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Accutane (Isotretinoin) And the Liver - Liver Enzymes and Accutane Results



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Polat M, Lenk N, Bingöl S, Oztaş P, Ilhan MN, Artüz F, Alli N.

Plasma homocysteine level is elevated in patients on isotretinoin therapy for cystic acne: a prospective controlled study.

J Dermatolog Treat. 2008; 19 (4):229-32


The purpose of this study was to evaluate homocysteine (Hcy) levels, vitamin B12, and folate in patients receiving treatment with Isotretinoin (Iso) for cystic acne. Oral isotretinoin is sold under several trade names including Accutane and Roaccutane. Isotretinoin is commonly used in the treatment of moderate to severe acne. It was originally developed as a chemotherapy drug for use in cancer treatment. Iso is known to have many adverse side effects. An elevated level of blood serum homocysteine is a known risk factor for cardiovascular disease. Vitamin B12 and folate have been shown to lower Hcy levels.


Study participants included seventy-four patients with cystic acne and a control group consisting of 80 individuals. Blood levels of Hcy, vitamin B12, and folate were assessed at baseline in all participants. Those with cystic acne were treated for forty five days with oral isotretinoin. Those individuals were once again assessed for serum Hcy and vitamin levels.

The study found a statistically significant increase in blood serum homocysteine levels in those patients receiving isotretinoin therapy, while vitamin levels were unaltered. That group also had statistically significant elevated serum lipids and liver enzymes.


The study concluded that the drug may inhibit an enzyme required in the metabolism of homocysteine, directly or indirectly as a result of liver dysfunction. The researchers recommended that patients receiving isotretinoin therapy be prescribed both vitamin B12 and folate to prevent premature coronary artery disease.

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