Isotretinoin (accutane) while on cycle

[Rez.]

Once I decided to go for 150mg/kg cumulative, and it was going to take forever unless I really ramped up the dose, I tried to go up as fast as possible.

As soon as the sides (other than dry lips, which you can only keep using lip balm for) eased off and I felt ok, I'd double.

On average, every two weeks.

At 180mg (2mg/kg, the absolute max) after a week it didn't get better, some SI joint pain, so I dropped down to 160mg which was tolerable.

I was so happy with the results after 3 months, I decided to go for 220mg/kg cumulative, the "magic" number with the highest documented rate of never needing retreatment.

However, the other thing that predicts best long term results beyond cumulative dose, is continuing for 2 months beyond complete clearance (with the added benefit of reducing old acne scars because skin turnover accelerates to an incredibly fast rate).

My shoulders were last to clear, at 3 months, and I was going too fast, because I'd hit 220mg/kg before the 5 month mark.

So I've been easing off, down to 100mg/day. Once I started reducing, there have been zero sides other than dry lips.

Always split dose to twice a day. This makes a big difference in sides. Always eat after food, preferably high fat. Most failures are attributed to lack of absorption by failing to eat high fat meals. Effectiveness is reduced by 80%+ without it. If you can't manage that, you'll need to buy Sotret NF, which doesn't rely on high fats for absorption, but'll be more expensive. For 20,000mg $450-500 vs $200-250. By comparison 20,000mg of the equivalent NF stuff in the US is $18,000.

Stay disciplined, all sides have been temporary (until 180mg). Don't panic when acne returns or worsens. That's a good sign. It happened multiple times, in different body areas as the treatment "reached" those areas. I got (very short term) acne in places I never had it before, like my stomach! Once that happens, the area will clear and be "done".

Stock up early, consistent daily use has proven vital for effective treatment. You don't want to lose ground and go through sides again. Murphys law I had a hell of a time ensuring I didn't run out and came. very close. The larger gelcaps 30-40mg make things a lot cheaper when buying 20,000mg of this stuff, but you need some 10-20mg to have flexibility of dosing.

Dude! Really appreciate that indepth response, a very well explained protocol on Accutane. Some great great tips in there. Thanks for taking the time to share that info, I'll incorporate the doubling technique and stock pile in advance like you suggested and see how I get on. Nice one!

 

[Avarice911]

Accutane is the only thing that works for me, post cycle. I am prone to getting bad acne when on cycle. Fine when off cycle.

Anyone have experience staying on isotretinoin (accutane) WHILE on cycle to PREVENT acne in the first place?

Late to the party but I’m currently running 300mg test cyp and 25mg var. Typically, when I run var, I get some cystic acne within the first week or so and it’s persists throughout. This time that I’m running it, I’ve been taking 10mg isotretinoin for about 6 months prior and still taking alongside it, and acne has not popped up at all. Game changer for me. Having (very mild) cystic acne on my arms was not a good look

 

[hungryalways]

Late to the party but I’m currently running 300mg test cyp and 25mg var. Typically, when I run var, I get some cystic acne within the first week or so and it’s persists throughout. This time that I’m running it, I’ve been taking 10mg isotretinoin for about 6 months prior and still taking alongside it, and acne has not popped up at all. Game changer for me. Having (very mild) cystic acne on my arms was not a good look

Good to hear. Any sides at 10mg? Indian pharma?

 

[undersc0re]

How many months do you guys take this before taking a break?

 

[MfgEng]

Do a proper isotretinoin cycle and never deal with acne or excessively greasy skin again.

Thank you so much for the voice of reason. Either play with the stuff and get nothing for long term effectiveness or do it right, get the total dosage needed in within 6mths just like doctors say. Sure there are piles of people on here that know way more than some old doctor and decades of evidence and testing however I'm going to stick with @Ghoul and the medical industry since I feel safer in that direction

 

[Ghoul]

How many months do you guys take this before taking a break?

You're either taking low dose, usually 10mg/day, temporarily to suppress breakouts during a cycle.

Or, you're going for a cure, in which case:

1. You want a total cumulative dose from 150mg to 220mg / kg. The higher the better your chances of acne not coming back.

2. You want to take it for at least 2 months after you observe full clearance of acne.

3. You want to get this done within 24 weeks. (168 days).

4. Max daily dose 2mg/kg

So let's say you're 90kg .

150mg x 90 = 13,500
220mg x 90 = 19,800

You're fully clear at 60 days. You have to go to 120, minimum(2 months post clearance). At day 120, if you've reached 13,500 and don't want to deal with it anymore, you can stop, or keep going until you've hit 19,800 or 168 days.

