Details of Drug

Drug General Information (ID: D0863)
Drug Name	Isotretinoin
Drug Type	Small molecule
Drug Synonymous	Accutane; Amnesteem; Claravis; Isotane; Isotretinoine; Isotretinoino; Isotretinoinum; Isotrex; Roaccutan; Roaccutane; Roacutan; Sotret; Teriosal; Neovitamin A acid; R 3255; Ro 4 3780; Ro 43780; Accutane (TN); Amnesteem (TN); BML2-E07; CIP-Isotretinoin; Claravi (TN); Clarus (TN); Decutan (TN); Isotane (TN); Isotretinoin (USP); Isotretinoin Zinc Salt, 13 cis Isomer; Isotretinoine [INN-French]; Isotretinoino [INN-Spanish]; Isotretinoinum [INN-Latin]; Izotek (TN); Oratane (TN); Ro 4-3780; Ro-43780; Roaccutane (TN); Sotret (TN); Isotretinoin [USAN:INN:BAN]; Ro-4-3780; Isotretinoin Zinc Salt, 13-cis-Isomer; (2Z,4E,6E,8E)-3,7-dimethyl-9-(2,6,6-trimethylcyclohexen-1-yl)nona-2,4,6,8-tetraenoic acid; (2Z,4E6E,8E)-3,7-dimethyl-9-(2,6,6-trimethylcyclohex-1-en-1-yl)nona-2,4,6,8-tetraenoic acid; (7E,9E,11E,13Z)-retinoic acid; 13-RA; 13-cis RA; 13-cis-Vitamin A acid; 3,7-Dimethyl-9-(2,6,6-trimethyl-1-cyclohexen-1-yl)2-cis-4-trans-6-trans-8-trans-nonatetraenoic acid Click to Show/Hide
Disease Class	ED80: Acne vulgaris
Therapeutic Class	Antiacne Agents/Antineoplastics
Structure
Structure	3D Structure		2D Structure
Formula	C20H28O2
InChI	1S/C20H28O2/c1-15(8-6-9-16(2)14-19(21)22)11-12-18-17(3)10-7-13-20(18,4)5/h6,8-9,11-12,14H,7,10,13H2,1-5H3,(H,21,22)/b9-6+,12-11+,15-8+,16-14-
InChIKey	SHGAZHPCJJPHSC-XFYACQKRSA-N
Canonical SMILES	CC1=C(C(CCC1)(C)C)C=CC(=CC=CC(=CC(=O)O)C)C
External Link
	Pubchem ID	5282379
	CAS Number	4759-48-2
	CHEBI ID	6067
	TTD ID	D00DKK
	INTEDE ID	DR0890

Drug-Drug Interaction Network
Sunburst Graph		Legend Information AM004 Affected intra/extra-hepatic metabolism AM006 Pharmacodynamic additive effects AM007 Pharmacodynamic antagonistic effects BM017 CYP450 enzyme inhibition BM022 CYP450 enzyme induction BM055 Increased risk of hepatotoxicity BM075 Increased risk of photosensitivity reactions BM077 Increased risk of pseudotumor cerebri BM079 Increased risk of skin rash BM085 Antagonize the effect of antithrombotic agents BM109 Increased risk of other adverse reactions (Unspecific)
Relation Graph

Full list of drugs interacting with Isotretinoin
Affected intra/extra-hepatic metabolism
	CYP450 enzyme inhibition					Drug Num: 11
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0002		Abametapir (topical)	C12H12N2	15664	Moderate		Inter Info	[60]
D0007		Abiraterone	C24H31NO	132971	Moderate		Inter Info	[27], [1], [61]
D0699		Fostamatinib	C23H26FN6O9P	11671467	Moderate		Inter Info	[72]
D0869		Ivacaftor	C24H28N2O3	16220172	Moderate		Inter Info	[74], [75], [76], [77]
D0899		Lefamulin	C28H45NO5S	25185057	Moderate		Inter Info	[78], [79], [80]
D0906		Letermovir	C29H28F4N4O4	45138674	Moderate		Inter Info	[82]
D1409		Ripretinib	C24H21BrFN5O2	71584930	Moderate		Inter Info	[4], [89]
D1432		Rucaparib	C19H18FN3O	9931954	Moderate		Inter Info	[90]
D1459		Selpercatinib	C29H31N7O3	134436906	Moderate		Inter Info	[1], [91]
D1687		Vemurafenib	C23H18ClF2N3O3S	42611257	Moderate		Inter Info	[4], [1]
