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There is no known drug-drug interaction between Accutane (isotretinoin, Roaccutane) and marijuana or cannabidiol (CBD). Using cannabis or CBD with Accutane is unlikely to have any adverse effect.
However, Accutane does have some adverse side effects that concurrent cannabis use may enhance or even treat. We would suggest caution and careful dosing if using cannabis and Accutane together.
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What Is Accutane?
Accutane is the trade name for isotretinoin, aka 13-cis-retinoic acid, a skincare product, and acne medication. Accutane is also sold under the brand name Roaccutane and is a retinoid, meaning it is related to vitamin A. Accutane is most often prescribed for people when other treatments, including antibiotics, fail to stop severe acne breakouts. Isotretinoin’s isomer, tretinoin, is also an acne drug.
Uses and How It Works
Accutane is usually administered as a topical or capsule and is believed to work by decreasing the size of the skin’s sebaceous glands. These sebum glands are responsible for oil production, which can clog pores and cause acne.
Dermatologists and doctors also prescribe Accutane for:
- Hidradenitis suppurativa (HS). Sometimes known as acne inversa or Verneuil’s disease, Hidradenitis suppurativa is a painful dermatological condition characterized by inflamed and swollen lumps.
- Rosacea. Rosacea is a long-term skin condition that causes redness, swelling, and pimples, typically affecting the face.
- Harlequin-type ichthyosis. Harlequin-type ichthyosis is a genetic disorder that results in thickened skin over the body at birth.
- Xeroderma pigmentosum (XP). Xeroderma pigmentosum is a genetic disorder with a decreased ability to repair DNA damage such as that caused by ultraviolet (UV) light.
- Fibrodysplasia ossificans progressiva. Fibrodysplasia ossificans progressiva is a rare connective tissue disease in which fibrous connective tissue such as muscle, tendons, and ligaments turn into bone tissue.
- Genital warts.
- Neuroblastoma. Neuroblastoma is a form of nerve cancer.
- Squamous cell carcinoma.
The liver metabolizes Accutane and is best consumed immediately after a high-fat meal.
Potential Health Benefits and Risks
Accutane has several potential benefits for many skin disorders and treatment-resistant acne. However, it does have some adverse side effects, including:
- Anemia, a blood disorder in which the blood has a reduced ability to carry oxygen due to a lower-than-normal number of red blood cells or a reduction in the amount of hemoglobin.
- Neutropenia, or abnormally low concentration of neutrophils in the blood. Neutrophils are white blood cells that are essential to the immune system and help the body fight infection.
- GI upset and the potential of making conditions like irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD) worse.
- An increased chance of being affected by some kinds of bacterial infections (rare).
- Anaphylactic reactions and allergic skin reactions (rare).
- Diabetes (rare).
- Dry eyes.
- Pink eye, aka conjunctivitis, which is inflammation of the eyes.
- Blurred vision, cataracts, color blindness, and other vision problems (rare).
- Anxiety and severe depression.
- An increased risk of suicide (rare).
- Impaired hearing (rare).
- Dry skin.
- Back pain.
- Skin fragility.
- Increased blood glucose.
- Increased triglyceride levels and decreased high-density lipoprotein (HDL) levels.
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What to Know About Using Cannabis and Accutane at the Same Time
Although there is no known negative drug-drug interaction between cannabis and Accutane, some of the side effects of Accutane (e.g., dry eyes, increased anxiety if using high amounts of THC) may be worsened by using cannabis at the same time. On the other hand, medical cannabis can help mitigate some negative side effects of Accutane use, such as poor insulin resistance, depression, and bone or joint pain.
Accutane’s adverse effects are also associated with high doses and oral rather than topical administration. Accutane overdose is similar to vitamin A overdose. Topical cannabis and CBD products may help reduce the need for Accutane and help manage acne.
So, even though Accutane/isotretinoin and cannabis don’t interact negatively, it’s a good idea to be careful when using the two together.
The Bottom Line
There seems to be little danger in using Accutane/isotretinoin and cannabis together, mainly if the isotretinoin is topically applied.
However, there are some side effects of Accutane that concurrent cannabis use may potentially worsen and compound. On the plus side, with careful dosing of medical cannabis, some of these negative effects may be managed and perhaps even reduce or replace the need for Accutane entirely.
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