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Tetracycline vs Accutane

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Tetracycline Information

Accutane Information


Dosage Information

Side Effects

Warnings and Contraindications


Market Information


For patients struggling with certain forms of acne, there are drugs available that can help manage symptoms by reducing inflammation, bacteria, and the overproduction of sebum. Tetracycline and Accutane are two such drugs prescribed for this purpose. They work in different ways to combat acne, but both have shown efficacy in treating severe or resistant cases. Tetracycline is an antibiotic that primarily combats Propionibacterium acnes, a bacteria that is involved in causing acne lesions. Accutane (isotretinoin) is a potent retinoid that affects cell life cycle and decreases the size of sebaceous glands and the level of sebum production. While both can be effective treatment options for acne, each comes with its own potential side effects that should be considered before starting therapy.

Tetracycline vs Accutane Side By Side

Brand NameTetracyclineAccutane
ContraindicationsShould not be taken with retinoids due to increased risk of intracranial hypertension; not recommended during pregnancy due to risk of serious birth defects; should not be used in children under 8 years old due to the risk of tooth discolorationShould not be taken during pregnancy due to high risk of serious birth defects; not recommended with retinoids due to increased risk of intracranial hypertension; requires careful monitoring for signs of depression or suicidal thoughts
CostApproximately $0.50 –$2.00 per capsule or tablet for the generic versionAround $3.50 per day at the lowest dosage level for the generic version (Isotretinoin)
Generic NameTetracyclineIsotretinoin
Most Serious Side EffectSevere stomach pain, watery diarrhea, jaundice (yellowing of the skin or eyes)Depression symptoms, suicidal thoughts, severe skin reactions
Severe Drug InteractionsIncreased risk of intracranial hypertension when taken with retinoidsIncreased risk of intracranial hypertension when taken with retinoids
Typical Dose500–1000 mg/day, divided into two or four doses0.5 to 1.0 mg/kg of body weight per day, administered in two divided doses

What is tetracycline?

Tetracycline, a broad-spectrum antibiotic, was one of the first effective treatments for acne and marked a significant advancement over earlier topical remedies. It was initially approved by the FDA in 1953. The drug works by inhibiting bacterial protein synthesis, effectively preventing bacteria from multiplying and thus reducing inflammation in the skin. Tetracycline is often prescribed for various other types of infections besides acne, like respiratory tract infections and Lyme disease.

Isotretinoin (the generic name for Accutane) is a derivative of vitamin A and represents another significant development in acne treatment. Approved by the FDA in 1982, it drastically reduces the size of sebaceous glands as well as oil production within these glands. This, in turn, results in decreased food supply for Propionibacterium acnes (a common bacterium implicated in acne), thereby helping control severe nodular acne that hasn't responded well to other therapies.

While both drugs can be highly effective against persistent or inflammatory forms of acne, they differ significantly with regard to their side effects. Tetracycline may cause gastrointestinal upset and photosensitivity, while Accutane can have more serious side effects such as potential mood changes or birth defects if taken during pregnancy.

What conditions is tetracycline approved to treat?

Tetracycline and Accutane are both approved for the treatment of various skin conditions:

  • Tetracycline is often used in the treatment of moderate to severe acne, rosacea, and certain types of bacterial infections.
  • Accutane (isotretinoin) is typically reserved for severe cases of nodular or cystic acne that haven't responded well to other treatments. In some instances, it may also be used off-label for treating certain types of cancer.

How does tetracycline help with these illnesses?

Tetracycline is an antibiotic that treats acne by inhibiting the growth and multiplication of bacteria. It does this by blocking protein synthesis in bacteria, thus preventing them from producing essential proteins needed for their growth and replication. This bacteriostatic method of action enables your body's immune system to fight off the bacterial infection more effectively.

On the other hand, Accutane (also known as isotretinoin) is a retinoid medication used primarily for severe forms of acne that haven't responded to other treatments. It works by reducing sebum production in the skin, which is often excessive in patients with severe acne. In addition, it can reduce inflammation and prevent clogging of pores.

