“Isotretinoin”: instructions for use, analogues, indications and reviews

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Acne is a pathological process on the skin caused by changes in the hair follicle and external secretion glands secreted by sebum. One of the remedies for this disease is “Isotretinoin”. The drug has gained great popularity among dermatologists. In the instructions for use, “https://www.japan-zone.com/news/buy-accutane-online-usa/” is indicated as a dermatotropic agent. This means that the medicine not only eliminates pathology, but also protects the skin from the effects of pathogens, activates the processes of restoration and epithelialization of skin cells.

“Isotretinoin” medicine

The chemical compound isotretinoin, or 13 cis-retinoic acid, is a derivative of vitamin A. Retinol is essential for the maintenance and repair of skin cells and mucous membranes. Isotretinoin is included in the composition of various dermatotropic agents, and is also used as an independent drug.

The medicinal substance protects the skin from damage by various microbes and parasites. It activates the processes of regeneration, repair and remodeling of the skin, softens and resorbs scar tissue.

The remedy is mainly used to treat severe stages of acne. In rare cases, it is used to prevent papillary skin cancer. Applied for violations of keratinization. Cosmetologists prescribe a remedy to eliminate fine wrinkles and as complex measures aimed at rejuvenating the skin of the face.

Pharmaceutical companies manufacture the drug in the form of capsules, suppositories, and ointment bases.

Medicinal action

In the instructions for use, “Isotretinoin” is indicated as anti-inflammatory, dermaprotective, anti-acne, anti-siborrheic, A-vitamin-like agent. The drug normalizes the process of implementation at the genetic level of the program for the development of a special phenotype of cells, showing their ability to change the size, configuration, and metabolic activity. It inhibits cell division, in which the volume of tissue in the ducts of the sebaceous glands increases, inhibits the formation of the smallest residues of decay products and facilitates their excretion. Reduces the production and facilitates the secretion of fatty secretions (sebum, or sebum) by the holocrine glands.

13 cis-retinoic acid, acting on the terminal differentiation of the main cells of the epidermis, normalizes redox and renewal processes, in which retinol derivatives play an important role. The medicine can inhibit the secretion of the sebaceous glands and reduce their number.

After oral administration, the absorption is unstable, the absorption is low. But when taken with food, bioavailability doubles. The maximum medicinal effect is achieved in 2-4 hours. It is metabolized to form three active compounds – 4-hydroxy-isotretinoin, tretinoin and 4-hydroxy-retinoin. The drug is excreted by the kidneys and with bile.

“Isotretinoin” for acne

The drug belongs to medicines. The cosmetic effect appears due to the renewal and healing of the skin. Based on what is written in the reviews and instructions, “Isotretinoin” very quickly helps to get rid of acne. Efficiency is achieved due to the special mechanism of action of the drug:

  • Exfoliation. When applied externally, the drug irritates the stratum corneum, which contains dead cells rich in keratin closely adjacent to each other. The stratum corneum is characterized by exfoliation, and “Isotretinoin” helps to accelerate and improve this process. The pores become open without the formation of fat plugs.
  • Anti-comedogenic action. A fatty substance accumulates in the pores, forming plugs. They are a favorable breeding ground for pathogenic microorganisms. The drug is able to dissolve the substance, which leads to the cleansing of pores from acne.
  • Suppression of the activity of the sebaceous glands. With intense work of the glands, a large amount of fatty secretion is released, which clogs the pores. The tool normalizes the work of the glands, the production of sebum decreases.

Drug for signs of skin photoaging

Judging by the reviews and instructions, “Isotretinoin” has not only therapeutic properties. It makes the skin firmer, softer, and helps to reduce the depth of wrinkles. There have been no clinical studies confirming such effects. However, the drug does have some cosmetic effect.

  • Peeling effect. Under the action of the drug, the keratinized upper layer of the epidermis is eliminated. Blood supply and nutrition of tissue cells improves. The skin looks healthier and younger.
  • Activation of the process of stem cell division. The drug helps to accelerate the processes of division and transformation of the structural forms of stem keratinocytes into mature ones. The hydrophobic properties of the epidermis are improved, the skin is well hydrated.
  • Stimulates the production of elastin, collagen and hiauronic acids.

Indications for use

13 cis-retinoic acid is closely related to rutinol, a naturally occurring vitamin A derivative that is important for the maintenance and regeneration of epithelial tissues.

The use of “Isotretinoin” is indicated for the following pathological conditions:

  • Common acne.
  • Severe acne.
  • Rash with the development of cysts in the subcutaneous tissue, filled with pus and sebum.
  • Heaped or multiple acne.
  • Acne with a high likelihood of scarring.
  • An inflammatory disease characterized by an increase in sebum secretion.
  • A chronic, relapsing skin disease on the face, characterized by redness, expansion of superficial vessels, the formation of papules, pustules.
  • Perioral dermatitis.

Also, the drug is used if the previously prescribed therapy was unsuccessful.

In what cases is “Isotretinoin” contraindicated?

