Isotretinoin

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Isotretinoin is a medication used to treat acne. During treatment, you will have regular reviews, blood test monitoring and in some cases pregnancy testing. These are required to make sure you are taking it safely and remain well whilst on the treatment.

Dose and treatment length

When starting isotretinoin, you will start on a low dose, usually one 20mg capsule per day. At your reviews the clinician will discuss with you whether it is suitable to increase the dose.

You will have a ‘target dose’ calculated before starting, this is a personalised dose that estimates how much isotretinoin you will likely need to treat your acne.

If you miss any days of taking your isotretinoin, please make a note/bring left over medication of this so we can accurately calculate how far through the treatment you are.

Review appointments

After a doctor has started isotretinoin, review appointments are likely to be carried out by a nurse. The length of time between reviews can vary between monthly to 3-monthly. This is individual to each patient and is carefully considered by the clinical team. Patients with childbearing potential will require regular monitoring for pregnancy testing (pregnancy prevention programme, see below).

Blood testing

Fasting blood tests are required before starting isotretinoin. Ongoing monitoring is required through treatment.

It is your responsibility to book and have any required blood test before your isotretinoin review.
If a blood test is due and you have not had this the review cannot be completed, and your next prescription cannot be given.
If for any reason you have had your blood test cancelled/ rearranged, please contact East Kent Dermatology to adjust your appointment, so that results are available and appointments are not wasted.

If you are not local to the area of Kent East Kent Dermatology when a blood test is due it is your responsibility to arrange a blood test and send the results to us.

Pregnancy Prevention Programme

You will be told by your clinician if you require regular pregnancy testing. All patients with childbearing potential require regular testing during treatment, even if not sexually active.

If pregnancy testing is required:

For a face-to-face appointment please bring a urine sample ready to be tested to the appointment. If you have forgotten, please ask at reception when checking in for a sample pot and do whilst waiting.
For a telephone review you will need to do a pregnancy test at home, on the morning of your appointment and send it to the service; via a secure text messaging service, so it is available to be checked during your appointment.

A negative pregnancy test result needs to be documented for a pharmacist to authorise and issue you the medication

Mood questionnaire

Although it is a rare side effect, changes to mood and anxiety have been reported by patient on isotretinoin. These will be monitored when on the medication. You will be asked about your mood and may be asked to complete questionnaires. It is important you are honest in answering these questions.

Telephone/remote isotretinoin reviews

In some cases, it is appropriate to carry out isotretinoin reviews via telephone. This will be decided by the initiating or reviewing clinician.

It is important to be aware that if required monitoring (blood tests, pregnancy tests, mood questionnaires) has not been undertaken prior to your appointment, review will not be undertaken, and your next prescription will not be issued.

The person taking the isotretinoin must be present for the telephone review, a parent or carer cannot undertake this on their behalf.

Prescriptions

The prescription will be printed; it cannot be sent electronically to a pharmacy.

For female patients, please hand the prescription to the pharmacy within seven days of the date it is printed. This is important if posted to you after a telephone review. After seven days the pharmacy may not issue the medication, delaying treatment.