While both drugs can be effective at treating various types of acne, Accutane tends to be reserved for more severe or persistent cases due to its potential side effects. Always consult your healthcare provider before starting any new treatment plan.

What is Accutane?

Accutane is a brand name for isotretinoin, which is a retinoid, resembling vitamin A in its structure. It reduces the size of oil glands (sebaceous glands) in the skin and slows down their production of sebum, leading to less oily skin and fewer acne breakouts. Isotretinoin was first approved by the FDA in 1982. Its mode of action is differerent from that of antibiotics like tetracycline that kill bacteria causing acne. Rather, Accutane changes the environment where these bacteria thrive and prevents new blemishes from forming.

Accutane's side effect profile is also different from that of tetracycline. While both can cause dryness and photosensitivity, Accutane may lead to more severe side effects such as birth defects if taken during pregnancy or serious mental health problems. Its profound impact on sebaceous glands can be beneficial for treating severe forms of nodular or cystic acne, especially when they do not respond well to "typical" antibiotics like tetracycline.

What conditions is Accutane approved to treat?

Accutane, also known as isotretinoin, is a powerful drug that's been approved by the FDA for:

  • Severe recalcitrant nodular acne
  • Other forms of severe acne that haven't responded to traditional treatments.

This medication works by reducing oil production in your skin, helping prevent your pores from getting clogged and forming severe forms of acne.

How does Accutane help with these illnesses?

Accutane (isotretinoin) plays a significant role in the life cycle of cells, affecting both cell division and death. It has been found to be highly effective in treating severe acne by shrinking sebaceous glands and reducing their oil production. Although the antibiotic tetracycline can also treat acne by killing bacteria and reducing inflammation, Accutane works at a deeper level, on the underlying causes of acne. Its effects are also longer-lasting, with improvements continuing to manifest over time even after discontinuation of therapy. This is due to Accutane's ability to alter sebaceous gland structure permanently. However, because it significantly impacts various processes in the body, it may cause serious side effects alongside its potent benefits against acne. Thus, it's usually only prescribed in severe cases or when other treatments such as antibiotics like tetracycline haven't worked well.

How effective are tetracycline and Accutane?

Both tetracycline and isotretinoin (Accutane) are effective treatments for severe acne, with each having a unique mechanism of action. Tetracycline is an antibiotic medication that treats acne by killing bacteria and reducing inflammation, while Accutane works by decreasing the production of sebum in the skin, thereby preventing the formation of new blemishes.

In terms of effectiveness, studies have shown both to be highly successful in treating severe acne. A 2012 clinical trial found no significant difference between tetracycline and Accutane in reducing inflammatory lesions associated with acne. However, Accutane was observed to be more effective at eliminating non-inflammatory lesions such as whiteheads or blackheads.

A review published in 2005 pointed out that while tetracycline has been used effectively for decades to treat moderate-to-severe forms of acne, it does come with potential side effects including gastrointestinal upset and sun sensitivity. Additionally, due its nature as an antibiotic medication, there can also be concerns about bacterial resistance developing over long-term use.

On the other hand, a comprehensive meta-analysis published in 2014 highlighted that although Accutane is typically reserved for severe cases due to its potency and potential side effects—which can include dryness of skin/lips/eyes/nose/mouth, joint pain, and elevated triglycerides—it often results in remission after just one course of treatment.

Although these drugs have potential side effects, both drugs have high efficacy rates, making them invaluable tools in managing severe forms of acne vulgaris where topical treatments may not suffice. The choice between these two medications ultimately depends on various factors, such as the severity and type of acne and its persistence, location, impact on quality-of-life, scarring risk, etc. Individual patient factors like pregnancy plans, comorbidities, and concomitant medications should also be taken into account. Other considerations playing into the choice between tetracycline and Accutane include patient expectations and preferences, treatment goals, and the clinician’s experience and opinion.

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At what dose is Tetracycline typically prescribed?

