Accutane (Isotretinoin) Dosages: Your GoodRx Guide

If you’ve ever experienced severe acne, you know how frustrating it can be. Besides affecting your skin, it can also affect your mental health. Luckily, multiple types of acne treatments are available, including a medication called Accutane (isotretinoin).

Accutane comes from vitamin A and is FDA approved to treat a severe type of acne called nodular acne. For some people, it’s very effective — it helps them get rid of their acne entirely. But if you’re prescribed Accutane, it's important to take it exactly as prescribed. Here, we’ll cover everything you need to know about Accutane dosages.

Brand-name Accutane was removed from the market years ago. Isotretinoin is available as a generic medication, but since it's most commonly known by the brand name Accutane, we’ll use the name throughout this article. There are multiple other brand names of isotretinoin, including Absorica, Claravis, and Myorisan.

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What’s the typical Accutane dosage for adults and children over 12 years old?

The appropriate Accutane dosage will depend on how much you weigh. The typical dose is between 0.5 mg to 1 mg per kilogram body weight per day, given in two divided doses. Treatment usually lasts between 4 to 5 months. For people with severe acne, scarring, or acne that is on the chest and shoulders, the dose may be even higher (2 mg per kilogram body weight per day). 

People whose acne isn’t as severe may start at a dose of 0.5 mg per kilogram body weight per day. Your prescriber may increase your dose based on how well you respond.

For example, if you weigh 70 kg (154 lbs), your total daily dose will likely be somewhere between 35 mg to 70 mg per day depending on how your skin is responding and if you’re experiencing any side effects. You’ll divide this into two doses.

Good to know: Accutane isn’t approved for acne in children under 12 years old. Though some research shows Accutane is effective for children who are younger, it has severe side effects to be aware of. If you're interested in Accutane for your child, talk to their pediatrician.

How do you take Accutane?

It’s important to take Accutane exactly as prescribed. Here are some general guidelines to follow:

• Take Accutane with a full glass of water or other liquid. This helps minimize damage to the esophagus.

• Take Accutane with a meal. Taking Accutane with food helps it be absorbed. If you don’t take it with a meal, it may not have the desired effect. Since you’ll typically take Accutane twice a day, consider taking it with breakfast and dinner. However, keep in mind that it may be a good idea to avoid foods that can worsen acne while taking Accutane.

• You’ll need two forms of birth control if you could become pregnant. Accutane can cause significant birth defects if you take it while pregnant. For this reason, you shouldn’t become pregnant while taking Accutane. If it’s possible you’ll become pregnant during Accutane treatment, you’ll need to use two forms of birth control while you’re taking it, and for at least one month before and after. Additionally, monthly pregnancy tests are required. If you become pregnant during treatment, let your dermatologist know right away. You’ll need to stop taking Accutane.

• You’ll need to enroll in a special program called iPLEDGE. Anyone taking Accutane has to enroll in a special risk management program called iPLEDGE. This program was created due to the risk of birth defects with Accutane treatment. Even if you can’t become pregnant, you have to enroll in iPLEDGE. Your prescriber, and the pharmacy you use to get Accutane, has to enroll, too. 

• Let your prescriber know about other medications you take. Accutane can interact with other medications and supplements, including vitamin A supplements. And taking too much vitamin A can lead to toxicity. Before you start Accutane, give your prescriber and pharmacist an up-to-date medication list, so they can check for interactions.

• Your provider may adjust your Accutane dose while you’re taking it. At higher doses, Accutane is more likely to cause side effects like dry skin or lips. If you’re having side effects, your provider may lower your dose to make Accutane more tolerable.

Not all of these tips apply to all brand names of isotretinoin. For example, another brand name of isotretinoin called Absorica should be taken with a full glass of water, but it doesn’t need to be taken with food. 

How long should you take Accutane?

It depends. If your acne clears up quickly after taking Accutane, it’s possible that you won’t need to take it for more than a couple months. 

But most people will need to take Accutane for about 4 to 5 months. And some people will need a second treatment with Accutane if their acne doesn’t completely go away or if it comes back. But you have to wait at least 2 months in between treatments. This is because your skin may continue to clear for 2 months after you stop Accutane. And you want to make sure a repeat treatment is really needed before starting Accutane again.

EXPERT PICKS: WHAT TO READ NEXT

• How long does it take Accutane to work? Accutane can begin to work within a month. But find out why it will take longer to see its full effects.

• What to eat while taking Accutane: There aren’t food restrictions while taking Accutane. But you may want to avoid these foods that worsen acne.

• Accutane side effects: Learn about possible Accutane side effects and how you can manage them.

If you’re taking Accutane, stay in touch with your prescriber to discuss whether your acne is improving. They’ll help you determine how long you need to continue taking Accutane.

What happens if you miss a dose of Accutane?

If you miss a dose of Accutane, skip that dose. Then resume your regular dosing schedule at the next dose. For example, if you miss your morning dose of Accutane, don’t take it later in the day. Just take the evening dose at your usual time.

Accutane sticks around in your body for a while. So missing one dose won’t cause much harm. But taking too much Accutane has serious risks.

What should you do if you take too much Accutane?

Taking too much Accutane can be dangerous. It can cause vomiting, problems with coordination, and facial flushing.

Taking Accutane with other vitamin A products (like supplements) can also cause toxicity. It can cause dry skin, lips, and eyes. It can also cause skin peeling, and hair loss. This is why you should avoid taking vitamin A products with Accutane.

If you take too much Accutane, call Poison Control at 1-800-222-1222 right away, or seek emergency treatment immediately.

How to save on Accutane

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

• Save with GoodRx. GoodRx may be able to help you save on the average retail price of generic Accutane. Sixty capsules of generic Accutane (isotretinoin) 30 mg at certain pharmacies may be $40.00 with a free GoodRx discount.

• Save with a copay savings card. Some manufacturers of isotretinoin offer savings to help lower the cost of their medication. For instance, if you have commercial insurance, you may be eligible to pay as little as $25 for a month’s supply of Absorica capsules. For the generic version of Absorica, you may be eligible to pay as little as $20 for a month’s supply.

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Written by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Maria Robinson, MD, MBA

Maria Robinson, MD, MBA, is a board-certified dermatologist and dermatopathologist who has practiced dermatology and dermatopathology for over 10 years across private practice, academic, and telehealth settings. She is a fellow of the American Academy of Dermatology and the American Society of Dermatopathology.

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