Public record

Isotretinoin: the public record

9 tables from US federal sources. Latest data date: Nov 11, 2026.

Each table is computed from the named federal dataset as of its data date; the method is under each one.

Label

FDA label facts for isotretinoin

The FDA label read for isotretinoin (Absorica LD, application NDA211913) was last revised on 2026-08-19. It carries a boxed warning. Of the 4 population sections checked, 4 are present: pregnancy, lactation, pediatric use, geriatric use.

FDA label facts for isotretinoin: the figures
MeasureValueNote
Label revision date2026-08-19
Label readAbsorica LDNDA211913, brand-name application
Boxed warningYes
Pregnancy sectionPresent
Lactation sectionPresent
Pediatric use sectionPresent
Geriatric use sectionPresent

Source: FDA drug label via openFDA, viewable on NIH DailyMed, data as of Nov 11, 2026

How this was calculated

Selected the most recently revised prescription label for this single ingredient from an original manufacturer, preferring a brand-name application. Checked which sections exist and quoted headings and sentences exactly as printed.

Scope: One label: the newest prescription label for single-ingredient isotretinoin from an original manufacturer

Read from one label. Labels for other brands, strengths or forms of the same ingredient can differ. A missing section heading does not mean there is no guidance. Read the full label before relying on it.

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Approvals

FDA approval history for isotretinoin

The earliest FDA approval on file for a isotretinoin product is 1982-05-07. Drugs@FDA lists 19 applications for it and 273 approved supplements, the most recent on 2026-11-03.

FDA approval history for isotretinoin: the figures
MeasureValueNote
Earliest FDA approval on file1982-05-07
Applications with an approval on file19
New drug applications (NDA)3
Generic applications (ANDA)16
Approved supplements273label, manufacturing and efficacy changes
Most recent supplement approval2026-11-03
Sponsoring companies13

Source: FDA, Drugs@FDA, data as of Nov 11, 2026

How this was calculated

Selected applications with a product whose only active ingredient is this substance, then counted approved original and supplemental submissions. The earliest approved original submission is the first approval.

Scope: Applications with a single-ingredient isotretinoin product in Drugs@FDA, all sponsors and strengths

Older approvals can be missing dates, and tentative approvals are not counted. An approved application does not mean the product is currently marketed.

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Patents and generics

Patents and generic approvals for isotretinoin

The FDA Orange Book lists 16 approved generic applications for isotretinoin, the first approved on 2002-11-08. 2 listed patents on specific brand products have not yet expired, the last on 2035-08-04; generics of other versions are already approved.

Patents and generic approvals for isotretinoin: the figures
MeasureValueNote
Brand-name applications (NDA)3
Approved generic applications (ANDA)16first approved 2002-11-08
Companies with a generic not marked discontinued9
Listed patents not yet expired2
Latest listed patent expiry2035-08-04on any product; may cover only one brand formulation
Earliest approval date on file1982-05-07
Products not marked discontinued59 of 74

Source: FDA, Orange Book (Approved Drug Products with Therapeutic Equivalence Evaluations), data as of Oct 9, 2026

How this was calculated

Selected Orange Book products whose only active ingredient is this substance, then counted applications by type and the distinct patents and exclusivities listed against them. Expired patents are left out.

Scope: All single-ingredient isotretinoin products in the Orange Book, every brand and strength, files dated 2026-10-09

An approved generic or an expired patent does not show that a generic is on sale. Launch timing also depends on litigation, settlements and supply. Biologics and compounded products are not in the Orange Book.

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Medicare Part D

Medicare Part D spending on isotretinoin

Medicare Part D spending on isotretinoin products was $3.0M in 2024 across 17,187 claims, compared with $3.3M in 2023 (-9.5%). Average spending per claim was $174, before rebates.

Medicare Part D spending on isotretinoin: the figures
MeasureValueNote
Total spending, 2024$3.0M
Total spending, 2023$3.3M
Change in spending, 2023 to 2024-9.5%
Claims (prescription fills), 202417,187
Average spending per claim, 2024$174
Isotretinoin: spending, 2024$1.5M7,711 claims
Claravis: spending, 2024$592,7714,013 claims
Zenatane: spending, 2024$542,7083,444 claims

Source: CMS, Medicare Part D Spending by Drug, data as of 2024

How this was calculated

Summed total spending and claims over every brand and generic row with this generic name in the CMS file, using the Overall manufacturer rows. Combination products excluded. Average per claim is spending divided by claims.

Scope: Every single-ingredient isotretinoin product in Part D (Isotretinoin, Claravis, Zenatane), 2024.

Gross drug cost before manufacturer rebates, so net cost is lower. Part D excludes some uses by law (for example erectile dysfunction, weight loss and hair growth), so claims reflect covered uses only. Compounded products are not included.

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Medicaid

Medicaid prescriptions for isotretinoin by state

State Medicaid programmes paid for 242,660 isotretinoin prescriptions in 2025, with $47.7M reimbursed before rebates. California reported the most (54,479), followed by New York (25,655) and North Carolina (12,666); 51 states and territories reported any.

Medicaid prescriptions for isotretinoin by state: the figures
MeasureValueNote
Prescriptions paid by Medicaid, 2025242,660
Total reimbursed before rebates, 2025$47.7M
States and territories reporting51with at least one count CMS did not suppress
California54,479 prescriptions$10.7M reimbursed
New York25,655 prescriptions$5.8M reimbursed
North Carolina12,666 prescriptions$3.4M reimbursed
Florida11,326 prescriptions$2.3M reimbursed
Texas10,828 prescriptions$2.5M reimbursed

Source: CMS, Medicaid State Drug Utilization Data 2025, data as of 2025

How this was calculated

Matched each Medicaid product code to the FDA NDC Directory by labeler and product code, kept finished single-ingredient products, then summed prescriptions and reimbursement by state. National roll-up and suppressed rows dropped.

