Isotretinoin

Chemotherapy

Brand names:

Absorica®, Absorica LD®, Accutane®, Amnesteem®, Claravis®, Zenatane®

Other names:

Cis-Retinoic Acid

Often used for:

Neuroblastoma, Acne

What is 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 often 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 each prescription of this medication. It is not safe to take isotretinoin during pregnancy.

Your child may have blood tests to monitor blood counts, blood sugar, lipid levels, and liver function.

May be taken as a capsule by mouth

Possible side effects

Eye conditions, such as dryness, irritation, swelling, sensitivity to light, or problems seeing at night
Skin conditions, such as itching, dryness, swelling
Dry mouth, nose, and lips
Muscle or joint pain (especially with physical activity)
Increased cholesterol levels
Reduced bone mineral density
Sun and UV light sensitivity
Liver problems
Hearing problems
Abdominal (belly) pain
Headache
Hair loss
Mood changes including depression, anxiety
Low blood counts
Increased blood sugar levels

Call your care team right away if your child has symptoms of an allergic reaction. These may include: rash, hives, itching, runny nose, fever, chills, headache, muscle ache, shortness of breath, coughing, tightness in the throat, swelling of the face or neck, dizziness, low blood pressure, or pain in the chest, side, or back.

Not all patients who take isotretinoin will experience these side effects. Common side effects are in bold, but there may be others. Report any symptoms or side effects to your health care provider or pharmacist. Find more information on side effects.

Possible long-term or late effects

Patients who take isotretinoin are at risk for medical problems that continue or develop later in life. These may include:

Bone loss and decreased bone mineral density
Growth problems

Your care team can give you more information about your child’s risk.

Tips for patients and families

Be sure to discuss all questions and instructions with your health care provider or pharmacist.

Patients should not take multivitamins or other dietary supplements while taking this medicine unless recommended by a doctor or pharmacist.
This medicine may cause a severe skin reaction. Contact your health care team right away if your child has any skin reactions such as red, swollen, blistered, or peeling skin. 
Watch for changes in your child’s mood or mental health, such as worsening depression, anxiety, agitation, irritability, panic attacks, and trouble sleeping.
Seek medical help right away if your child has any suicidal thoughts or actions or signs of self-harm.
Isotretinoin may affect alertness, eyesight, or make it hard to see in the dark. Do not let your child drive or do anything that could be dangerous until you see how this medicine affects them.
Do not donate blood while taking this medicine and for 1 month after completion of therapy.
Take steps to protect skin from the sun and UV lights. Have your child wear sunscreen and protective clothing. Avoid sun exposure when possible.
Avoid skin procedures such as dermabrasion, laser, or waxing while taking this medicine and for at least 6 months after to prevent scarring.
Talk to your health care team about physical activity and how your child can be physically active while taking this medicine.
It is important that patients tell the care team if they are sexually active, pregnant, or breastfeeding. It is not safe to take isotretinoin if pregnant.
Sexually active patients should use 2 forms of birth control to prevent pregnancy while taking this medicine and for 1 month after stopping the medicine.
Caregivers should follow instructions for safe handling and disposal of the medicine. Pregnant caregivers should not handle isotretinoin.

Isotretinoin at home:

Take the medicine with meals unless otherwise instructed by a doctor or pharmacist.
Capsules: Soft gelatin capsules can be swallowed whole (preferred) or chewed and swallowed.
If your child is unable to swallow the capsules, the capsule may be softened by placing it 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 in the cup.
- 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. Take the medicine immediately.
If your child has a feeding tube, the contents from the capsules can be given in the medicine port. Talk to your care team about how to give the medicine through a feeding tube.
Store capsules at room temperature. Protect from light.
In case of a missed dose, give the missed dose as soon as possible. If it is near the time for the next dose, skip the missed dose. Do not give 2 doses at the same time.
Follow instructions for safe handling, storage, and disposal.

Learn more about isotretinoin

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Always check the medication label. Many medicines look the same. Do not take any new medicine, including over-the counter medicines or supplements, without checking with your doctor or pharmacist. Talk to your doctor or pharmacist about what to do in the case of a missed dose, allergic reaction, or medical emergency.

This information is not intended to be a complete guide and is not a substitute for talking with your provider. Medicine names, appearance, formulas, or availability may vary by clinic location. Always follow the instructions given by your care team.

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Reviewed: January 2026

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