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Isotretinoin oral capsule dosage: A detailed guide

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Form and strengthsDosageFAQCouponOverdoseBoxed warning
Doctors prescribe isotretinoin oral capsule for a certain type of severe acne called nodular acne. You take it by mouth two times per day.
Medically reviewed by Melissa Badowski, PharmD, MPH, FCCP
Updated on

This article describes the dosages and strengths of isotretinoin oral capsule and explains how to take it. You’ll also find information on cost savings and coupon options for isotretinoin. To learn more about isotretinoin, talk with your doctor.

Isotretinoin oral capsule is a generic version of the brand-name drugs Absorica, Amnesteem, Claravis, Zenatane, and Accutane (which is no longer available). Isotretinoin only comes as a capsule that you swallow. This article describes dosages of isotretinoin.

Isotretinoin oral capsule has a boxed warning. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the end of this article.

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Form and strengths of isotretinoin

Isotretinoin oral capsule comes as follows:

  • Form: capsule that you swallow
  • Strengths: 10 milligrams (mg), 20 mg, 25 mg, 30 mg, 35 mg, and 40 mg

Dosage of isotretinoin

This article describes the recommended dosages for isotretinoin oral capsule. The drugmaker provides these dosages.

If your doctor prescribes this medication, you should follow the dosage they prescribe. Your doctor will determine the dosage that best meets your needs. Do not change your dosage of isotretinoin oral capsule without your doctor’s recommendation.

Usual recommended dosages of isotretinoin in adults

Isotretinoin is used to treat nodular acne. Your doctor will likely only prescribe isotretinoin if you have severe acne. There is no recommended dosage for mild acne because of the potential for serious side effects related to isotretinoin.

Usually, doctors start by prescribing a low dosage of isotretinoin oral capsule. Then, they’ll adjust it over time until the right dosage is reached. Ultimately, your doctor will prescribe the smallest dosage of isotretinoin oral capsule that gives the desired outcome.

You can take isotretinoin with or without food. You should swallow the capsules whole with a full glass of liquid. This helps prevent isotretinoin from irritating your esophagus.

Dosage for nodular acne

Isotretinoin dosage is based on your body weight in kilograms (kg).

  • Maintenance dosage: 0.5 to 1 mg/kg per day (in two divided doses)
  • Maximum dosage: 2 mg/kg per day (in two divided doses)

Below is the daily dose in mg that your doctor will likely prescribe based on your weight. This dose would be divided into two doses and taken two times per day.

Body weight in kilograms (kg)Approximate body weight in pounds (lb)0.5 mg/kg/day1 mg/kg/day
40 kg 88 lb20 mg40 mg
50 kg110 lb25 mg50 mg
60 kg132 lb30 mg60 mg
70 kg154 lb35 mg70 mg
80 kg176 lb40 mg80 mg
90 kg198 lb45 mg90 mg
100 kg220 lb50 mg100 mg

For example, if you weigh about 80 kg and your doctor prescribes an isotretinoin dosage of 0.5 mg/kg per day, your daily dose would be 40 mg per day. Because isotretinoin is given in two divided doses, you would take 20 mg two times per day.

Dosages of isotretinoin in children

Doctors can prescribe isotretinoin for a certain type of severe acne called nodular acne in children ages 12 years and older. The dosage is the same as the dosage for adults. Please refer to the “Usual recommended dosages of isotretinoin in adults” section for more information.

Frequently asked questions

Below are answers to some commonly asked questions about isotretinoin oral capsule and its dosage.

Is 40 mg of isotretinoin considered a high dose?

It depends. Doctors base your dosage of isotretinoin on your body weight in kg and how well your condition responds to the medication. If you have a lower body weight and your condition responds well, your doctor may prescribe a dosage of 10 mg or 20 mg two times per day. In this case, a 40 mg dose of isotretinoin might be high.

But 40 mg may be considered a maintenance dose for certain people. This includes people with a higher body weight and those whose condition does not respond as well to the drug.

Talk with your doctor if you have questions about your isotretinoin dosage.

What should I do for a missed dose of isotretinoin?

If you realize you forgot to take a dose of isotretinoin, you should skip that dose. You should not take two doses of isotretinoin at the same time. If you have questions about a missed dose, talk with your doctor or pharmacist.

For tips on how to plan your doses of isotretinoin and avoid missing a dose, read this article. You could also try:

  • downloading a reminder app on your phone
  • setting an alarm
  • putting a note where you’ll see it, such as on your calendar, bathroom mirror, or bedside table

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Overdose of isotretinoin

It’s important that you do not take more isotretinoin oral capsule than your doctor prescribes. Doing so can lead to harmful effects.

Symptoms of isotretinoin overdose

Symptoms of an overdose can include:

  • vomiting
  • facial flushing
  • abdominal pain
  • headache
  • dizziness
  • swelling, cracking, or scaling of your lips or the corners of your lips
  • issues with balance or walking

What to do if you take too much isotretinoin

If you think you’ve taken too much isotretinoin, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have severe symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

Boxed warning for isotretinoin

Isotretinoin has a boxed warning for the high risk for problems with fetal development (commonly known as birth defects). A boxed warning is the most serious warning from the FDA.

High risk of problems with fetal development: Any exposure of the developing fetus to isotretinoin can cause life threatening or fatal congenital malformations. You should not take isotretinoin during pregnancy or if you think you could become pregnant. Isotretinoin can only be obtained through a risk evaluation and mitigation strategy program (REMS). This program has requirements that your doctor, pharmacy, and certain people who can become pregnant must follow.

You can talk with your doctor to learn more about this warning.

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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