Weight Change and Dose Adjustment in Isotretinoin Therapy: A Retrospective Study

Isotretinoin is used to treat severe nodulocystic acne. Cumulative doses of 120 to 150 mg/kg have been shown to limit adverse events while maximizing efficacy. Also proven safe, doses of 220 mg/kg and higher may be necessary to achieve optimal clinical results. The current standard of care uses the patient’s starting weight to determine goal dosing. This study seeks to identify specific patient groups among adolescents who are likely to experience a significant change in weight necessitating an adjustment to isotretinoin dosage over time. A retrospective cohort study was conducted on adolescent patients who received isotretinoin therapy at Augusta University between 2015 and 2020. A total of 57 patients were analyzed in subgroups of age, gender, and duration of therapy. Results demonstrated that despite a statistically significant weight change among the stratified treatment duration groups, the differences did not prove to be clinically impactful and do not support changing the current standard of care.Citation: Coulanges EK, Myers HE, Madray VM, Davis LS. Weight change and dose adjustment in isotretinoin therapy: a retrospective study. J Drugs Dermatol. 2025;24(6):639-640.