Acne
Can You Drink Alcohol on Accutane? What the Evidence Says
If you’re on an Accutane (isotretinoin) treatment course for acne, you might be wondering if you can drink alcohol, what happens if you do drink while on it, or why you can’t in the first place.
Can You Drink Alcohol on Accutane?
Alcohol use during an Accutane (isotretinoin) course is strongly discouraged because both are processed by the liver. Isotretinoin itself can elevate liver enzymes as well as triglycerides, and alcohol strains both of those as well. This is not just a cautious convention; the FDA label singles out patients with increased alcohol intake as a group needing especially careful risk assessment before starting, alongside patients with diabetes, obesity, or lipid metabolism disorders.
US Food and Drug Administration (2002). Accutane (isotretinoin) prescribing information
So if you want to keep yourself healthy overall and maintain your clear skin, it might be worth skipping, or at least decreasing regular use, for the duration of the treatment course.
We know it’s hard. Especially because many isotretinoin users are young, and alcohol use is common socially, but staying healthy and safe is important too. Below is why it’s not a great idea, what the data actually shows, what happens if you do drink, and how monitoring works.
Why Can’t You Drink on Accutane?
Using both isotretinoin and alcohol in combination can increase the risk of side effects such as liver damage or high cholesterol. These changes show up in the form of elevated liver enzyme levels and lipid (fat in the bloodstream) levels on blood tests.
The label puts real numbers on the lipid side. In clinical trials, marked elevations of triglycerides above 800 mg/dL were reported in about 25% of patients on Accutane, roughly 15% developed a decrease in HDL, and about 7% showed an increase in cholesterol. Notably, the label also lists restricting dietary fat and alcohol as one of the ways patients have brought elevated triglycerides back down while staying on treatment.
US Food and Drug Administration (2002). Accutane (isotretinoin) prescribing information
Drinking can also make some of the more uncomfortable side effects like dry skin and lips, mood changes, or nausea more common, potentially resulting in a lower quality of life and lower compliance with the medication.
How Common Are Liver and Lipid Problems on Accutane?
In a 2018 systematic review of 11 randomized trials, abnormal bloodwork made up around 2% of all adverse events reported on isotretinoin, most commonly elevated liver enzymes or elevated serum lipids. That figure is a share of side effects, not a share of patients. As the label numbers above show, lipid changes themselves are common.
Vallerand et al. (2018). British Journal of Dermatology
What is less common is a change serious enough to stop treatment. Across those same trials, 2 patients out of 372 taking isotretinoin withdrew because of elevated liver enzymes, and no cases of pancreatitis were reported. That is among participants whose bloodwork was being watched throughout, which is the entire point of monitoring.
What Actually Happens if You Drink on Accutane
If you do drink while taking isotretinoin, there is usually not an immediate problem in the short term, and your acne results are unlikely to be affected. The main concern is that you are adding more stress to your liver and cholesterol levels, which can potentially accumulate damage over time.
It’s also important to remember that reactions are highly individual; just because one person is able to drink and not experience issues doesn’t mean that you won’t.
These longer-term changes can be tracked with blood panels. If you do notice any acute symptoms, depending on severity, contact emergency services or your physician immediately.
How Much Alcohol Is Too Much on Accutane?
It’s also important to distinguish between light drinking, for example a drink once or twice a week, and heavy drinking. This isn’t black and white, because the issue is more to do with chronic habits and cumulative strain over time on your organs and health overall.
To drink at all on Accutane (isotretinoin), discuss it with your provider first. If your provider agrees and your blood markers are in range, light drinking may be acceptable. That is a judgment made about your labs, not a general rule that applies to everyone.
If your provider has signed off, a few things are worth keeping in mind: avoid drinking on consecutive days, stay hydrated and eat beforehand, and watch for symptoms. None of that makes alcohol neutral on isotretinoin. It only avoids stacking strain on top of strain. One practical note that catches people out: the label advises at least 36 hours between drinking and having your lipids drawn, so a drink the night before a blood test can distort the result your provider is relying on.
US Food and Drug Administration (2002). Accutane (isotretinoin) prescribing information
Who Should Avoid Alcohol Entirely on Accutane?
