Utilized to treat severe acne, unresponsive to other medications.

Associated with a marked risk of tetrogenicity among pregnant women.

Its use suggests an association with inflammatory bowel disease, although clinical studies do not support such a link (Bernstein CN).

Isoretinoin is the only acne medication with potential to result in a complete remission of the process.

Isotretinoin is approved for treating severe recalcitrant nodular acne, but is often used to treat resistant to persistent moderate to severe acne, as well as acne producing scarring or significant psychological distress.

Relapse after isotretinoin therapy is common.

Isotretinoin usual dosage guideline starts at a dose of 0.5 mg per kilogram per day for the first four weeks, increases to 1 mg per kilogram per day thereafter until a cumulative dose of 120-950 mg/kilogram is given, which may take up to 4-6 months.

Females of childbearing age are registered in a risk management program to ensure monthly monitoring of contraception and pregnancy testing.

It is teratogenic and is associated with a risk of spontaneous abortion in approximately 20% of patients.

The risk of isotretinoin embryopathy is approximately 18 to 28%.

Side effects include mucocutaneous processes : cheilitis, xerosis and dermatitis.

It is associated with myalgias.

.Adverse effects are dose dependent and reversible upon  discontinuation of the drug.

Increased doses of the medication associated with increased adverse effects.

Associated with elevated cholesterol levels, triglyceride levels, and liver transaminases.

Less common adverse effects include skeletal affects of hyperostosis and premature epiphyseal closure, potential for development of inflammatory bowel disease, and depression.

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