 

[MfgEng]

Bingo! Best to get bloods done as well as this stuff really is toxic. I got a script in 1992 at 80mg/day. Took 40mg/day and got every side effect in the book. My acne was pretty bad but not horrible. This was before any anabolics when I was 21. Two weeks and the change was night and day. Acne never came back until I really upped the dosages 15yrs later then it came back in spades due to my own fault

 

[Ghoul]

Bingo! Best to get bloods done as well as this stuff really is toxic. I got a script in 1992 at 80mg/day. Took 40mg/day and got every side effect in the book. My acne was pretty bad but not horrible. This was before any anabolics when I was 21. Two weeks and the change was night and day. Acne never came back until I really upped the dosages 15yrs later then it came back in spades due to my own fault

The only purpose of bloods is to watch liver enzymes. I've read a million studies, low dose, high dose, long and short protocols. and no one ever had to cease treatment for bad bloodwork. Some derms have questioned the need to bother.

That said, I wouldn't drink while using it.

The other big warning (besides don't get pregnant because of the birth defects), is not to use a tetracycline antibiotic. Could cause excess brain pressure. And yet, some derms prescribe Doxycycline while using accutane!

 

[Dookrich]

Currently running 20mg MWF on 750test 400EQ 6iu gh and it’s been amazing with what it’s been doing for my skin. Almost have a glow now

 

[Rez.]

Necked another 10mg 3hrs before bed last night. Same protocol. So 20mg total / day.

1x slice of cheese for fat absorption (5g of fat, not sure if that's enough?)
1-ltr of water with 2g of Pink Himalayan Salt.

Zero sides, so @Ghoul suggestion of splitting the doses in two works a treat. I'm guessing the first dose has had time to absorb and work it's way through the system.

Next plan is to double each dose from 10mg to 20mg (40mg / day total). If still no sides I'll do that on Monday.

 

[Ghoul]

Necked another 10mg 3hrs before bed last night. Same protocol. So 20mg total / day.

1x slice of cheese for fat absorption (5g of fat, not sure if that's enough?)
1-ltr of water with 2g of Pink Himalayan Salt.

Zero sides, so @Ghoul suggestion of splitting the doses in two works a treat. I'm guessing the first dose has had time to absorb and work it's way through the system.

Next plan is to double each dose from 10mg to 20mg (40mg / day total). If still no sides I'll do that on Monday.

The body really adapts to isotretinoin. surprisingly well. I would've never thought I could stand the levels I reached, that ultimately had no effect other than dry lips.

We're essentially talking about mega doses of Vitamin A, so it may be because we're already equipped to deal with it.

Don't get too hung up on fat. I've heard some people taking it with 50g which is nuts.

You just need a modest amount in your digestive system, since the drug is lipophillic, to properly dissolve. The beauty of the pharma gelcaps is it comes in soybean oil, so already has a head start.

A 1/2 teaspoon of olive oil added to whatever you're eating could help a lot.

The main thing is to be relentless, just keep going, and bumping up the dose once sides ease off to a tolerable level.

Keep in mind most derms just follow the 1g /kg formula and start kids off on that. So you're really easing into it.

 

[XanMour]

The only purpose of bloods is to watch liver enzymes. I've read a million studies, low dose, high dose, long and short protocols. and no one ever had to cease treatment for bad bloodwork. Some derms have questioned the need to bother.

That said, I wouldn't drink while using it.

The other big warning (besides don't get pregnant because of the birth defects), is not to use a tetracycline antibiotic. Could cause excess brain pressure. And yet, some derms prescribe Doxycycline while using accutane!

Quite depends also on the rest of your life.

An alcoholic or someone with an auto-immune disease wouldn’t tolerate taking roa.

Also, just a viral infection and you start getting yellow

 

[Ghoul]

Quite depends also on the rest of your life.

An alcoholic or someone with an auto-immune disease wouldn’t tolerate taking roa.

Also, just a viral infection and you start getting yellow

I guess I should clarify, there doesn't seem to be need for continuing, monthly liver tests. They do an initial test to make sure the patient doesn't have a compromised liver, in which case they don't start them at all.

Hopefully everyone here gets enough basic health care to know the general condition of their liver. What I'm referring to is that isotretinoin doesn't appear to cause liver dysfunction of concern, but it'll certainly worsen pre-existing problems.

 

[XanMour]

I guess I should clarify, there doesn't seem to be need for continuing, monthly liver tests. They do an initial test to make sure the patient doesn't have a compromised liver, in which case they don't start them at all.

Hopefully everyone here gets enough basic health care to know the general condition of their liver. What I'm referring to is that isotretinoin doesn't appear to cause liver dysfunction of concern, but it'll certainly worsen pre-existing problems.

Oh maybe I did not either understand.

Yeah you should at least do a check up before and after iso and then stop basically. No need to check that much of it.

 

[Avarice911]

Good to hear. Any sides at 10mg? Indian pharma?

Nothing other than slightly dry lips

How many months do you guys take this before taking a break?

I’ve been taking the 10mg for prob about 6-7 months now. From reading this thread tho, seems I should up the dose over time

 

[MfgEng]

They do an initial test to make sure the patient doesn't have a compromised liver, in which case they don't start them at all.

@Ghoul This was the problem. I tested really well before and the first blood came back really badly. It's just me. I react badly to almost all drugs. Last month I got a tooth pulled and they used a freezing agent that included Epinephrine and I broke out in a profuse sweat and damn near went down. Another time I got anesthetized and this massive lump popped right up at the IV site as soon as they started pushing in and everyone went wild in the OR room running around as I passed out. In 1992 at 21 I took at 200mg E2D cycle for 30 days and gained 30lbs mega water due to diet.

