Can You Take Amoxicillin with Accutane?
Yes, amoxicillin can be safely taken with isotretinoin (Accutane), as there is no documented contraindication between these medications. 1
Key Safety Considerations
Avoid Tetracycline Antibiotics, Not Amoxicillin
The critical drug interaction concern with isotretinoin involves tetracycline-class antibiotics (doxycycline, minocycline, tetracycline), which must be avoided due to the risk of pseudotumor cerebri—a serious condition causing increased intracranial pressure. 1 Amoxicillin is a penicillin-based antibiotic and does not carry this risk. 2
Amoxicillin as a Safe Alternative
When treating infections in patients on isotretinoin, amoxicillin is specifically recommended as an appropriate alternative antibiotic choice. 1
The American Academy of Dermatology guidelines list amoxicillin as an adjunctive treatment option for acne, including during pregnancy, with dosing of 250 mg twice daily up to 500 mg three times daily for adults. 2
Amoxicillin has demonstrated efficacy in treatment-resistant acne cases and can be used when other systemic agents are not indicated or desired. 3
Monitoring Recommendations
While no specific interaction exists between amoxicillin and isotretinoin, maintain standard isotretinoin monitoring:
Liver function tests at baseline and monthly for the first 3 months, then every 3 months. 1
If amoxicillin is used for more than a short course, consider additional LFT monitoring as a precautionary measure. 1
Continue routine isotretinoin monitoring including lipid panels and pregnancy testing as required by the iPLEDGE program. 2
Common Pitfall to Avoid
The main pitfall is confusing amoxicillin (a penicillin) with tetracycline antibiotics. Only tetracyclines are contraindicated with isotretinoin. 1 If a patient has a penicillin allergy and cannot take amoxicillin, consider macrolides or fluoroquinolones as alternatives—but never tetracyclines. 1