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Isotretinoin

Isotretinoin belongs to the retinoid class of medicines. It is taken by mouth for severe, hard-to-treat acne, and other treatments, including courses of antibiotics, are normally tried first. A course runs for 16 to 24 weeks.

Medicines containing Isotretinoin

Isotretinoin

Severe Acne

10 · 20mg

Isotretinoin capsules contain isotretinoin for severe acne; they are never taken in pregnancy. You can choose from several strengths and pack sizes. You see the price per capsule for each option.

FromUS$1.17/ tabletView

Tretiva

Severe Acne, Nodulocystic Acne

5 · 10 · 20 · 30mg

Tretiva is isotretinoin in soft capsules for severe and nodulocystic acne. It comes in the widest range of strengths here, and each option lists its price per capsule.

FromUS$0.98/ tabletView

Isotroin

Acne Vulgaris, Severe Acne

10 · 20mg

Isotroin supplies isotretinoin as soft capsules for acne vulgaris and severe acne. You can choose from several strengths and pack sizes; you see the price per capsule for each.

FromUS$1.17/ tabletView

Key points

  • Isotretinoin is used for severe acne, including nodulocystic acne, that has not answered other treatment.
  • It shrinks the sebaceous glands and slows their output, so less oil and keratin reach the skin surface.
  • It is highly teratogenic, so it must not be used in pregnancy or breastfeeding, and strict contraception is needed.

What it is used for

Isotretinoin treats severe acne, including nodulocystic acne. Some products are also used for acne vulgaris, where standard skin care has not been enough on its own. The goal is fewer and less severe breakouts, with less chance of them returning. Visible change generally appears within 2 to 4 weeks.

How it works

Isotretinoin is a retinoid. It works on the sebaceous glands, the structures in the skin that release oil. These glands become smaller and less active, so less sebum is released, and keratinisation in the skin falls. Fewer blocked pores and less oil make the skin a poorer setting for the bacteria that drive inflamed spots.

Forms and brands

Three tablet ranges contain isotretinoin as the active ingredient, and they differ in the strengths they offer:

  • Isotretinoin 10 mg and 20 mg, for severe acne.
  • Tretiva 5 mg, 10 mg, 20 mg and 30 mg, for severe acne and nodulocystic acne.
  • Isotroin 10 mg and 20 mg, for acne vulgaris and severe acne.

Orders are prepared by pharmacy partners in India and shipped to Malaysia in discreet packaging.

Who should not take it

Isotretinoin cannot be used in pregnancy or during breastfeeding. Other contraindications are hepatic impairment, hypervitaminosis A and elevated blood lipids. Women who could become pregnant must use strict contraception. It is used with caution in adolescents.

Side effects and interactions

Dry skin, chapped lips and dry eyes are common. Muscle pain, joint pain and headache are also reported. Depression, suicidal ideation and pancreatitis are serious effects that need immediate medical attention. Avoid sun exposure while taking isotretinoin, do not donate blood during treatment, and expect regular liver function monitoring. Vitamin A supplements and tetracycline antibiotics should not be taken with it.

What the sources say

  • Women who can become pregnant must use two acceptable forms of birth control for one month before treatment, during it and for one month afterwards. (MedlinePlus)
  • The micro-dosed progestin minipill is not suitable during treatment, because isotretinoin interferes with its action. (MedlinePlus)
  • Severe congenital disabilities have been documented in babies whose mothers took isotretinoin while pregnant. (StatPearls)
  • Isotretinoin acts on four causes of acne: bacteria, blocked pores, excess oil and inflammation. About 85% of patients see permanent clearing after one course. (AAD)

Further reading

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