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Isotretinoin is strictly contraindicated for use during pregnancy due to significant risks, including severe birth defects, miscarriages, and premature births. It is crucial for women to prevent pregnancy while taking this medication. The following guidelines must be followed:

• Women of childbearing potential must use two reliable forms of contraception, or abstain from sexual intercourse, starting one month before isotretinoin treatment, throughout the treatment period, and for one month after discontinuation.
• Monthly counseling on pregnancy prevention is mandatory.
• Minipills (non-estrogen-containing birth control pills) should not be used as a contraceptive method while taking isotretinoin, as their effectiveness may be compromised.
• If you miss a menstrual period or have unprotected intercourse without two effective birth control methods, discontinue isotretinoin immediately and contact your healthcare provider.

In the United States, patients must comply with the REMS Program requirements for isotretinoin. Those in Canada or other countries should seek guidance from their healthcare providers regarding local regulations.

Consult your doctor to thoroughly understand the potential risks and benefits associated with isotretinoin use.

You might experience dry lips and mouth, minor swelling around the eyelids or lips, crusty skin, nosebleeds, upset stomach, or hair thinning while taking this medication. These are common side effects and should be monitored. If they persist or worsen, seek advice from a healthcare professional. To alleviate dry mouth, consider using sugarless gum or candy, sucking on ice chips, drinking water, or using saliva substitutes.

It's important to be aware of serious side effects, although they are less common. Contact a healthcare provider immediately if you experience mental or mood changes like depression or anxiety, tingling in the skin, persistent sore throat, fever, back, joint, or muscle pain, painful swallowing, or peeling skin on your palms or soles. The drug can rarely cause pancreatitis, which is potentially life-threatening. Discontinue use and consult a healthcare provider if you develop severe stomach pain or persistent nausea and vomiting.

In rare cases, there may be very serious side effects such as severe headache, vision changes, ringing in the ears, hearing loss, chest pain, yellow eyes or skin, dark urine, severe diarrhea, or rectal bleeding. Seek immediate medical attention if these occur. Allergic reactions are also rare but require urgent care if you experience rash, itching, swelling, severe dizziness, or trouble breathing.

Always consult a healthcare provider if you observe any other symptoms not listed.