What Pharmacists Say About How Long Isotretinoin Takes to Work (Plus 4 More Tips)

When your healthcare provider writes you a prescription for isotretinoin, you’re probably looking for a treatment for troublesome acne. In many cases, this medication can start to work as early as 4 weeks. However, taking isotretinoin can be a complex process. Even though the prospect of having clearer skin is exciting, you'll want to first ensure you understand all of the ins and outs of taking isotretinoin.

What is isotretinoin?

Isotretinoin is an oral prescription medication that’s FDA approved to treat acne. It treats severe nodular acne that hasn’t responded to other acne medications or treatments. Nodular acne is a type of painful acne where knots and bumps develop under the skin. Isotretinoin can also be used off-label for other reasons, such as oily skin and rosacea. 

You may also hear isotretinoin referred to by several other names. Accutane is one popular brand name that’s no longer available. You can find isotretinoin as a generic medication or under other brand names, like:

• Absorica

• Absorica LD

• Amnesteem

• Claravis

• Myorisan

• Zenatane

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Isotretinoin is closely related to vitamin A. It works by reducing the size of your skin’s oil glands. It can also help reduce the amount of oil that your skin produces. 

5 tips for taking isotretinoin

If you’re looking to get acne symptoms under control, you may be wondering how long isotretinoin takes to work. Taking isotretinoin as recommended can help you get the most out of your prescription and lower the risk of side effects.

1. You may not see results right away

A typical course of isotretinoin lasts about 15 to 20 weeks (4 to 5 months). You may start to see some improvement in acne symptoms in as early as 4 weeks, but it usually takes longer to see complete results. 

In some cases, you may see a significant response to the medication before 20 weeks have passed. If this happens, your healthcare provider may tell you to stop taking isotretinoin early. Even after isotretinoin is stopped, your acne may continue to improve.

If desired results aren’t seen within 15 to 20 weeks of taking isotretinoin, your healthcare provider may recommend a second course of isotretinoin after a 2-month waiting period. Your acne may also initially get worse before it starts to get better. 

2. It’s an oral pill, but specific doses vary

Isotretinoin is an oral pill that you take by mouth. It’s usually taken twice a day. Your specific dose of isotretinoin will depend on your body weight. After you start taking isotretinoin, your healthcare provider may adjust your dose depending on your response to isotretinoin or side effects that you experience.

3. Foods and other medications may affect isotretinoin 

Food can impact how well your body absorbs isotretinoin. Some forms of isotretinoin, like Absorica, can be taken with or without food. But many forms of isotretinoin should be taken with food. Since there’s some variety, make sure to ask your pharmacist about how you should take your specific isotretinoin prescription. However, make sure to take each dose of isotretinoin with a full glass of water. This helps lower the risk of esophagus irritation.

Diet aside, isotretinoin can interact with other medications that you may be taking. Isotretinoin is closely related to vitamin A. In order to prevent vitamin A toxicity, you shouldn’t use other products containing vitamin A while you’re taking isotretinoin. Some seizure medications, antibiotics, and corticosteroids can also interact with isotretinoin. 

If you’re taking any of these medications — or have concerns about other medications — make sure to chat with your healthcare provider or pharmacist. It’s helpful if you give them an updated list of medications and supplements that you’re taking. This helps them screen for any interactions.

4. Isotretinoin has some side effects to be aware of

Isotretinoin has many possible side effects. The most common isotretinoin side effects include:

• Dry skin

• Chapped lips

• Dry eye

• Dry mouth

• Nosebleeds

These types of side effects may be managed by drinking water, using hydrating eye drops, and applying skin or lip moisturizers. Your skin may also be more sensitive to sunlight, so it’s important to use sunscreen and protect yourself from direct sunlight when possible. And as a preventative measure, your healthcare provider may also monitor your blood work over time. This is because isotretinoin can affect your blood sugar, cholesterol, and other laboratory tests.

More serious side effects are also possible. Isotretinoin can cause harm to unborn babies, so anyone that uses isotretinoin must not become pregnant. And even though isotretinoin is used for acne, your acne may initially worsen before it starts to get better.

These are just some side effects of isotretinoin. For a complete list of side effects, make sure to talk to your healthcare provider or pharmacist.

5. You must participate in iPLEDGE

Before you can fill a prescription for isotretinoin, it’s important to be aware of iPLEDGE. iPLEDGE is a medication safety program that you must participate in before you can start taking isotretinoin. It helps make sure that isotretinoin’s benefits outweigh its risks. 

The iPLEDGE program’s main goal is to make sure that pregnant people aren’t exposed to isotretinoin. This is due to isotretinoin’s severe risk of birth defects in unborn babies.

How iPLEDGE works

Your healthcare provider and pharmacist should walk you through the iPLEDGE process. The first step is to enroll in iPLEDGE, which is an FDA-required Risk Evaluation and Mitigation Strategy (REMS) program. After you enroll, you must sign an “informed consent” form that shows you understand how isotretinoin can harm unborn babies. 

If you’re able to get pregnant, there are a few more requirements. You’ll be required to use two forms of birth control at the following times:

• At least 1 month before starting isotretinoin

• While you’re taking isotretinoin

• For 1 month after your last dose of isotretinoin

You must also have two negative pregnancy tests before starting isotretinoin. Once these results are gathered, you must pick up your prescription for isotretinoin within 7 days. And as a precaution, you’re only allowed to get one 30-day prescription at a time. You’ll need a negative pregnancy test before you can get another 30-day prescription.

If you’re unable to get pregnant or you commit to being abstinent, these birth control and pregnancy test requirements don’t apply. And if you have male reproductive organs, you don’t need to use any special form of birth control, such as external condoms, while taking isotretinoin. There’s not a pattern of birth defects among babies born to fathers taking isotretinoin. But to be safe, your healthcare provider may still recommend using a condom as a precaution. 

While you’re taking isotretinoin, you shouldn’t donate blood, breastfeed, or share your isotretinoin prescription with anyone.

Tips on how to save money with your isotretinoin prescription

There are many ways to save on isotretinoin, which is available as both a brand-name and generic medication. 

• Save with GoodRx. GoodRx can help you save over 79% off the average retail price of the generic version. Generic isotretinoin at certain pharmacies is less than $100 with a free GoodRx discount.

• Save with a copay savings card. Some manufacturers offer savings for certain versions of isotretinoin. For instance, if you have commercial insurance, you may be eligible to pay as little as $20 for generic isotretinoin using a savings card from one manufacturer. 

• Save with patient assistance programs. If you’re uninsured or underinsured, you may be eligible for Absorica’s patient assistance program, which offers the medication free of cost for up to 6 months.

Why trust our experts?

Written by:

Mandeep Sohal, PharmD

Mandeep Sohal, PharmD, has more than 7 years of experience in the pharmaceutical industry and is licensed in California. In his career, he’s had experience with specialty pharmacy, community pharmacy, pharmacy benefit management, and pharmaceutical manufacturers.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

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