibit sebaceous gland function and keratinization (the process by which skin cells mature and are shed). The reduction in sebum is temporary and depends on the dose and length of treatment. Isotretinoin and its metabolites have retinoid activity, which may contribute to its effects. Although isotretinoin is not used to treat blood cancers like Juvenile Myelomonocytic Leukemia (JMML), it is sometimes used in other types of cancers or skin conditions as part of a broader treatment plan.

Who Should take it

Isotretinoin is approved for the treatment of severe recalcitrant nodular acne in patients 12 years of age and older who have not responded to other treatments, including systemic antibiotics. It is reserved for patients with many large, inflamed acne nodules (greater than 5 mm in diameter) who have not improved with conventional therapy.

In rare cases, isotretinoin may be used off-label in certain cancers or skin conditions, but it is not a standard treatment for blood cancers such as Juvenile Myelomonocytic Leukemia. If you have questions about its use in other diseases, please consult your healthcare provider.

Who should not take it

Isotretinoin should NOT be taken by anyone who is pregnant or planning to become pregnant, as it can cause severe, life-threatening birth defects. It is also contraindicated in people with a known hypersensitivity to isotretinoin, vitamin A, or any of its components.

People with a history of severe allergic reactions, or those who cannot comply with strict pregnancy prevention programs (such as iPLEDGE), should not take isotretinoin. It should be used with caution in patients with liver disease, high blood lipids, or bone disorders, and is not recommended for children under 12 years of age.

Commonly used with

Isotretinoin is typically used alone for severe acne and is not commonly combined with other medications for this purpose. However, patients may be advised to use gentle skin care products or moisturizers to help manage dryness.

It should not be used with vitamin A supplements or tetracycline antibiotics, as these combinations can increase the risk of side effects. Always inform your healthcare provider of all medications and supplements you are taking.

Commonly tested with

Before and during treatment with isotretinoin, your healthcare provider will monitor you with blood tests, including liver function tests and lipid panels, to check for side effects. Pregnancy tests are required for patients who can become pregnant, both before starting and throughout treatment.

Isotretinoin is not typically tested in combination with other medications for blood cancers or Juvenile Myelomonocytic Leukemia, as it is not a standard treatment for these conditions.