{"id":"oral-isotretinoin","safety":{"commonSideEffects":[{"rate":"90","effect":"Cheilitis (lip inflammation)"},{"rate":"80","effect":"Dry skin and mucous membranes"},{"rate":"25-40","effect":"Elevated triglycerides"},{"rate":"15-20","effect":"Elevated liver enzymes"},{"rate":"10-15","effect":"Headache"},{"rate":"10","effect":"Photosensitivity"},{"rate":"null","effect":"Teratogenicity (if exposed during pregnancy)"}]},"_chembl":null,"_dailymed":null,"mechanism":{"_ai_source":"claude-haiku-4.5","explanation":"Isotretinoin is a synthetic derivative of vitamin A that acts as a ligand for retinoid acid receptors (RAR) and retinoid X receptors (RXR) in the nucleus, modulating transcription of genes involved in sebaceous gland function, keratinocyte differentiation, and inflammation. It dramatically reduces sebaceous gland size and sebum production, and has anti-inflammatory and anti-proliferative effects on skin cells. These combined effects make it highly effective for severe acne by addressing multiple pathogenic factors.","oneSentence":"Isotretinoin is a potent retinoid that binds to nuclear retinoid receptors to regulate gene expression, reducing sebum production and normalizing epithelial cell differentiation in the skin.","_ai_confidence":"high"},"_scrapedAt":"2026-03-27T23:58:45.806Z","_scrapedBy":"cloudflare-swarm","_wikipedia":null,"indications":{"approved":[{"name":"Severe recalcitrant nodular acne"},{"name":"Acne at high risk of permanent scarring"}]},"trialDetails":[{"nctId":"NCT05384821","phase":"PHASE1, PHASE2","title":"Metronomic Chemotherapy in Wilms Tumor (MetroWilms-1906)","status":"RECRUITING","sponsor":"Centre Oscar Lambret","startDate":"2022-09-14","conditions":"Wilms Tumor","enrollment":28},{"nctId":"NCT07481370","phase":"PHASE2","title":"Isotretinoin vs hCG for Male Infertility Due to Low or Absent Sperm","status":"NOT_YET_RECRUITING","sponsor":"University of 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