Accutane got me badly. Super bad reaction so if anyone happens to feel like God awful hell they may be a reactor like me and if that is true its not so good at all. My brother got jaundice from it as he had smoking bad acne and those deep red pock mark bacterial nodule lums looked so disgusting that he couldn't stop treatment. The "zits" all over were bleeding and so raw. Wow he ended up really fat afterwards.

 

[Ghoul]

Oh maybe I did not either understand.

Yeah you should at least do a check up before and after iso and then stop basically. No need to check that much of it.

@Ghoul This was the problem. I tested really well before and the first blood came back really badly. It's just me. I react badly to almost all drugs. Last month I got a tooth pulled and they used a freezing agent that included Epinephrine and I broke out in a profuse sweat and damn near went down. Another time I got anesthetized and this massive lump popped right up at the IV site as soon as they started pushing in and everyone went wild in the OR room running around as I passed out. In 1992 at 21 I took at 200mg E2D cycle for 30 days and gained 30lbs mega water due to diet.

Accutane got me badly. Super bad reaction so if anyone happens to feel like God awful hell they may be a reactor like me and if that is true its not so good at all. My brother got jaundice from it as he had smoking bad acne and those deep red pock mark bacterial nodule lums looked so disgusting that he couldn't stop treatment. The "zits" all over were bleeding and so raw. Wow he ended up really fat afterwards.

What a coincidence. I literally read about this this morning.

Liver fat deposits/dysfunction was just recently linked to Cushing Syndrome which causes metabolic syndrome and obesity.

There are effective treatments once it's identified. Also, Tirzapetide has potent liver clearing and scar reversal effects independent of weight loss, which might help.

If he hasn't asked to be tested for Cushing's, you may want to suggest it. Tirzapetide (not Semaglutide, this is about GIP, not GLP) may not be a bad ideal either...

Cushing's syndrome linked to liver fat buildup: Study

Elevated cortisol levels in Cushing's syndrome are directly linked to metabolic abnormalities leading to liver fat buildup, a study found.

cushingsdiseasenews.com

 

[XanMour]

What a coincidence. I literally read about this this morning.

Liver fat deposits/dysfunction was just recently linked to Cushing Syndrome which causes metabolic syndrome and obesity.

There are effective treatments once it's identified. Also, Tirzapetide has potent liver clearing and scar reversal effects independent of weight loss, which might help.

If he hasn't asked to be tested for Cushing's, you may want to suggest it. Tirzapetide (not Semaglutide, this is about GIP, not GLP) may not be a bad ideal either...

Cushing's syndrome linked to liver fat buildup: Study

Elevated cortisol levels in Cushing's syndrome are directly linked to metabolic abnormalities leading to liver fat buildup, a study found.

cushingsdiseasenews.com

Scar Reversal? Can you develop? Can’t find info on that.

 

[Ghoul]

Scar Reversal? Can you develop? Can’t find info on that.

First it clears fatty liver, then reverses fibrosis(scarring).

Tirzepatide Shows Improvements in MASH Resolution, Fibrosis

Encouraging phase 2 results of tirzepatide in the resolution of MASH and improvement in fibrosis support further investigation into the GIP–GLP-1 receptor agonist for liver disease.

www.medscape.com

The mechanism is independent of weight loss, direct activation of the densely packed GIP receptors in the liver.

A lot better than Liv52 for liver protection...as in, it actually works:

https://www.thelancet.com/journals/landia/article/PIIS2213-8587(22)00074-2/abstract

In my mind, this is the single most important distinction between Sema and Tirz. It was the primary reason I switched (didn't require any weight loss, was on maintainance dose of Sema), resolved my stage 1 fatty liver disease back to 0, reversing 20 years of incremental damage.

 

[Country Club Hero]

The body really adapts to isotretinoin. surprisingly well. I would've never thought I could stand the levels I reached, that ultimately had no effect other than dry lips.

We're essentially talking about mega doses of Vitamin A, so it may be because we're already equipped to deal with it.

Don't get too hung up on fat. I've heard some people taking it with 50g which is nuts.

You just need a modest amount in your digestive system, since the drug is lipophillic, to properly dissolve. The beauty of the pharma gelcaps is it comes in soybean oil, so already has a head start.

A 1/2 teaspoon of olive oil added to whatever you're eating could help a lot.

The main thing is to be relentless, just keep going, and bumping up the dose once sides ease off to a tolerable level.

Keep in mind most derms just follow the 1g /kg formula and start kids off on that. So you're really easing into it.

Sounds like you have a good bit of experience running it also. I still have oily skin at 44 lol. Zero acne but some minor blackheads on sides of nostrils. Not noticeable unless in a magnifying mirror but I still hate the general oil production.

I’ve considered going hard on the Accutane for the minimum time required to dry me out for good. However, I am almost certain that oral steroids will turn those oil glands on full blast for me no matter how dry I get from Accutane.

My question is does this not happen to you or others? Am I an outlier here?