Scope: All single-ingredient isotretinoin products in the FDA NDC Directory, fee-for-service and managed care, 2025

Counts under 11 are suppressed by CMS and left out, so totals are a floor. Amounts are before rebates. Differences between states reflect programme size and coverage rules. Compounded products are not included.

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Pharmacy cost

Pharmacy acquisition cost (NADAC) for isotretinoin

Retail pharmacies paid an average of $1.96 per unit for ISOTRETINOIN 10 MG CAPSULE as of 2026-11-11, compared with $11.38 twelve months earlier (-82.7%). This is a pharmacy purchase cost, not a patient price.

Pharmacy acquisition cost (NADAC) for isotretinoin: the figures
MeasureValueNote
ISOTRETINOIN 10 MG CAPSULE$1.96 per unit12 months earlier $11.38 (-82.7%)
ISOTRETINOIN 20 MG CAPSULE$1.93 per unit12 months earlier $9.41 (-79.5%)
ISOTRETINOIN 30 MG CAPSULE$2.01 per unit12 months earlier $9.89 (-79.7%)
ISOTRETINOIN 40 MG CAPSULE$2.19 per unit12 months earlier $15.05 (-85.4%)
ISOTRETINOIN 25 MG CAPSULE$10.59 per unit12 months earlier $10.95 (-3.2%)
ZENATANE 10 MG CAPSULE$1.96 per unit12 months earlier $1.97 (-0.3%)

Source: CMS, National Average Drug Acquisition Cost (NADAC), data as of Nov 11, 2026

How this was calculated

Matched NADAC product codes to the FDA NDC Directory, kept finished single-ingredient products, and listed the product descriptions with the most package codes. The earlier price is the same package code in the file one year before.

Scope: Generic versions of isotretinoin in the weekly NADAC file of 2026-11-11, compared with the file of 2025-11-12

NADAC is the average invoice price retail pharmacies pay, from a voluntary survey. It leaves out rebates, dispensing fees and markups, and it is not what a patient or insurer pays. Compounded products are not surveyed.

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Adverse event reports

Most reported events in FDA adverse event reports for isotretinoin

Through 2026-10-28, FDA had received 40,259 adverse event reports for isotretinoin, 16,920 of them marked serious by the reporter. The symptom terms named most often were depression (3,288), dry skin (1,935) and headache (1,888).

Most reported events in FDA adverse event reports for isotretinoin: the figures
MeasureValueNote
All reports received40,259
Reports the reporter marked serious16,920death, hospitalisation, disability or similar outcome
Depression3,288 reports
Dry skin1,935 reports
Headache1,888 reports
Arthralgia1,829 reports
Mood altered1,544 reports

Source: FDA Adverse Event Reporting System (FAERS) via openFDA, data as of Oct 28, 2026

How this was calculated

Counted FAERS reports listing this active substance, then the reaction terms named most often. A report can name several reactions, and a term can describe the illness being treated and not an effect of the drug. Terms about product use or complaints rather than symptoms (for example exposure during pregnancy) were left out of the list.

Scope: Reports where FDA recorded isotretinoin as a single-ingredient active substance (any brand), all years to 2026-10-28

FAERS reports are unverified and do not prove the drug caused the event. Reporting rises with use, publicity and lawsuits, so these counts cannot give rates or risks and cannot be compared between drugs.

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Recalls

FDA drug recalls naming isotretinoin

FDA enforcement reports list 20 drug recall entries naming isotretinoin from 2015 to 2026-04-29. 12 of them are for compounded or other unlisted products and 8 for products FDA lists under a label. The most common stated reason was dissolution or stability failure (10 of 20).

FDA drug recalls naming isotretinoin: the figures
MeasureValueNote
Recall entries on record20
For products FDA lists under an approved or registered label8
For compounded or other unlisted products12matched by the name in the product description
Class I (most serious)0
Class II11
Class III9
Most recent recall reported2026-04-29
Most common stated reasondissolution or stability failure10 of 20 entries

Source: FDA, Enforcement Reports (drug recalls) via openFDA, data as of Nov 10, 2026

How this was calculated

Counted enforcement report entries matched by FDA's listed active substance, or by the name in the product description where FDA lists none. Reasons were grouped by keywords in FDA's stated reason.

Scope: Recalls of single-ingredient isotretinoin products, plus compounded or unlisted products whose description names it

Each recall covers specific lots from one firm and is not a statement about every product with this ingredient. One event can appear as several entries, one per product.

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Clinical studies

Registered clinical studies of isotretinoin

ClinicalTrials.gov lists 214 registered studies that name isotretinoin as an intervention as of 2026-11-11. Of these, 13 are recruiting, 124 are completed and 34 are phase 3 studies.

Registered clinical studies of isotretinoin: the figures
MeasureValue
Registered studies214
Recruiting now13
Not yet recruiting7
Completed124
Terminated, withdrawn or suspended26
Phase 3 (including phase 2/3)34
Phase 2 (including phase 1/2)71
Phase 134

Source: NIH National Library of Medicine, ClinicalTrials.gov, data as of Nov 11, 2026

How this was calculated

Searched the ClinicalTrials.gov intervention field for the name, downloaded every matching record and counted by overall status and phase. Combined phases are counted under the higher phase. Phase not applicable covers observational, device and behavioural studies.

Scope: Studies whose intervention field matches isotretinoin, any condition, any country, all statuses

A registered study is not a result. Counts include studies where the drug is a comparator or background treatment, and studies that never finished or reported.

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Articles on Isotretinoin