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Isotretinoin

Chemotherapy

Brand names:

Absorica®, Amnesteem®, Claravis®, Myorisan®, Zenatane®, Accutane®

Other names:

Cis-Retinoic Acid

Often used for:

Neuroblastoma, Acne

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About Isotretinoin

Isotretinoin is a type of medicine called a retinoid. It acts on specific receptors of the cell nucleus to control cell growth. Isotretinoin may be used as a chemotherapy to treat certain types of cancer such as neuroblastoma. It is usually used as a treatment for severe acne.

Although retinoids are related to vitamin A (retinol), the actions are very different. It is important to follow the care team’s instructions and warnings when using a retinoid drug.

Female patients of childbearing age will be given a pregnancy test before starting this medicine. Patients will have regular blood draws to monitor blood counts, blood sugar, lipid levels, and liver function.

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May be taken as a capsule by mouth

 
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Possible Side Effects

  • Dry, peeling skin
  • Dry mouth, nose, and lips
  • Dry eyes, change in eyesight, or problems wearing contacts
  • Sun sensitivity
  • Muscle or joint pain
  • Change in behavior
  • Liver problems
  • Increased blood lipid levels
  • Rash, itching
  • Mouth sores
  • Nausea and vomiting
  • Fatigue or weakness
  • Fever
  • Sweating
  • Abdominal pain
  • Diarrhea
  • Headache
  • Hair loss
  • Depression, anxiety
  • Low blood counts (may cause increased risk of infection, bleeding, anemia and/or fatigue)
  • Increased blood sugar levels

Not all patients who take isotretinoin will experience these side effects. Common side effects are in bold, but there may be others. Please report all suspected side effects to your doctor or pharmacist.

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Possible Side Effects with Long-Term Use

Some patients may experience long-term or late effects of treatment that may continue or develop months or years after treatment ends. Possible long-term side effects due to isotretinoin include:

  • Decrease in bone mineral density
  • Growth problems
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Tips for Families

Be sure to discuss these and other recommendations with your doctor or pharmacist.

  • Patients should not take multivitamins or other dietary supplements containing vitamin A (retinol) while taking this medicine unless recommended by a doctor or pharmacist.
  • While taking isotretinoin, patients should not take any medicine that contains tetracycline.
  • Patients should avoid drinking alcohol while on this medicine.
  • Patients should protect their skin from the sun while taking this medicine.
  • Sexually active patients should take steps to prevent pregnancy during treatment and for 1 month after completion of therapy.
  • Patients should tell their doctor if they are pregnant or breastfeeding. Patients should immediately discontinue isotretinoin if they become pregnant while taking this medicine.
  • Caregivers should follow instructions for safe handling and disposal of the medicine. Pregnant caregivers should not handle isotretinoin.

Isotretinoin at home:

  • Isotretinoin may affect alertness, eyesight, and/or night vision. Do not drive or do anything that could be dangerous until you see how this medicine affects you.
  • Take the medicine with meals unless otherwise instructed by a doctor or pharmacist. Take with a full glass of water.
  • Soft gelatin capsules can be swallowed whole (preferred) or chewed and swallowed.
  • If your child cannot swallow the capsules whole, there are other ways to take this medicine. The capsule may be softened by placing in a small cup with warm water or milk for 2-3 minutes, and then:
    • Drink the liquid and the softened capsule.
    • Chew or swallow the softened capsule and discard the liquid.
    • Place the softened capsule on a spoonful of food and eat.
    • Puncture the capsule and squeeze the medicine into a spoonful of food such as peanut butter, pudding, or ice cream.
  • Isotretinoin can be given by feeding tube. Follow the instructions given by your doctor or pharmacist.
  • Store capsules at room temperature. Protect from light.
  • Give a missed dose as soon as possible. If it is near the time of the next dose, skip the dose. Do not give 2 doses at the same time.
  • Do not use the medicine past the expiration date.
  • Follow instructions for safe handling, storage, and disposal.