Isotretinoin (Acnetrent) is a type of vitamin A and has effects such as “inhibiting keratinization,” “suppressing sebum production (shrinking the sebaceous glands),” “antibacterial action against acne-causing bacteria,” and “anti-inflammatory action,” making it highly effective for treatment-resistant acne.
In Europe and the United States, it has been used for over 30 years as a treatment for moderate to severe acne; however, in Japan it is not approved by the Ministry of Health, Labour and Welfare, so it is not covered by insurance. It is available only as a self-pay treatment.
*This medication is prescribed only to those who are indicated for it as a treatment for severe acne, after we explain the precautions. Therefore, we cannot prescribe it to patients whom we determine during the consultation to be not indicated. Thank you for your understanding.
In Europe and the United States, it has been used for over 30 years as a treatment for moderate to severe acne; however, in Japan it is not approved by the Ministry of Health, Labour and Welfare, so it is not covered by insurance. It is available only as a self-pay treatment.
*This medication is prescribed only to those who are indicated for it as a treatment for severe acne, after we explain the precautions. Therefore, we cannot prescribe it to patients whom we determine during the consultation to be not indicated. Thank you for your understanding.
Recommended for those who:
- Those with moderate to severe acne whose recurrences cannot be controlled despite thorough insurance-covered treatment
- Those with cystic acne or nodular acne with severe inflammation
- Those at high risk of acne scarring.
Dosage
| Dosage | Isotretinoin is taken at a dose of 0.5–1.0 mg/kg. (Treatment usually starts at 0.5 mg/kg.) The average dose is 20–40 mg for women and 30–60 mg for men. |
|---|---|
| How to take | Take 1 capsule once daily after a meal (be sure to take it after a meal). If you forget to take a dose, take your usual dose at the next scheduled time. Do not take more than one dose at a time, even if you missed a dose. Do not open the capsule or take a damaged capsule. |
| Treatment period | One course lasts 4–6 months. If you wish to take a second course, you must have a drug-free period of at least 2 months. |
| Tests | A blood test is required in advance for prescription. For women, a pregnancy test is required. After starting the medication, blood tests are also required at 1 month and 3 months. |
Precautions while taking this medication
- If pregnancy occurs while taking this medication, even for a short period and at any dose, there is an extremely high risk of congenital abnormalities, miscarriage, preterm birth, and stillbirth. Because it may affect the fetus (risk of birth defects), it must not be taken during pregnancy.
- If a woman takes this medication, please use contraception for 1 month before starting, during treatment, and for 1 month after finishing. Use two or more methods of contraception together.
- There is no established medical necessity for special contraceptive measures while men are taking isotretinoin; however, as a precaution, we recommend contraception for 1 month before starting, during treatment, and for 1 month after finishing.
- Because blood transfusion to a pregnant woman may pose a risk of isotretinoin affecting the fetus, please refrain from donating blood during treatment and for 1 month after finishing.
- Do not breastfeed during treatment and for 1 month afterward.
- Do not share isotretinoin with anyone else.
- Because there is a risk of worsening liver or kidney function and a risk of increased blood glucose levels, those with liver or kidney dysfunction or diabetes must take special care when using this medication. During treatment and for 6 months after finishing, pregnancy and breastfeeding must be strictly avoided.
Possible Side Effects
- Dry skin; dryness of the mucous membranes of the mouth, nose, and eyes
- Dermatitis due to dryness, facial redness, and nosebleeds
- Liver dysfunction and lipid abnormalities
- There have also been reports of complications such as inflammatory bowel disease (e.g., ulcerative colitis), anaphylaxis, and depression.
Those who cannot receive treatment
- Those who are pregnant, trying to conceive, or breastfeeding
- Children under 15 years old (those who are still growing in height)
- Those with psychiatric disorders (depression or depressive tendencies)
- Those with liver or kidney dysfunction
- Those with high triglycerides or cholesterol
- Those with diabetes
- Those with inflammatory bowel disease
- Those with parabens, soy, or peanut allergies
- Those with fructose intolerance
- Those with hypervitaminosis A or who have had an allergic reaction to vitamin A
- Those within 6 months before or after LASIK surgery
Medications, supplements, and treatments requiring caution when used together
- Tetracycline antibiotics (e.g., Minomycin, Vibramycin)
- Vitamin A preparations, including supplements
- Oral steroids
- Antiepileptic drugs (phenytoin)
- Please consult your doctor about cosmetic treatments during the treatment period.