From WikiHealth

What to expect when taking Accutane

Before starting Accutane

Together with your doctor, you will decide if Accutane is the right step to take in treating acne. See article on The decision to take Accutane. Given the seriousness of the decision, your doctor will need to take initial blood tests to get a base reading on your blood levels. A urine sample will also be collected to ensure you are not pregnant.

When the doctor receives the results from the blood test, and affirms that you are not pregnant, they will write you a prescription for Accutane. The prescription will have a yellow sticker on the back with a date on it. Your prescription needs to be filled within 7 days from the date of issue or the pharmacy cannot honor it. This is very important. If you miss the prescription date, you will have to go back to the doctor for another slip.

Depending on severity of the acne and your responsiveness to the Accutane, you will most likely be taking the Accutane for 4-6 months. The standard dose is 40mg a day but this may change based on doctors evaluation of how you are responding and your tolerance to the drug.

The first month

When starting to take the drug, it is important to be familiar with all the literature that comes with it. The medication guide outlines a number of side-effects that may be triggered from the medication. Some are normal and not so severe, some are more rare and quite severe.

Contact your doctor immediately, if you experience any of the more severe side-effects:

Feelings of deep depression or thoughts of death
Vomiting or blood in the stool
Hives or trouble swallowing or breathing
Blurred vision or seizures
Yellowing skin or eyes

Some of the more common and non-alarming side-effects are:

Headaches: It is really common to have intense headaches the first few weeks-month on the medication. These headaches feel more like dehydration headaches and should not feel like migraines.
Dry skin: It is common to start to experience some dry skin on the lips, face and back. However, the more extreme symptoms of dryness usually do not set in until the second month of medication.
An increase in exhaustion: Accutane can make you very tired; especially as the body gets used to absorbing it.
Increase in thirst: Given that accutane has such a drying effect on the body, it is common to experience an increase in thirst. It is important to drink enough water to stay hydrated.

Many notice an increase in their acne over the first month. In other words, it can get worse before it gets better. If this happens to you, be patient, the skin will start to clear up in the second month. So resist the urge to pop pimples (as that can cause scarring).

The second month

Common side-effects can shift during the second month of taking the medication as the levels of isotretinoin increase in the blood. Generally, the headaches should lessen as should some of the feelings of tiredness (although, some patients report feeling exhausted throughout their entire course.)

Other side effects that may start to occur:

Muscle pain: Patients that are very active should talk to their doctors; it is not uncommon to have additional muscle soreness and pain from Accutane. Generally a decrease in excercise or heavy muscle use will help this. Most who suffer from this side effect say it goes away after the end of the second month of treatment.
Bone or joint pain: Some patients experience bone or joint pain, especially common in those that suffer from arthritis. It is a good idea to talk to your doctor right away if you are suffering from an increase or new bone and/or joint pain. Patients who suffer an increase in arthritic joint pain have said that it tends to dissipate after the third month.
Dryness: By the end of the second month you should start to experience an increase in dry lips and skin.

It is important to avoid drinking alcohol while taking this medication. It will reduce the risk of liver toxicity and it will also minimize feelings of dehydration (both orally as well as in the muscles.)Most doctors agree that if you don't drink much, there should not be a problem.

The third month

By this time, the skin is likely to be quite dry. This could include:

Very dry itchy back- some report an increase in scaly patchy areas
An increase in dry facial skin and scalp. Some find that their face gets redder and flakier as if they are recovering from a sunburn.
An increase in dry lips. The majority of those who take Accutane experience dry lips. This could range from moderately dry to extremely dry and cracking. Some dermatologists recommend using 'Aquaphor' on the lips as a treatment both keep them moist and to heal them.

By the end of the third month, you should notice a vast improvement in your skin. If you do not, you may have to talk to your doctor about continuing the treatment beyond the 4 month minimum.

Generally, if patient's blood tests show no sign of toxicity or negative impact on body by the third month, they are unlikely to experience any serious reactions that would result in them being taken off the medication.

The fourth/final months

At this stage, the patient should be feeling better; less burdened with potential side effects from the medication. However, dryness of the skin and lips will likely continue until the full course of the Accutane is completed.

Some patients will be required to take Accutane for up to 6 months or even longer (depending on severity of acne and how they respond to the medication). Many of the mentioned side effects may continue throughout the course of the treatment. Other may go away and others may start later in the treatment. It is vital to be in close contact with your doctor throughout the entire dose of this prescription.

Most patients report a clearing of all symptoms once the course of treatment is complete.

Final note: you should NOT stay on this medication beyond the prescribed dose. And it is ALWAYS essential to call your doctor if you feel anything out of the ordinary, and call the emergency room if you experience anything extreme or what appears to have the potential to be life-threatening while taking Accutane. However, Accutane is a very strong drug so expect to feel at least a few side side effects. Overall, if your acne has been an emotional and physical problem for you for awhile, the side effects of the medication will be well worth it!