| Indication | Dose | Timing | 30-Day Supply Price (Our In-House Pharmacy) |
|---|---|---|---|
| Severe Nodular Acne (70 kg adult) | 40 mg (0.5 mg/kg/day) | Twice daily with food | $40 – $60 |
| Severe Nodular Acne (70 kg adult) | 80 mg (1 mg/kg/day) | Twice daily with food | $60 – $90 (60 capsules) |
| Severe Nodular Acne (Low-Dose / Maintenance) | 20 mg daily | Once daily with food | $30 – $50 |
Our in-house pharmacy prices • No insurance required • Same-day pickup at North Babylon
Typical full course: 120–150 mg/kg cumulative over 4–6 months
Same-day appointments & medication pickup • No prior authorization delays
Quick Reference
| Feature | Details |
|---|---|
| Class | Systemic retinoid (Vitamin A derivative) |
| Brand / Generic | Accutane (brand) – generic isotretinoin |
| Available strengths | 10 mg, 20 mg, 30 mg, 40 mg capsules |
| Typical 30-day cost (our pharmacy) | $30 – $90 |
| FDA-approved use | Severe recalcitrant nodular acne |
| Pregnancy category | Category X – strictly contraindicated |
Dosage & Administration
| Parameter | Recommendation |
|---|---|
| Standard dose | 0.5–1 mg/kg/day in 1–2 divided doses |
| Maximum dose | 2 mg/kg/day (rare, severe cases only) |
| Administration | With high-fat meal (absorption ↑ 1.5–2×) |
| Course duration | 4–6 months (target cumulative 120–150 mg/kg) |
Common & Serious Side Effects
Common (manageable)
- Dry lips & skin (cheilitis)
- Dry eyes, nosebleeds
- Muscle/joint aches
- Elevated triglycerides
- Hair thinning (reversible)
Serious – Stop & Call Immediately
- Pregnancy (severe birth defects)
- Severe depression or suicidal thoughts
- Severe headache + vision changes (pseudotumor cerebri)
- Pancreatitis symptoms
- Inflammatory bowel disease flare
Critical Safety Information – iPLEDGE Program
- Absolutely contraindicated in pregnancy – Category X teratogen
- All patients must be enrolled in the national iPLEDGE program
- Females of childbearing age: 2 forms of contraception + monthly pregnancy tests
- Monthly blood work (lipids, LFTs) and office visits required
- No blood donation during treatment and for 1 month after
Patient Counseling Points
- Always take with a high-fat meal – never on an empty stomach
- Use intensive moisturizers, lip balm, artificial tears daily
- Avoid sun exposure – use SPF 50+ sunscreen
- Report mood changes, severe headaches, or vision problems immediately
- Complete the full course for permanent remission in most patients
Medical Director & Reviewer
Roman Liberman, MD
Board-Certified Pulmonary, Sleep & Critical Care Medicine
NYU Langone Health – North Babylon
In-house isotretinoin program with same-day dispensing
Dr. Liberman personally oversees all isotretinoin patients. All content on this page has been medically reviewed and approved for accuracy.