Oral Isotretinoin (Roaccutane)

 

RED List drug - only to be prescribed by consultant/ specialist clinician

Side-effects of oral isotretinoin

  1. dryness of skin and mucous membranes -  nose bleeds, cracked lips

  2. 2o infection with Staph aureus - abscesses, impetigo, cellulitis, follicuitis

  3. Drowsiness, dizziness, visual disturbance - avoid driving, operating machinery

  4. Joint pain and stiffness

  5. Hypertriglyceridaemia, elevated cholesterol

  6. Abnormal LFTs

  7. Teratogenicity - patients must undergo a “pregnancy prevention programme” including two forms of contraceptions, monthly visits/ pregnancy tests

  8. Depression - requires mood surveillance

Significant drug interactions

  1. Vitamin A -  risk of Hypervitaminosis A

  2. Tetracyclines -  benign intracranial hypertension

  3. Topical keratolytic - increased skin irritation

  4. Carbamazepine - reduced serum levels