D1143		Nitisinone	C14H10F3NO5	115355	Moderate		Inter Info	[27], [4], [103]
	CYP450 enzyme induction					Drug Num: 16
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0554		Efavirenz	C14H9ClF3NO2	64139	Moderate		Inter Info	[27], [1], [2], [54], [8], [3]
D0044		Alpelisib	C19H22F3N5O2S	56649450	Moderate		Inter Info	[62]
D0095		Apalutamide	C21H15F4N5O2S	24872560	Moderate		Inter Info	[1], [63]
D0300		Cenobamate	C10H10ClN5O2	11962412	Moderate		Inter Info	[67]
D0406		Dabrafenib	C23H20F3N5O2S2	44462760	Moderate		Inter Info	[1], [68]
D0545		Echinacea	NA	NA	Moderate		Inter Info	[4], [69]
D0578		Enzalutamide	C21H16F4N4O2S	15951529	Moderate		Inter Info	[70], [4], [1], [71]
D0901		Lemborexant	C22H20F2N4O2	56944144	Moderate		Inter Info	[4], [81]
D0953		Lorlatinib	C21H19FN6O2	71731823	Moderate		Inter Info	[83]
D0958		Lumacaftor	C24H18F2N2O5	16678941	Moderate		Inter Info	[84], [1], [75]
D1302		Pitolisant	C17H26ClNO	9948102	Moderate		Inter Info	[1], [85]
D1493		Somapacitan	C54H95N13O20S2	129894493	Moderate		Inter Info	[4], [1], [92]
D1495		Somatrem	C43H72N14O14	5487805	Moderate		Inter Info	[4], [1], [93], [92]
D1546		Telotristat ethyl	C27H26ClF3N6O3	25181577	Moderate		Inter Info	[1], [94]
D1128		Nevirapine	C15H14N4O	4463	Moderate		Inter Info	[4], [1], [101], [102]
D1494		Somatotropin	NA	NA	Moderate		Inter Info	[4], [1], [92]
Pharmacodynamic additive effects
	Increased risk of hepatotoxicity					Drug Num: 23
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0900		Leflunomide	C12H9F3N2O2	3899	Major		Inter Info	[27], [28], [29]
D0944		Lomitapide	C39H37F6N3O2	9853053	Major		Inter Info	[30]
D1073		Mipomersen	C230H324N67O122P19S19	118984467	Major		Inter Info	[31]
D1258		Pexidartinib	C20H15ClF3N5	25151352	Major		Inter Info	[32]
D1556		Teriflunomide	C12H9F3N2O2	54684141	Major		Inter Info	[27], [28], [29]
D0114		Asparaginase Escherichia coli	NA	NA	Moderate		Inter Info	[35], [36], [37], [4], [1], [38], [39], [40], [41], [42], [43], [44], [45]
D0357		Clofarabine	C10H11ClFN5O3	119182	Moderate		Inter Info	[50]
D0584		Epirubicin	C27H29NO11	41867	Moderate		Inter Info	[4], [1], [55]
D0826		Interferon beta-1a	NA	NA	Moderate		Inter Info	[56], [57], [58], [59]
D0827		Interferon beta-1b	NA	NA	Moderate		Inter Info	[56], [57], [58], [59]
D0113		Asparaginase Erwinia chrysanthemi	NA	NA	Moderate		Inter Info	[35], [36], [37], [4], [1], [38], [39], [40], [41], [42], [43], [44], [45]
D0149		Bedaquiline	C32H31BrN2O2	5388906	Moderate		Inter Info	[64]
D0199		Brentuximab vedotin	NA	NA	Moderate		Inter Info	[65]
D0232		Calaspargase pegol	NA	NA	Moderate		Inter Info	[35], [36], [37], [4], [1], [38], [39], [40], [41], [42], [43], [44], [45]
D0248		Cannabidiol	C21H30O2	644019	Moderate		Inter Info	[1], [66]
D0789		Idelalisib	C22H18FN7O	11625818	Moderate		Inter Info	[73]
D1239		Peginterferon beta-1a	NA	NA	Moderate		Inter Info	[56], [57], [58], [59]
D1389		Remdesivir	C27H35N6O8P	121304016	Moderate		Inter Info	[4], [1], [86], [87], [88]
D1615		Trabectedin	C39H43N3O11S	108150	Moderate		Inter Info	[1], [95]
