Comprehensive medication guide to {drug} including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Accutane is the original brand name for Isotretinoin, a powerful oral retinoid (vitamin A derivative) used to treat severe recalcitrant nodular acne that has not responded to other treatments, including oral antibiotics. While the Accutane brand was discontinued by Roche in 2009, several generic versions remain widely available, including Amnesteem, Claravis, Myorisan, Zenatane, and the micronized formulation Absorica. Isotretinoin is one of the most effective acne treatments available and often produces long-lasting remission after a single course.
Isotretinoin works through multiple mechanisms to combat severe acne. It dramatically reduces sebaceous gland size and sebum production by up to 90%, which cuts off the oil that fuels acne. It also normalizes follicular keratinization (preventing pore clogging), reduces Cutibacterium acnes bacterial colonization, and has anti-inflammatory effects. These combined actions address every major factor in acne development. A typical treatment course of 15–20 weeks can produce lasting remission for many patients.
Your dermatologist will typically prescribe based on your body weight, targeting 0.5–1.0 mg/kg/day with a cumulative dose of 120–150 mg/kg over a 15–20 week course.
Isotretinoin (the generic name for Accutane) is not currently on the FDA drug shortage list, but patients frequently report difficulty finding it at their local pharmacy. The iPLEDGE REMS program creates narrow dispensing windows — prescriptions must be filled within a 7-day window each month, and pharmacies often stock limited quantities of this specialty medication. Specific dose strengths (especially 30 mg and 40 mg) can be harder to locate. Supply chain disruptions affecting individual generic manufacturers also cause periodic gaps. Overall, Isotretinoin is generally available but may require calling multiple pharmacies or using Medfinder to locate it in stock near you.
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Dermatologists are the primary prescribers of Isotretinoin and have the most experience managing its side effects and monitoring requirements. Some family medicine and primary care physicians also prescribe it, though this is less common. Pediatricians may prescribe it for adolescent patients with severe acne. All prescribers must be registered with the iPLEDGE REMS program before they can write prescriptions for Isotretinoin. Note that telehealth prescribing of Isotretinoin is generally not available due to the in-person monitoring and lab work requirements of the iPLEDGE program.
No, Isotretinoin is not a DEA-scheduled controlled substance. However, it is subject to strict distribution restrictions through the iPLEDGE REMS (Risk Evaluation and Mitigation Strategy) program. Both prescribers and patients must be registered with iPLEDGE. Female patients of childbearing potential must complete monthly pregnancy tests and use two forms of contraception. Prescriptions have a narrow 7-day dispensing window each month. These restrictions exist because of the extremely high risk of severe birth defects if taken during pregnancy.
Serious risks include severe birth defects (the primary concern), and rarely: depression or mood changes, inflammatory bowel disease, pseudotumor cerebri, and pancreatitis. Report any concerning symptoms to your prescriber immediately.
None of these alternatives match the potency of Isotretinoin for severe recalcitrant nodular acne, which is why it remains the gold standard when other treatments fail.
Always inform your prescriber of all medications, supplements, and herbal products you are taking before starting Isotretinoin.
Isotretinoin remains one of the most effective treatments for severe acne, with the potential for lasting remission after a single course. While the original Accutane brand is no longer manufactured, multiple generic versions are widely available. The iPLEDGE REMS program and monthly monitoring requirements add complexity, but these safeguards exist for important safety reasons. If you're having trouble finding Isotretinoin in stock at your local pharmacy, try Medfinder to quickly locate pharmacies near you that have it available. With discount coupons, generic Isotretinoin can cost as little as $40–$90/month — a fraction of the retail price. Talk to your dermatologist about whether Isotretinoin is right for your acne treatment plan.
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