Isotretinoin
Isotretinoin capsules for severe nodular acne, in 5mg to 30mg strengths: Tretiva and Isofair (also sold as Isotroin and plain Isotretinoin), all containing the same oral retinoid.
How does isotretinoin clear severe acne?
Isotretinoin is a retinoid, a vitamin A-related capsule for severe recalcitrant nodular acne. That is the deep, inflamed, painful kind, the kind antibiotics and other treatments have not shifted. The capsules shrink the sebaceous (oil) glands, so the skin makes far less oil. Pores clog less, acne bacteria have less to feed on, and dead cells stop piling up inside the hair follicles. Because it cuts the oil supply instead of treating the surface, acne often carries on improving once the course is over.
Which isotretinoin should I order?
Strength is what separates these. Tretiva is the one to look at if you need 5mg or 30mg, because nothing else here comes in those sizes, and it also comes in 10mg and 20mg. Isofair, also sold as Isotroin and plain Isotretinoin capsules, is 10mg and 20mg only. The active ingredient is the same in both, and both are capsules. Pack sizes are on each product page.
Taking isotretinoin and what to expect
Capsules are swallowed whole with a full glass of liquid, usually with meals, and are not chewed, crushed or sucked. A course normally lasts 4 to 5 months at a time. Acne may get worse early in treatment, which is expected, and the full benefit takes several weeks or longer. Skip a missed dose rather than doubling the next one, and keep the capsules away from heat and damp.
What are the risks of isotretinoin?
Dry is the word. Lips go red and crack, skin dries out, and so do the eyes, mouth and nose, which is why nosebleeds turn up. Some people peel on the palms and soles, lose some hair, feel tired or burn quickly in the sun. Contact lenses can become uncomfortable, and night vision may get worse, so be careful driving after dark. Waxing, laser treatment and dermabrasion raise the risk of scarring; leave them for 6 months after treatment ends.
Mood changes including depression, severe headache with blurred vision, yellow skin or eyes, severe stomach pain, bloody diarrhoea or rectal bleeding, and bone, joint or muscle pain are serious signs that mean stopping the capsules and getting urgent care. Vitamin A supplements, tetracycline antibiotics and St John's wort should not be taken alongside isotretinoin, and progestin-only "minipills" do not give reliable contraception with it.
Isotretinoin must never be taken during pregnancy, because it carries a high risk of pregnancy loss and birth defects. Pregnancy has to be avoided before treatment, throughout it and for a month after the last dose, and breastfeeding and blood donation are ruled out for that month too.
Sources
- Isotretinoin: MedlinePlus Drug Information — National Library of Medicine
- What can clear severe acne? - American Academy of Dermatology — American Academy of Dermatology
Is Isotretinoin available to order in Hong Kong?
You can order isotretinoin online with delivery to Hong Kong. The range includes Isofair, also sold as Isotroin and as plain Isotretinoin capsules, as 10mg and 20mg capsules, and Tretiva as 5mg, 10mg, 20mg and 30mg capsules. Each order arrives in plain, unbranded packaging with nothing on the outside indicating the contents.
How are Isotretinoin prices shown?
Each of the two isotretinoin products has its own price per pack, shown on its page in HKD or your selected currency; larger packs usually cost less per unit.
What branded versions of Isotretinoin can I order?
What brand names does isotretinoin have?
Is isotretinoin the same as Accutane or Roaccutane?
Yes, in terms of active ingredient. Accutane and Roaccutane are brand names of isotretinoin capsules. The products here are Tretiva and Isofair (also sold as Isotroin and plain Isotretinoin), both of which contain isotretinoin as their only ingredient.
Why does acne sometimes get worse before it gets better on isotretinoin?
A flare in the first weeks is a recognised part of the course, as the skin adjusts to lower oil production. It does not mean the capsules are failing, and the acne often continues to improve even after treatment finishes.
Can I wear contact lenses while taking isotretinoin?
Dry eyes are a common effect and can make lenses uncomfortable during and after the course. Many people switch to glasses for the duration and use lubricating drops for the dryness, while the eyes recover once the capsules are finished.
Can I take vitamin A supplements with isotretinoin?
No. Isotretinoin is itself related to vitamin A, so extra vitamin A supplements add to the same effects and should be left out. Multivitamins that contain vitamin A fall under the same rule.