Isotretinoin 20 mg is a strong vitamin A-based medicine used to treat severe acne by reducing oil production in the skin. Take it exactly as prescribed, daily at the same time, and don’t stop without your doctor’s okay. Common side effects include dry lips, joint pain, nosebleeds, and skin irritation. Avoid alcohol, and if you’re pregnant or have high blood pressure, let your doctor know, as it can cause serious risks. 

Stick to the prescribed dose and never exceed it – too much can cause toxicity. If you miss a dose, take it when you remember unless it’s almost time for the next one. Isotretinoin can interact with other medicines, so always inform your doctor about anything else you’re taking. Store it properly and handle it with care for the best and safest results. 

Isotretinoin 20 mg is an oral medicine belonging to the class of retinoids (Vitamin A derivative) medicines. It is used to treat severe acne. 

1. Take isotretinoin exactly as prescribed by your doctor, regularly at the same time each day. 
2. Do not stop taking isotretinoin without your doctor’s approval, even if you feel better. 
3. If you forget to take the medicine, take it as soon as you remember, unless it’s almost time for the next one, then just skip it. 

More Common 

1. Joint pain 
2. Burning, redness, itching or other sign of eye inflammation 
3. Difficulty in moving 
4. Nose bleeding 
5. Scaling, redness, burning, pain, or other signs of inflammation of the lips 
6. Skin infection or rash 

Less Common

1. Unexplained bruising 
2. Easy bleeding 
3. Frequent infections 
4. Mood change 
5. Hallucination 

Isotretinoin is derived from vitamin A. It works by shrinking the oil-producing glands known as sebaceous glands, which helps reduce oil production, preventing clogged pores and acne.  

1- Pregnancy

Isotretinoin can cause fetal disabilities if taken during pregnancy. Therefore, if you are planning to conceive or are already pregnant, inform your doctor.

2- High Blood Pressure

Patients with hypertension should avoid taking this medication as it can elevate your blood pressure.

Avoid taking isotretinoin 20 mg with the following medicines, as it may increase or decrease the desired effect, or in worse cases, it could be fatal: 

Isotretinoin does not interact with any food products, but alcohol should be avoided before and after taking the medicine, as it can increase or decrease the effect of the medicine. 

1. The medicine should be stored at room temperature  
2. Keep away from sunlight and moisture  
3. Keep away from the reach of children 

IUPAC (International Union of Pure and Applied Chemistry)/ Chemical name

(2Z,4E,6E,8E)-3,7-dimethyl-9-(2,6,6-trimethylcyclohex-1-enyl)nona-2,4,6,8-tetraenoic acid. 

Daily dose

Take isotretinoin exactly as your doctor recommends. The dose may change based on your condition and how well you respond. Do not take more than prescribed without consulting your doctor.

Missed Dose

If you forget to take your medicine, take the medication soon as you remember. If it’s nearly time for your next dose, skip the missed one and continue with your regular schedule. Always consult the doctor before making any changes to your dosage.

Overdose

You should not take more than 900 mg of isotretinoin, as it can cause toxicity in your body. Symptoms of overdose include dry skin and inflammation of the lips.

1- Will isotretinoin affect future pregnancies? 

There is no evidence of isotretinoin affecting fertility. However, if you take this medication while pregnant or planning to conceive, it can cause birth defects in the baby. 

2- Will isotretinoin cause weight gain? 

No, there is no evidence of weight gain due to isotretinoin. 

3- Can isotretinoin cause hair loss?

Yes, isotretinoin can cause hair loss, but the exact mechanism of how it causes hair loss is unknown. 

4- Why does isotretinoin cause more acne? 

In some cases, isotretinoin causes more acne, but these cases are quite rare. 

1. NHS. Pregnancy, breastfeeding and fertility while taking isotretinoin capsules [Internet]. 2024 [cited 2025 Feb 13]. Available from. 
2. GoodRx. Does Accutane (isotretinoin) cause weight gain? [Internet]. 2024 [cited 2025 Feb 13]. Available from. 
3. Tran PT, Evron E, Goh C. Characteristics of Patients with Hair Loss after Isotretinoin Treatment: A Retrospective Review Study. Int J Trichology. 2022 Jul-Aug;14(4):125-127. doi: 10.4103/ijt.ijt_80_20. Epub 2022 Jul 16. PMID: 36081443; PMCID: PMC9447463. Available from. 
4. American Academy of Dermatology. Isotretinoin: Side effects and risks [Internet]. 2024 [cited 2025 Feb 13]. Available from.