D1025		Methotrexate	C20H22N8O5	126941	Moderate		Inter Info	[1], [96]
D1106		Naltrexone	C20H23NO4	5360515	Moderate		Inter Info	[100]
D1234		Pegaspargase	C14H19NO	436058	Moderate		Inter Info	[35], [36], [37], [4], [1], [38], [39], [40], [41], [42], [43], [44], [45]
D1589		Tioguanine	C5H5N5S	2723601	Moderate		Inter Info	[106], [107]
	Increased risk of photosensitivity reactions					Drug Num: 6
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0062		Aminolevulinic acid	C5H9NO3	137	Major		Inter Info	[6], [7]
D0063		Aminolevulinic acid (topical)	C5H9NO3	137	Moderate		Inter Info	[4], [1], [34]
D1033		Methyl aminolevulinate (topical)	C6H11NO3	157922	Moderate		Inter Info	[4], [1], [34]
D1028		Methoxsalen	C12H8O4	4114	Moderate		Inter Info	[4], [97], [6], [98], [99]
D1314		Porfimer sodium	C68H74N8O11	135577896	Moderate		Inter Info	[104], [1], [105]
D1691		Verteporfin	C82H84N8O16	11980904	Moderate		Inter Info	[1], [97], [6], [108]
	Increased risk of pseudotumor cerebri					Drug Num: 11
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0018		Acitretin	C21H26O3	5284513	Major		Inter Info	[1], [2], [3], [4], [5]
D0441		Demeclocycline	C21H21ClN2O8	54680690	Major		Inter Info	[9], [10], [11], [12], [4], [13], [14], [15], [16], [17], [18], [2], [19], [20], [21], [22], [5], [23], [24], [1], [25], [3], [26]
D0530		Doxycycline	C22H24N2O8	54671203	Major		Inter Info	[9], [10], [11], [12], [4], [13], [14], [15], [16], [17], [18], [2], [19], [20], [21], [22], [5], [23], [24], [1], [25], [3], [26]
D0589		Eravacycline	C27H31FN4O8	54726192	Major		Inter Info	[9], [10], [11], [12], [4], [13], [14], [15], [16], [17], [18], [2], [19], [20], [21], [22], [5], [23], [24], [1], [25], [3], [26]
D1070		Minocycline	C23H27N3O7	54675783	Major		Inter Info	[9], [10], [11], [12], [4], [13], [14], [15], [16], [17], [18], [2], [19], [20], [21], [22], [5], [23], [24], [1], [25], [3], [26]
D1175		Omadacycline	C29H40N4O7	54697325	Major		Inter Info	[9], [10], [11], [12], [4], [13], [14], [15], [16], [17], [18], [2], [19], [20], [21], [22], [5], [23], [24], [1], [25], [3], [26]
D1445		Sarecycline	C24H29N3O8	54681908	Major		Inter Info	[9], [10], [11], [12], [4], [13], [14], [15], [16], [17], [18], [2], [19], [20], [21], [22], [5], [23], [24], [1], [25], [3], [26]
D1209		Oxytetracycline	C22H24N2O9	54675779	Major		Inter Info	[9], [10], [11], [12], [4], [13], [14], [15], [16], [17], [18], [2], [19], [20], [21], [22], [5], [23], [24], [1], [25], [3], [26]
D1564		Tetracycline	C22H24N2O8	54675776	Major		Inter Info	[9], [10], [11], [12], [4], [13], [14], [15], [16], [17], [18], [2], [19], [20], [21], [22], [5], [23], [24], [1], [25], [3], [26]
D1626		Tretinoin	C20H28O2	444795	Major		Inter Info	[1], [2], [3], [4], [5]
D1702		Vitamin A	C20H30O	445354	Major		Inter Info	[1], [2], [3], [4], [5]
	Increased risk of skin rash					Drug Num: 4
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0024		Adapalene (topical)	C28H28O3	60164	Moderate		Inter Info	[1], [33]
D1636		Trifarotene (topical)	C29H33NO4	11518241	Moderate		Inter Info	[1], [33]
