Isotretinoin (Rentinoic Acid, Accutane®)

These instructions are for Children's Hospital of Philadelphia (CHOP) patients with certain cancers, such as neuroblastoma, who are prescribed isotretinoin.

Important information:

• Isotretinoin is a medicine that is given by mouth.

• It affects the growth of cells and their development into different cells.

• It comes in capsules - follow the instructions below about how to give the capsule.

• Side effects may include:

  • Redness and pain around lips

  • Eye, nose, mouth and skin dryness and irritation

  • Itching

  • Nausea or vomiting

  • Irritation to the liver

  • May decrease blood counts

  • Mood changes

Instructions for isotretinoin:

• The capsule should be swallowed whole.

• If your child is unable to swallow the capsule whole, chew capsule (best absorbed if chewed with high fat food).

• If your child is unable to swallow whole or chew, cut capsule open and squeeze the contents into a high fat food immediately before administration.

• If your child is unable to take by mouth, you may give through a nasogastric (NG) tube or a gastrostomy tube (G-tube). There is a chance this medicine will clog the tube. Please consider this a last option. To give through a NG or G-tube there are 2 options:

  1. Puncture capsule (softgel formulations only) with a needle or cut with scissors and draw liquid into oral syringe. Add 1 to 5 mL of medium chain triglyceride (MCT), soybean, or safflower oil to the oral syringe. Mix gently and administer via feeding tube. Flush feeding tube with safflower oil so that no medicine is left sitting in the tube.

  2. Dissolve whole capsule in warm whole milk or formula and administer via feeding tube. Flush feeding tube with safflower oil so that no medicine is left sitting in the tube

• After giving isotretinoin through a feeding tube, flush the NG or G-tube with safflower oil.

• It is recommended to wear gloves when touching this medicine and wash your hands after removing gloves. If gloves are unable to be worn, please wash your hands with soap and water very well after handling the medicine.

• It is recommended to wear gloves when touching soiled diapers and urine while your child is taking this medicine. Wash your hands after removing gloves. If gloves are unable to be worn, please wash your hands with soap and water very well.

Call your CHOP oncology team with any questions or concern, or if your child:

• Misses any doses

• Cannot tolerate the medicine

• Has severe nausea or vomiting

• Blisters or severe dry skin

• Has a fever of 101.3°F (38.5°C) once, or 100.4°F (38°C) three times in a 24-hour period, taken at least 2 hours apart

If your child shows signs of a life-threatening reaction, call 911.

Oncology Contact Information

Reviewed on March 1, 2022, by Jennifer Saggio, MSN, CRNP; Erika Pineda, PharmD, BCPPS