Short answer: The isotretinoin label says no. Isotretinoin is closely related to vitamin A, and the Absorica label says to avoid supplements containing vitamin A because together they may lead to isotretinoin side effects. Its Medication Guide lists vitamin A supplements and tetracycline antibiotics as medicines not to take during treatment. ODS adds that retinoid medicines plus vitamin A supplements can raise the risk of vitamin A toxicity.
Isotretinoin is 13-cis-retinoic acid, chemically related to retinol, the main form of vitamin A (Absorica label, section 11). Section 7.1 says to avoid using it with supplements containing vitamin A, because the combination "may lead to ABSORICA/ABSORICA LD-associated adverse reactions." The label also lists an allergy to vitamin A as a reason not to take isotretinoin.
The Medication Guide names two things not to take during treatment:
It also asks people to tell the provider about all vitamins and herbal supplements, naming St. John's wort.
Several of the effects listed for isotretinoin, such as dry skin, joint and muscle pain, headache and changes in liver tests, overlap with signs of too much vitamin A. The Absorica label reports musculoskeletal symptoms such as joint pain in about 16% of people in one trial and mild to moderate liver enzyme rises in about 15%. ODS describes chronic vitamin A excess as causing dry skin, painful muscles and joints, fatigue, depression and abnormal liver tests, and acute excess as causing severe headache, blurred vision, nausea and dizziness, with raised pressure around the brain in severe cases.
ODS sets the adult upper limit for preformed vitamin A at 3,000 mcg a day. That limit covers retinol from animal foods and supplements; beta-carotene from plants is counted separately and is not known to cause birth defects, ODS says. On isotretinoin, the label advice is to avoid vitamin A supplements altogether rather than stay under a number.
Both isotretinoin and high doses of preformed vitamin A can cause birth defects. Isotretinoin is only available through the iPLEDGE program (a REMS), which requires two forms of birth control, or a commitment to no sexual contact that could cause pregnancy, from 1 month before until 1 month after treatment for people who can become pregnant. The label also says not to donate blood during treatment and for 1 month after.
ODS gives the same warning for other oral retinoids, naming acitretin (Soriatane) for psoriasis and bexarotene (Targretin). For any of these, the prescriber or pharmacist can review a supplement list line by line. Dose Track keeps vitamins and prescriptions together on one list, which makes that review quicker. Other common supplement pairs are on orlistat and vitamins and minerals and antibiotics.
Read more on Dose Track: REMS · Dietary supplement · Interaction checker in Dose Track