Isotretinoin is a retinoid, which is a type of Vitamin A. It is commonly used for the treatment of severe acne. Retinoids are thought to influence the way in which cells grow and develop, and prevent the production of specific genes that may cause cancer.This page from Great Ormond Street Hospital (GOSH) explains what isotretinoin is, how it is given and some of the possible side effects.
How is it given?
What are the side effects?
Drying of skin, lips and eyes
Sensitivity to sunlight
Changes in liver function
Increase in blood fats
Effects on the unborn child
Bone marrow suppression
Interactions with other medicines
Giving isotretinoin in a mixture at home
- Assemble all the equipment you will need:
- gloves (disposable or household)
- a small pair of sharp, clean scissors (to be used only for this purpose)
- a dessert spoon
- a teaspoon
- a small tray (this can be plastic or disposable cardboard)
- small portion of ice cream, yoghurt or chocolate mousse
- kitchen roll - kept just for this purpose
- a sharps bin
- a plastic medicine pot
- Put the on gloves.
- Remove the capsule from the blister pack and put the required number of capsules for each dose into the plastic medicine pot.
- Place the dessert spoon on a clean surface.
- Take a capsule between finger and thumb and hold upright firmly
- Working over the tray use the scissors to cut the tip off the capsule and then carefully squeeze the contents on to the dessert spoon.
Note: If the capsules are too hard to cut, try putting them (still in their foil packaging) in the plastic medicine pot with some warm water for a minute or two.
- Discard the empty capsule in the sharps bin.
- Use the kitchen roll to wipe any drug from the gloves and then dispose of the used kitchen roll immediately in the sharps bin.
- Repeat for each capsule needed.
- After all the required capsules have been snipped, use the teaspoon to place some soft ice cream, yoghurt or mousse onto the dessertspoon.
- Using the teaspoon mix the ice cream, yoghurt or mousse with the medicine.
- Give the medicine to your child.
- Clean all equipment, including scissors and gloves (if using house-hold gloves) in warm soapy water.
- Put the disposable gloves in the sharps bin. Wash your hands thoroughly.
- Return the sharps bin to hospital when full.
- If you accidentally spill the contents of the capsules or mixture on the work surface or floor, wearing gloves, cover the spillage with kitchen paper. Wipe the area with water then clean with household cleaner and water.
- If the mixture gets onto your skin, you must wash the area immediately, using plenty of water. If the skin is sore you should contact your GP (family doctor) for advice.
- If the mixture accidentally gets into your eyes, wash with plenty of running water for at least 10 minutes. If your eyes are sore after this, you should go to your nearest Accident and Emergency (A&E) department.
- If the mixture is spilt on clothing, the spill should be blotted dry with kitchen paper. Clothing should be removed immediately and washed separately from other items. Used kitchen paper should be disposed of as above.
- Used paper towels, masks, vomit and dirty disposable nappies should be placed inside two rubbish bags and disposed of along with your normal rubbish.
- Keep all medicines in a safe place where children cannot reach them.
- Isotretinoin capsules should be kept in a cool, dry place away from direct sunlight or heat. Keep the capsules in their original packaging.
- You may be able to obtain further supplies from your Shared Care Centre. Ask the pharmacist when you collect your child’s prescription. You cannot get this medicine from your GP or local community pharmacy.
- Do not give your child any other medicines that contain Vitamin A, while they are taking isotretinoin. If you are not sure about other medicines, please ask your pharmacist, doctor or nurse.
- You should handle these medicines with care, avoiding touching the capsules where possible. If you are pregnant or think you could be pregnant, please discuss handling instructions with your doctor, nurse or pharmacist. Please see our Special handling requirements information sheet for further details.
- If you forget to give your child a dose and it is within a few hours of when the dose was due, give it as soon as you remember. Otherwise, do not give this dose but wait until the next dose is due. Do not give a double dose.
- If your child vomits straight after taking the dose, inform your doctor or nurse, as your child may need to take another one.
- If your doctor decides to stop treatment with isotretinoin or the medicine passes its expiry date, return any remaining medicine to the pharmacist. Do not flush it down the toilet or throw it away.
Please read this information sheet from GOSH alongside the patient information leaflet (PIL) provided by the manufacturer. If you do not have a copy of the manufacturer’s patient information leaflet please talk to your pharmacist. A few products do not have a marketing authorisation (licence) as a medicine and therefore there is no PIL.
For children in particular, there may be conflicts of information between the manufacturer’s patient information leaflet (PIL) and guidance provided by GOSH and other healthcare providers. For example, some manufacturers may recommend, in the patient information leaflet, that a medicine is not given to children aged under 12 years. In most cases, this is because the manufacturer will recruit adults to clinical trials in the first instance and therefore the initial marketing authorisation (licence) only covers adults and older children.
For new medicines, the manufacturer then has to recruit children and newborns into trials (unless the medicine is not going to be used in children and newborns) and subsequently amend the PIL with the approved information. Older medicines may have been used effectively for many years in children without problems but the manufacturer has not been required to collect data and amend the licence. This does not mean that it is unsafe for children and young people to be prescribed such a medicine ‘off-licence/off-label’. However, if you are concerned about any conflicts of information, please discuss with your doctor, nurse or pharmacist.