Table 2.

Indications, contraindications, warnings, and characteristics of isotretinoin in the treatment of acne, and conditions related to the need for retreatment

Indications for use	Conditions related to the need for more than one course of treatment	Contraindications for use	Warnings
Severe acne (conglobata and nodular-cystic)	Age ˂ 16 years and family history of severe acne	Concomitant treatment with antibiotics from the tetracycline group (risk of intracranial hypertension)	Oral isotretinoin may reduce serum levels of carbamazepine and phenytoin (caution when using concomitantly)
Moderate acne (nodular-cystic or papular-pustular) with resistance to initial treatments, tendency to scarring, significant emotional impairment or impaired social functions	Long-lasting acne	Liver failure	Progesterone microdoses (“mini-pills”) are unsuitable for necessary contraception
	Female sex and hormonal changes (polycystic ovary syndrome)	Pregnancy and breastfeeding	Do not donate blood during treatment and up to 30 days after termination (risk of accidental exposure of pregnant women to the drug)
	Drug intake outside mealtimes (except isotretinoin-lidose, not available in Brazil)	Pre-existing hypervitaminosis A	Avoid sun exposure
	Presence of macrocomedones	Severe dyslipidemia
	Treatment interruption before total resolution	Allergic to soy and parabens (excipient and preservative in capsule formulation, respectively)
	“Hormonal athletes”: patients with hyperandrogenism secondary to the use of androgen-containing drugs