An increase in vitamin A in the body can cause serious health problems. Isotretinoin is not recommended for use in the following cases:

  • Planned or confirmed pregnancy.
  • Breastfeeding period.
  • Liver failure.
  • A pathological condition caused by an excess of retinol (vitamin A) in the body.
  • Severe hyperlipoproteinemia.
  • Rectal pathologies (proctitis, hemorrhoids).
  • Diabetes.
  • A mental disorder characterized by persistent depressed mood.

In the presence of at least one pathology, it is recommended to replace “Isotretinoin” with analogs or a completely different agent.

Also, the drug is not prescribed for treatment with antibacterial drugs with a condensed four-cyclic system of chemical structure (tetracyclines).

Use of the product during pregnancy and lactation

According to the instructions for use, “Isotretinoin” is contraindicated during pregnancy. Clinical studies have shown that exposure to 13 cis-retinoic acid can cause impaired embryonic development. The use of the drug in the first trimester can negatively affect the zygote and blastocyst. The risks to the fetus from “Isotretinoin” outweigh the benefits to the pregnant woman.

If during lactation there is an urgent need to use the drug, then breastfeeding should be abandoned for the duration of therapy.

Instructions for the use of “Isotretinoin”

The drug can be administered orally, rectally or externally. The method and scheme of application are determined by a dermatologist or cosmetologist with a medical education, depending on the severity of acne. During the course of treatment, there will be positive or, conversely, negative therapeutic dynamics. In the second case, the doctor may change the method or dosage.

  • Oral administration. The capsules are drunk with meals. The initial dosage of “Isotretinoin” is 0.1 mg per 1 kg of body weight per day. The portion is divided into 2 doses. After 3-4 weeks, the dose is adjusted depending on the effectiveness of therapy and the patient’s tolerance to the drug. The portion is usually increased to 1 mg, the maximum dose should not exceed 2 mg per kg of body weight per day. The duration of therapy is 3-4 months. During the course of the treatment process without side reactions and reducing rashes, the portions are gradually reduced. If the acne has decreased by 70% or more, then the drug is canceled.
  • Rectally. Suppositories are administered at night at the rate of 0.5-1 mg per 1 kg of body weight. The duration of therapy is 8-12 weeks.
  • External use. The ointment is applied to clean, dry, acne-affected skin with a thin layer twice a day. The drug should not be applied to the area around the eyes, as well as to mucous membranes or injured skin (scratches, abrasions). The duration of the course is from 1 to 3 months.

Isotretinoin: side effects

In addition to high therapeutic efficiency, the drug causes various undesirable effects.

CNS and sense organs:

  • Severe loss of strength.
  • Dull, prolonged headaches.
  • Increased pressure inside the skull.
  • Convulsive seizures.
  • Lacrimation disorder, in which there is dryness of the conjunctiva and cornea.
  • Decreased visual acuity.
  • Photophobia.

Gastrointestinal organs:

  • Violation of salivation.
  • Inflammation and bleeding of the gums.
  • Nausea.
  • Stool disorder.
  • Intestinal inflammation (enteritis, dysbiosis).
  • Pancreatitis
  • Internal bleeding.

Hematopoietic system:

  • Anemia.
  • Decreased hematocrit.
  • Decrease in the level of leukocytes and neutrophilic granulocytes in the blood.
  • Changes in platelet concentration.
  • High ESR.

Musculoskeletal system:

  • Muscle pain.
  • Increase in the content of bone substance in bone tissue.
  • Calcification and ossification of tendons and ligaments.
  • Inflammation and disorders of cellular metabolism of tendon tissues

Skin covering:

  • Flaky palms and soles.
  • Excessive sweating.
  • Thinning hair.
  • Rash.
  • Onychodystrophy.
  • At the beginning of therapy, there is often a temporary worsening of acne.


In the instructions for use for “Isotretinoin” there are clear instructions on measures to help avoid problems when using a dermatotropic agent.

During treatment, it is necessary to monitor the level of lipids and liver function. Patients with diabetes should have their blood glucose checked more often.

In case of side effects, treatment is stopped. In order to avoid hypervitaminosis A, “Isotretinoin” is not prescribed to patients taking retinoid preparations.

During therapy, patients wearing contact lenses should temporarily wear glasses. If a woman becomes pregnant during treatment, the drug should be discontinued.

Interaction with other medicines

The simultaneous use of “Isotretinoin” with “Retinol”, “Acitretin,” Adapalene “or other retinoids increases the likelihood of developing hypervitaminosis A.

The drug should not be taken with tetracyclines, since the risk of pseudotumor brain formation is high. 13 cis-retinoic acid weakens the action of progesterone.

Oral contraceptives containing progesterone may not be effective in treating acne.

With the simultaneous use of sulfanomides, the likelihood of sunburn increases.


Opinions about the drug are mixed. Almost everyone expresses their dissatisfaction with the side effects of the drug. In reviews of Isotretinoin, users ironically say that there used to be one problem, but now there are several.

But those who had a short course are happy with the result. Young women, desperate to find an effective remedy, are doubly satisfied – an excellent result at a low cost. Young people who do not understand medicines and the intricacies of use are satisfied with the result. They especially note the ease of use and the ability to independently adjust the dosage based on weight.

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