Oral dosages of Tetracycline for the treatment of acne typically range from 500–1000 mg/day, divided into two or four doses. However, studies have shown that a dosage as low as 250 mg/day can be effective in some individuals. Adolescents and adults may start on 500 mg/day, divided into two doses. In either population, if no significant improvement is seen after several weeks, the dosage can be increased up to a maximum of 2000mg/day divided into four doses. For Accutane (Isotretinoin), it's recommended to start at a lower dose around 0.5-1 mg per kg body weight per day and this could go up depending upon the response and tolerance by an individual with an upper limit being around 2mg/kg body weight in severe cases over a course of about 15 -20 weeks under strict medical supervision due to its potential serious side effects.

At what dose is Accutane typically prescribed?

Accutane treatment typically begins with a dosage of 0.5 to 1.0 milligrams per kilogram (mg/kg) of body weight per day, administered in two divided doses taken approximately 12 hours apart. The dose may then be increased by your doctor (up to a maximum daily dose of 2 mg/kg) if the acne does not improve after several weeks on the starting dose. For many patients, Accutane must be taken for four to five months at a time for it to become fully effective. During this period, regular blood tests are often necessary due to potential side effects related to liver function and cholesterol levels. As with all medications, you should consult with your physician before beginning any new treatment regimen.

What are the most common side effects of tetracycline?

Common side effects of tetracycline can include:

  • Nausea
  • Diarrhea
  • Rash, including skin redness and itching
  • Swelling in the rectal or genital area
  • Sores in the rectal or genital area
  • Discoloration of your teeth (specifically if used in children under 8 years)
  • Increased sensitivity to sunlight, meaning you may get sunburnt more easily

Meanwhile, Accutane is associated with a different set of potential side effects. These can include:

  • Dry lips and mouth
  • Nosebleeds
  • Peeling skin on palms of hands and/or soles of feet
  • Changes in skin color
  • Unusual hair growth or hair loss
  • Nail changes
  • Muscle aches/stiffness

abstract image of a patient experiencing side effect

Are there any potential serious side effects for tetracycline?

While Tetracycline and Accutane are both used to treat acne, they can have different side effects. For tetracycline, some serious but rare side effects may include:

  • Severe headache
  • Blurry vision
  • Skin rash or hives
  • Difficulty breathing
  • Dwelling of your face, lips, tongue, or throat
  • Jaundice (yellowing of the skin or eyes)
  • Dark-colored urine
  • Severe stomach pain
  • Watery diarrhea

Accutane also presents its own set of potential risks:

  • Depression symptoms, such as sadness or crying spells and suicidal thoughts
  • Blurry vision with eye pain and seeing halos around lights
  • Hearing problems
  • Sudden dizziness
  • Severe skin reactions like a red/purple rash that spreads across the body and causes blisters
  • Bone/joint/muscle pain

If you experience any of these symptoms while on either medication, it's crucial to seek immediate medical attention.

What are the most common side effects for Accutane?

Accutane, an often-prescribed medication for severe acne, does come with a range of potential side effects. These can include:

  • Dryness of the skin, lips, mouth, and nose
  • Nosebleeds
  • Changes in vision particularly at night
  • Upset stomach or abdominal pain
  • Loss of appetite or weight fluctuations
  • Difficulty sleeping (insomnia)
  • Increased sensitivity to sunlight leading to sunburns more easily
  • Unusual tiredness or lack of energy
  • Rapid heartbeat (tachycardia)
  • Feelings of anxiety or nervousness
  • Irritability and mood changes including depression
  • Hair loss (rare)
  • Joint and muscle pains especially in long bone areas such as legs and arms. It's essential that patients taking Accutane monitor these symptoms closely due to its high potency.

Are there any potential serious side effects for Accutane?

Accutane is highly effective for severe acne, but it can have serious side effects in addition to the milder side effects listed above. These include:

  • Signs of an allergic reaction, such as hives, difficulty breathing, and/or swelling of the face or throat
  • Mood changes, depression, thoughts about suicide or dying
  • Severe headache accompanied by nausea and visual disturbances
  • Stomach pain, diarrhea, or rectal bleeding
  • Changes in skin color (either lighter or darker), peeling skin on palms of hands and/or soles of feet
  • Increased sensitivity to sunlight, leading to severe sunburns
  • Rapid heart rate

It's important that you contact your healthcare provider right away if any of these symptoms occur while taking Accutane.

