Isotretinoin (Accutane) FAQ in Columbus, Ohio

What is isotretinoin (Accutane)?

Isotretinoin (Accutane) is an oral medication used to treat acne. It's indicated for the treatment of severe acne, nodular-cystic acne, and/or acne that has not sufficiently responded to other treatments. Although there's no official cure for acne, isotretinoin treatment is the closest option.

What is iPledge?

iPLEDGE is a required safety program that prevents fetal exposure to isotretinoin. All patients must be enrolled before starting. Patients who can become pregnant must use two forms of contraception or practice continuous abstinence for 1 month before treatment, during treatment, and for 1 month after the last dose.

When can I start isotretinoin (Accutane)?

• Patients who cannot become pregnant: Registered in iPledge once consent forms and bloodwork are processed.

• Patients who can become pregnant: Registered in iPledge after processing consent forms and bloodwork but must wait 31 days from registration to start treatment. The iPledge program requires two negative pregnancy tests performed one month apart before providing access to the medication. After the second test you have a 7 day pharmacy pick-up window that begins on the day the specimen is collected. If you miss that window you will need a new confirmatory pregnancy test.

How often do I have to get bloodwork on isotretinoin?

Bloodwork will be required at least three times. These times are before the medicine is started, on the low dose isotretinoin (after month 1), and on the high dose isotretinoin (after month 2). Further monthly bloodwork may be needed if results are abnormal.

How long will I need to take isotretinoin?

The exact length of treatment depends on the patient, with an average length of treatment varying from 6-8 months.

What are the common side effects of isotretinoin?

Side effects may include dryness, muscle soreness/joint aches, and sun sensitivity. Over-the-counter analgesics and sunscreen with SPF 30 or above can manage these effects.

What will the first month be like on isotretinoin?

Results are not typically seen during the first month. At Rixis, we often use a low dose during month 1 to try and avoid a “skin purge” that some patients may experience. Most patients see results in months 2 and 3.

What if I miss my medication pick-up window?

• Patients who cannot become pregnant: the window is 30 days from the office visit date. Contact the clinic if you miss the window.

• Patients who can become pregnant: the window is 7 days from the pregnancy test date. If missed you will need a new confirmatory pregnancy test.

Do I need to fast for bloodwork on isotretinoin?

It's recommended that you fast for at least 6 hours before your bloodwork.

Do I need monthly appointments?

Yes. Patients who can become pregnant must complete monthly questions and pregnancy testing. Patients who cannot become pregnant still require monthly authorization and a 30 day pick-up window.

How soon after my appointment will I be confirmed in the iPledge system?

Our medical assistants try to confirm patients immediately after the appointment, but confirmation usually occurs before noon for morning patients and by 4:30 PM for afternoon patients.

Are there medications or products I should avoid on isotretinoin (Accutane)?

Avoid vitamin A supplements, other oral retinoids, and tetracycline antibiotics such as doxycycline or minocycline unless directed by your provider. Limit alcohol because it can worsen triglycerides and liver enzymes. Hold topical acne medications and oral acne antibiotics unless your provider instructs otherwise.

What products do you suggest to use in conjunction with isotretinoin (Accutane)?

Gentle fragrance-free cleanser, rich moisturizer twice daily, frequent lip balm or ointment, lubricating eye drops if contacts feel dry, saline nasal spray to nostrils, and daily SPF 30 or higher.

I've been on isotretinoin (Accutane) in the past, and I think I may want to start treatment again; what is the next step? Do I need a new iPledge number?

Schedule a visit to review options. A new course generally requires updated consents, labs, and re enrollment or reactivation in iPLEDGE. The team will guide you through timing and steps.