Royal berkshire hospital

Additional information about Isotretinoin (Roaccutane)
What is isotretinion and what is it used for?
Isotretinoin, also known as Roaccutane, is a vitamin A-like drug that is widely prescribed by
dermatologists for the treatment of acne. This information sheet will explain how to start
treatment and answers some of the questions that we commonly get asked about isotretinoin.
Blood tests
Before starting isotretinoin, you will need to have a blood test to check that your lipids
(cholesterol and triglyceride) and liver function are normal. This test should be done after a 12-
hour fast, during which you should have nothing to eat or drink except water. The blood test can
be done in the Pathology laboratory (South Block, Royal Berkshire Hospital) between 9am and
4pm, Mondays to Fridays. There is no need to make an appointment. Alternatively, you may
wish to ask your GP if they are willing to take your blood.
If you are a male, then after your blood test, please start taking isotretinoin as prescribed. In the unlikely event that your blood tests are abnormal, we will contact you and your doctor, but otherwise you will not be informed of the results.
If you are a woman of childbearing age who has not been sterilised
Isotretinoin may cause severe fetal malformations and deformities. Under the new legislations
isotretinoin cannot be prescribed unless you have had a negative pregnancy test within 7 days
of picking up the treatment for the first time and for each month of treatment. The result of your
blood tests and the pregnancy test will be present in the pharmacy. If they are normal and the
pregnancy test is negative then you will be given the tablets without question. However, the
pharmacy will not tell these results over the phone, even to you. You will be given four blood
test forms, one for each month. In addition, you should only start isotretinoin once your next
cycle has commenced. A blood pregnancy test is necessary, as urine pregnancy tests are
unreliable.
You must avoid pregnancy once you have started isotretinoin, and for one month after you have discontinued the drug. Adequate contraceptive precautions should be taken at all times, the contraceptive pill being the most reliable option.
Treatment regimes
Isotretinoin tablets may be prescribed in a once or twice daily regime. The average length of
treatment is for 14 to 16 weeks, but this may be shorter or longer according to your response to
treatment. If you are already taking Minocin or another tetracycline antibiotic, your doctor will
ask you to discontinue this when you start isotretinoin or shortly afterwards (within 1 to 2
weeks.)
Possible side effects of isotretinoin
Always ensure you carefully read the information leaflet that accompanies your
medication.
Isotretinoin works by reducing the skin’s sebum (grease) secretion, so you will notice that your skin becomes generally drier during treatment. This can be helped by using a moisturiser (e.g. aqueous cream, Vaseline Intensive Care lotion). All patients experience dryness and cracking of the lips (cheilitis) while taking isotretinoin and we recommend that you use a lip salve, ‘chap stick’ or Vaseline/liquid paraffin preparation to help reduce any discomfort. You will be more prone to sunburn while taking isotretinoin, so we advise you to avoid sunbathing. If you are going on a sunny holiday, you may wish to delay starting treatment until your return. The serious side effects that are mentioned on the information that accompanies the isotretinoin are rare, but if in doubt please consult your GP. For female patients, it is essential to remember that pregnancy should be avoided during and one month after treatment, and that under no circumstances must these tablets be given to anyone else.
Follow-up clinic appointments
Normal y there is no routine follow up appointment for patients taking this treatment, as it is
fairly safe and effective. However, in the event that you develop some side effects, or the blood
tests come back as abnormal, then a follow up appointment will be arranged for you either by us
(see below for contact details) or by your doctor.
Contacting us
Department of Dermatology
Telephone 0118 322 8975
Dermatology Secretary 0118 322 7417/
Telephone 01635 273417
8975/ 8145
Fax 01635 273345
Dermatology Secretary 01635 273566
(Wed & Fri only)
Other Dermatology leaflets are available on the Trust website: Written: August 2003, Revised July 2005, April 2006, January 2007, January 2008Review due: January 2009

Source: http://www.royalberkshire.nhs.uk/PDF/Isotretinoin_Roaccutane.pdf