PATIENT MEDICATION

Isotretinoin

 

Description

Isotretinoin (also called cis-retinoic acid, CRA, Claravis®, or Accutane®) is used to treat severe acne and certain types of cancer. Isotretinoin is related to vitamin A (retinol), but it has different effects. These two medicines should not be confused. Do not take any vitamins while taking isotretinoin unless a St. Jude doctor tells you to do so. Isotretinoin is available as a 10 mg capsule, a 20 mg capsule, and a 40 mg capsule. All are taken by mouth.

Warning: Do not become pregnant while you are taking this medicine.

Isotretinoin will cause birth defects. Women who are pregnant should not take or handle this medicine. Women who are taking isotretinoin should use 2 effective birth control methods for at least one (1) month before the start of isotretinoin and for one (1) month after stopping it.

How to store isotretinoin

Store the medicine in the original blister pack and keep at room temperature. Keep away from heat and sunlight.

How to take isotretinoin

You will take isotretinoin one (1) or 2 times a day with food or just after a meal. Read the directions on the bottle carefully to make sure you take this medicine correctly.

Isotretinoin is a fatty liquid inside of a hard gelatin shell. It is best to swallow the capsule(s) whole to make sure the entire dose is taken. If you cannot swallow the dose whole, there are a few other ways that you can take this medicine. Use caution when using any of these other methods. The liquid in the capsule is sensitive to light; it can also be irritating to the skin.

If you are mixing the medicine with something else or softening the capsules, take the dose right after making a form that you can swallow. You or the caregiver should wear gloves when handling isotretinoin.

Caregivers who are pregnant or planning to become pregnant should not handle this medicine.

Ways to take isotretinoin

  • Swallow the capsules whole (preferred).
  • Chew and swallow the capsule.
  • Place capsule(s) in a medicine cup or small bowl and add warm (not hot) tap water or warm milk to cover the capsule(s). Wait 2–3 minutes until capsule is soft, and then:
    • Drink the milk or water with the softened capsule, or
    • Discard the liquid. Then chew or swallow the capsule(s), or
    • Discard the liquid. Place the softened capsule(s) on a spoon of food. Swallow the spoonful, or
    • Discard the liquid. Bite the capsule and suck the contents from the capsule (swallow the empty capsule if you can).
  • Puncture the capsule with a needle or cut the capsule with scissors. Squeeze the contents of the capsule into a spoonful of food. It is best to use something fatty (like peanut butter, chicken noodle soup broth, pudding, or ice cream) to help absorb the medicine.
  • After you puncture the capsule with a needle or cut the capsule with scissors, you can suck the contents of the capsule into an oral syringe. Only use this method if other ways are not possible. It is hard to remove all of the drug from the capsule using an oral syringe.

Giving isotretinoin through a feeding tube

If you must give this medicine through a feeding tube (nasogastric, gastric, or jejunal tube), use one (1) of these 2 methods while wearing gloves:

Method 1

  • Puncture or cut open the capsule.
  • Draw the contents into an oral syringe. Use care to try to remove all of the drug from the capsule.
  • Then add 1ml–5ml of MCT, soybean, or safflower oil into the same syringe.
  • Gently mix the syringe to mix the contents.
  • Give the mixture through the feeding tube.
  • Flush the feeding tube well with a minimum of 30ml of milk or tube feed.

Method 2

  • Puncture or cut open the capsule.
  • Squeeze the liquid into 5ml–10ml of warm milk or tube feed.
  • Pull the mixture into an oral syringe.
  • Then, give the mixture through the feeding tube.
  • Flush the feeding tube well with a minimum of 30ml of milk or tube feed.

Special instructions

  • The company that makes isotretinoin has strict rules for giving out this drug. You must sign a separate consent form that says the staff has told you about the possible risks to a fetus if the patient or sexual partner becomes pregnant. The consent form will only refer to using this medicine to treat acne. Even so, the form still must be signed by patients receiving the drug to treat cancer.
  • Your doctor will regularly check blood sugar levels, lipid levels, liver function, and blood counts. It is very important that you come to the hospital often for blood tests.
  • Female patients of childbearing age will have a pregnancy test before starting isotretinoin.
  • Tell your doctor right away if you have a sudden onset of nausea, vomiting, headache, trouble seeing, stomach pain, rectal bleeding, or severe diarrhea while taking isotretinoin.
  • It is not known whether isotretinoin passes into breast milk. Because this medicine may cause serious harm to a nursing infant, women who are taking isotretinoin should not breast feed.
  • Do not take multivitamins that contain vitamin A or beta-carotene. These vitamins may make the side effects of isotretinoin worse.
  • While taking isotretinoin, do not take alcohol (found in many over-the-counter cough and cold medicines) or any medicine that contains tetracycline.
  • Use sunscreen and wear extra clothing when exposed to the sun for long periods of time.

Possible side effects

  • Dry mouth and nose, cracked lips
  • Dry eyes, making it hard to wear contacts
  • Skin more sensitive to sun
  • Dry, itchy, fragile skin
  • Muscle and joint pain
  • Hair loss
  • Nausea, vomiting, or diarrhea
  • Stomach pain
  • Feeling depressed and having suicidal thoughts
  • Changes in vision, decreased night vision, and blurred vision
  • Headache
  • Unusual tired feeling
  • Low blood counts with a higher risk of infection, bleeding, and anemia
  • Changes in liver function with possible yellowing of the eyes, skin, or urine
  • High lipid levels in the blood
  • Increased blood sugar levels

These are known side effects, but there may be others. Please report all side effects to the doctor or nurse.

In case of a severe side effect or reaction, call the doctor, nurse, or pharmacist at 901-595-3300. If you are outside the Memphis area, dial toll-free 1-866-2STJUDE (1-866-278-5833), and press 0 once the call is connected.


 

This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health concerns or specific treatment options should be discussed with your physician.

St. Jude complies with health care-related federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

ATTENTION: If you speak another language, assistance services, free of charge, are available to you. Call 1-866-278-5833 (TTY: 1-901-595-1040).

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-278-5833 (TTY: 1-901-595-1040).

  1-866-278-5833  تنبيه: إذا كنت تتحدث بلغة أخرى، فيمكنك الاستعانة بخدمات المساعدة اللغوية المتوفرة لك بالمجان. يرجى الاتصال بالرقم

.(1-901-595-1040 :الهاتف النصي)