D1537		Tazarotene (topical)	C21H21NO2S	5381	Moderate		Inter Info	[1], [33]
D1627		Tretinoin (topical)	C20H28O2	444795	Moderate		Inter Info	[1], [33]
	Increased risk of other adverse reactions (Unspecific)					Drug Num: 14
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0178		Bexarotene	C24H28O2	82146	Major		Inter Info	[1], [8]
D1743		Azelaic acid (topical)	C9H16O4	2266	Moderate		Inter Info	[1], [46]
D0172		Betamethasone	C22H29FO5	9782	Moderate		Inter Info	[47], [48], [49]
D0773		Hydrocortisone	C21H30O5	5754	Moderate		Inter Info	[47], [48], [49]
D1746		Benzoyl peroxide (topical)	C14H10O4	7187	Moderate		Inter Info	[1], [46]
D0215		Budesonide	C25H34O6	5281004	Moderate		Inter Info	[47], [48], [49]
D0436		Deflazacort	C25H31NO6	189821	Moderate		Inter Info	[47], [48], [49]
D0453		Dexamethasone	C22H29FO5	5743	Moderate		Inter Info	[47], [48], [49]
D1850		Octasulfur (topical)	S8	66348	Moderate		Inter Info	[1], [46]
D1041		Methylprednisolone	C22H30O5	6741	Moderate		Inter Info	[47], [48], [49]
D1332		Prednisolone	C21H28O5	5755	Moderate		Inter Info	[47], [48], [49]
D1334		Prednisone	C21H26O5	5865	Moderate		Inter Info	[47], [48], [49]
D1883		Salicylic acid (topical)	C7H6O3	338	Moderate		Inter Info	[1], [46]
D1628		Triamcinolone	C21H27FO6	31307	Moderate		Inter Info	[47], [48], [49]
Pharmacodynamic antagonistic effects
	Antagonize the effect of antithrombotic agents					Drug Num: 3
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0481		Dicoumarol	C19H12O6	54676038	Moderate		Inter Info	[51], [52], [53]
D0087		Anisindione	C16H12O3	2197	Moderate		Inter Info	[51], [52], [53]
D1711		Warfarin	C19H16O4	54678486	Moderate		Inter Info	[51], [52], [53]

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55	Product Information. Ellence (epirubicin) Pharmacia and Upjohn, Kalamazoo, MI.
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57	Product Information. Betaseron (interferon beta-1b). Berlex, Richmond, CA.
58	Product Information. Plegridy (peginterferon beta-1a). Biogen Idec Inc, Cambridge, MA.
59	Product Information. Rebif (interferon beta-1a). Serono Laboratories Inc, Norwell, MA.
60	Product Information. Xeglyze (abametapir topical). Dr. Reddy's Laboratories Inc, Upper Saddle River, NJ.
61	Product Information. Zytiga (abiraterone). Centocor Inc, Malvern, PA.
62	Product Information. Piqray (alpelisib). Novartis Pharmaceuticals, East Hanover, NJ.
63	Product Information. Erleada (apalutamide). Janssen Biotech, Inc., Horsham, PA, PA.
64	Product Information. Sirturo (bedaquiline). Janssen Pharmaceuticals, Titusville, NJ.
65	Product Information. Adcetris (brentuximab vedotin). Seattle Genetics Inc, Bothell, WA.
66	Product Information. Epidiolex (cannabidiol). Greenwich Biosciences Inc, Carlsbad, CA.
67	Product Information. Xcopri (cenobamate). SK Life Science, Inc., Paramus, NJ.
68	Product Information. Tafinlar (dabrafenib). GlaxoSmithKline, Research Triangle Park, NC.
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71	Product Information. Xtandi (enzalutamide). Astellas Pharma US, Inc, Deerfield, IL.
