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Isotretinoin is not suitable for use by pregnant women due to the high risk of severe birth defects, miscarriages, and premature births associated with its use during pregnancy. Women taking isotretinoin must take significant precautions to prevent pregnancy:

• A commitment to using two effective forms of contraception, or entirely abstaining from sexual intercourse, is essential for at least one month before starting isotretinoin, throughout the treatment, and for one month after discontinuation.
• Monthly pregnancy prevention counseling with your healthcare provider is mandatory.
• Avoid using minipills (non-estrogen-containing birth control pills) as they may be ineffective when used with isotretinoin.
• If your period is delayed, or if you engage in sexual activity without using two reliable contraceptive methods, discontinue isotretinoin immediately and contact your healthcare provider.

In the United States, isotretinoin can only be prescribed if you comply with the REMS Program guidelines. If residing in Canada or other countries, consult with your healthcare professional to understand the local regulations.

Discuss the potential risks and benefits of isotretinoin use with your doctor to make an informed decision.

You may experience dry lips and mouth, minor eyelid or lip swelling, crusty skin, nosebleeds, an upset stomach, or thinning hair while using this medication. These are common and usually not serious, but if they persist or worsen, it's important to inform your healthcare provider. To alleviate dry mouth, consider using sugarless hard candy or ice chips, chewing sugarless gum, drinking water, or using a saliva substitute.

Although most people do not experience severe side effects, it is critical to be aware of serious reactions. Contact your healthcare provider immediately if you experience mental or mood changes such as depression, anxiety, or suicidal thoughts, tingling sensations in the skin, back, joint, or muscle pain, persistent sore throat or fever, painful swallowing, or peeling skin on the palms or soles.

Isotretinoin can rarely lead to pancreatitis, which may be fatal. Discontinue use and seek emergency medical attention if you encounter severe stomach pain, nausea, or vomiting that is severe or persistent. Additionally, stop taking the medication and contact your healthcare provider if you experience severe headache, vision changes, ringing in the ears, hearing loss, chest pain, yellowing of the eyes or skin, dark urine, severe diarrhea, or rectal bleeding.

Though a serious allergic reaction is rare, seek immediate medical help if you notice symptoms such as a rash, itching or swelling (particularly of the face, tongue, or throat), severe dizziness, or difficulty breathing. This list does not include all possible side effects; if you observe any other unusual symptoms, reach out to your healthcare provider.