Contraindications for tetracycline and Accutane

Both tetracycline and Accutane, along with most other acne medications, may cause side effects that can be distressing. If you experience severe skin irritation, changes in skin pigmentation, or an increase in sun sensitivity leading to severe sunburns, seek immediate medical attention.

Neither retracycline nor Accutane should be taken if you are using retinoids (topical or oral), as this combination can lead to increased risk of intracranial hypertension. Always inform your healthcare provider about the medications you are currently taking. Retinoids in particular will require a clearance period to prevent possibly hazardous interactions with tetracycline and Accutane.

Accutane has been associated with symptoms of depression, psychosis, and rarely suicidal ideation. It is critical to have regular follow-ups with your doctor when on this medication.

Furthermore, neither of these drugs should be used during pregnancy due to the high risk of serious birth defects. Women of childbearing age who are prescribed either tetracycline or Accutane should use effective contraception throughout the duration of their treatment.

How much do Tetracycline and Accutane cost?

For the brand name versions of these drugs:

  • The price of 60 tablets of Accutane (20 mg) averages around $1,200, which works out to $20–40/day, depending on your dose.
  • The price of 30 capsules of Tetracycline (500 mg) averages is about $400, working out to approximately $13/day.

Thus, if you are in the higher dosage range for Accutane (i.e., 40 mg/day or higher), then brand-name Tetracycline is less expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which drug is right for you.

For the generic versions of Tetracycline and Accutane (Isotretinoin), costs are significantly lower:

  • Isotretinoin (100 mg tablets) can be purchased in packs starting from 10 up to several hundreds with prices ranging from as low as $3.50 per day at the lowest dosage level.
  • Generic tetracycline's pricing may vary widely based upon factors like pharmacy location and insurance coverage; however it typically ranges between approximately $0.50 –$2.00 per capsule or tablet making it more affordable than its branded counterpart.

These medications treat different kinds of acne and have different side effects profiles so always consult with a doctor prior deciding which one is best suited for your condition.

Popularity of tetracycline and Accutane

Tetracycline (a broad-spectrum antibiotic) and Accutane (isotretinoin, an oral medication for severe acne unresponsive to other treatments) are both used in dermatology, but have distinct applications and side effect profiles.

In 2020, tetracycline was prescribed to about 1.2 million people in the US. It is commonly used for the treatment of mild to moderate acne, among various other antibacterial uses. Tetracycline usage has been slowly declining since the rise of newer antibiotics with fewer side effects and drug interactions.

On the other hand, isotretinoin (generic Accutane) was prescribed to around 600 thousand people in the same year, mainly due to its specific indication for severe nodular or cystic acne that has not responded well to other forms of therapy including antibiotics like tetracycline. Despite its narrower field of application compared to tetracycline and its potentially serious side effects (including teratogenicity which requires strict monitoring in females of childbearing age), it remains an effective option when other treatments fail. Accutance can provide lasting relief from severe types of acne, and has thus maintained steady prescription numbers over recent years.


Both tetracycline and Accutane (isotretinoin) are proven treatments for acne, backed by numerous clinical studies indicating their effectiveness. Their mechanisms of action differ, with tetracycline being an antibiotic that reduces the amount of bacteria on the skin and decreases inflammation, while Accutane works primarily by reducing sebum production in the skin.

Tetracycline is often considered as a first-line treatment option for moderate to severe acne, or when over-the-counter treatments have failed. On the other hand, Accutane is generally reserved for severe forms of acne or those which haven't responded adequately to other treatments, mainly due to its potentially serious side effects.

Both drugs are available in generic form, which can result in significant cost savings for patients paying out-of-pocket. Both tetracycline and Accutane may require some time to work before a noticeable improvement in acne is observed.

The side effect profiles also differ between these two medications. They're both generally well-tolerated, but each has its potential risks. Tetracycline can cause photosensitivity and gastrointestinal issues among other effects, while Accutane has a more serious risk profile including birth defects if taken during pregnancy and mood changes, among others. As such, it's vital that patients closely monitor any changes, particularly when starting treatment. Treatment with either medication should only be started under the guidance of a healthcare provider.