72	Product Information. Tavalisse (fostamatinib). Rigel Pharmaceuticals, South San Francisco, CA.
73	Product Information. Zydelig (idelalisib). Gilead Sciences, Foster City, CA.
74	Product Information. Kalydeco (ivacaftor). Vertex Pharmaceuticals, Cambridge, MA.
75	Product Information. Orkambi (ivacaftor-lumacaftor). Vertex Pharmaceuticals, Cambridge, MA.
76	Product Information. Symdeko 4-Week (ivacaftor-tezacaftor). Vertex Pharmaceuticals, Cambridge, MA.
77	Product Information. Trikafta (elexacaftor/ivacaftor/tezacaftor). Vertex Pharmaceuticals, Cambridge, MA.
78	Product Information. Fycompa (perampanel). Eisai Inc, Teaneck, NJ.
79	Product Information. Xenleta (lefamulin). Nabriva Therapeutics US, Inc., King of Prussia, PA.
80	Warrington SJ, Ankier SI, Turner P "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology 15 (1986): 31-7. [PMID: 3725002]
81	Product Information. Dayvigo (lemborexant). Eisai Inc, Woodcliff Lake, NJ.
82	Product Information. Prevymis (letermovir). Merck & Company Inc, Whitehouse Station, NJ.
83	Product Information. Lorbrena (lorlatinib). Pfizer U.S. Pharmaceuticals Group, New York, NY.
84	Cerner Multum, Inc. "Canadian Product Information.".
85	Product Information. Wakix (pitolisant). Harmony Biosciences, LLC, Plymouth Meeting, PA.
86	European Medicines Agency "Summary on compassionate use. Remdesivir Gilead.".
87	Gilead Sciences, Inc "About Remdesivir.".
88	US Food and Drug Administration "Fact sheet for health care providers emergency use authorization (EUA) of remdesivir (GS-5734TM)".
89	Product Information. Qinlock (ripretinib). Deciphera Pharmaceuticals, Waltham, MA.
90	EMA. European Medicines Agency. European Union "EMA - List of medicines under additional monitoring.".
91	Product Information. Retevmo (selpercatinib). Lilly, Eli and Company, Indianapolis, IN.
92	Product Information. Zorbtive (somatropin). Serono Laboratories Inc, Rockland, MA.
93	Product Information. Humatrope (somatropin). Lilly, Eli and Company, Indianapolis, IN.
94	Product Information. Xermelo (telotristat ethyl). Lexicon Pharmaceuticals, Inc., The Woodlands, TX.
95	Product Information. Yondelis (trabectedin). Janssen Pharmaceuticals, Titusville, NJ.
96	Product Information. Methotrexate (methotrexate). Lederle Laboratories, Wayne, NJ.
97	Multum Information Services, Inc. Expert Review Panel.
98	Product Information. Oxsoralen (methoxsalen). ICN Pharmaceuticals Inc, Costa Mesa, CA.
99	Product Information. Uvadex (methoxsalen). Therakos Inc, Exton, PA.
100	Product Information. ReVia (naltrexone). DuPont Pharmaceuticals, Wilmington, DE.
101	Product Information. Viramune (nevirapine). Boehringer-Ingelheim, Ridgefield, CT.
102	Product Information. Viramune XR (nevirapine). Boehringer Ingelheim, Ridgefield, CT.
103	Product Information. Orfadin (nitisinone). Orphan Pharmaceuticals USA, Inc, Nashville, TN.
104	Blakely KM, Drucker AM, Rosen CF "Drug-induced photosensitivity-an update: Culprit drugs, prevention and management." Drug Saf 42 (2019): 827-47. [PMID: 30888626]
105	Product Information. Photofrin (porfimer). Sanofi Winthrop Pharmaceuticals, New York, NY.
106	Product Information. Aubagio (teriflunomide). Genzyme Corporation, Cambridge, MA.
107	Product Information. Tabloid (thioguanine). Prasco Laboratories, Cincinnati, OH.
108	Product Information. Visudyne (verteporfin) Valeant Pharmaceuticals, Costa Mesa, CA.

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