Patients who should be the most strict about drinking while on Accutane (isotretinoin) are those with pre-existing elevated lab markers, patients with binge drinking patterns, or patients taking other medications processed by the liver. The label’s own high-risk list points the same direction, naming increased alcohol intake alongside diabetes, obesity, and lipid metabolism disorders as reasons for especially careful consideration and more frequent lab checks.
US Food and Drug Administration (2002). Accutane (isotretinoin) prescribing information
How Blood Test Monitoring Works at Happyglow
For patients taking an Accutane (isotretinoin) treatment course at Happyglow, we require some monitoring to meet medical standards and keep patients safe.
In general, we require a blood test at the beginning of treatment to ensure there are no pre-existing abnormalities involving the liver or lipids. From there, we order blood tests as needed, at the physician’s discretion.
This is also the mechanism that answers the alcohol question for your specific case. Rather than guessing, your provider is looking at your actual liver enzymes and lipids and deciding from there.
Bloodwork is not the only monitoring that matters. Isotretinoin causes severe birth defects, so patients who can become pregnant are also enrolled in iPLEDGE, the FDA-mandated program requiring monthly pregnancy testing and two effective forms of contraception for the length of the course. Alcohol is one part of a treatment that is supervised closely for several reasons.
US Food and Drug Administration (2002). Accutane (isotretinoin) prescribing information
Alternatives to Accutane if You Can’t Avoid Alcohol
If you have pre-existing conditions that might rule out isotretinoin, or you know that cutting alcohol for the length of a course is not realistic for you, topical prescription acne and anti-aging medications like tretinoin are worth raising with a provider.
Due to the topical nature, tretinoin doesn’t act systemically or tax the body the same way isotretinoin does.
The Bottom Line on Alcohol and Accutane
Ultimately, alcohol compounds the potential for side effects because it stresses the same systems that Accutane (isotretinoin) does, so use is strongly discouraged. The good news is that the lipid effects are reversible once treatment ends, which is part of why most of this is a question about the length of your course rather than forever.
US Food and Drug Administration (2002). Accutane (isotretinoin) prescribing information
If clear skin is the priority and the course is only a few months, it may be worth cutting alcohol out entirely for the duration. For a sense of how long that actually is, see our month-by-month timeline.
How to Get Prescribed Isotretinoin (Accutane) Online
If you’re wondering how or where to get isotretinoin, Happyglow connects you with US-licensed physicians who decide whether starting isotretinoin is right for you, entirely online.
- Start your visit. Answer a few questions about your health and goals (~5 min).
- A physician reviews. They determine whether isotretinoin is appropriate for you or recommend a better fit.
- Delivered to your door. If approved, your prescription ships free, with refills coordinated with your monthly check-ins.
See if isotretinoin is right for you
Not approved? You’re refunded in full.
Common questions
Can You Drink on Accutane?
Drinking while taking Accutane (isotretinoin) is highly discouraged due to the medication having a propensity to cause elevated liver enzymes and triglycerides, both of which alcohol also worsens. For those with labs in range, light drinking may be discussed with your medical provider.
What Happens if You Drink on Accutane?
If you do drink while taking isotretinoin, nothing is likely to happen in the immediate short term, but you might be accumulating strain and therefore potential damage to your liver or cholesterol overall, which has negative downstream effects. These changes, if any, would be reflected in blood marker results.
How Long After Accutane Can I Drink?
Isotretinoin itself clears quickly, with an average elimination half-life of about 21 hours, so the drug is largely gone within a week. The practical advice many providers give is to wait longer than that, because liver enzymes and triglycerides need their own time to return to baseline. Ask your provider what makes sense for your labs.
Does Alcohol Ruin Accutane Results?
There is no good evidence that alcohol undoes your acne results. What it does do is stress the same liver and lipid systems isotretinoin already stresses, and add to the dehydration and dryness the drug causes. The concern is your health and comfort, not your skin outcome.
Can I Pause Accutane to Drink?
While this might seem logical, isotretinoin's effects on liver and lipid markers don't disappear overnight, and interrupting a course also sets back the cumulative dose that drives your result. Talk to your provider before changing anything about your regimen.
Sources
Primary evidence
- Systematic reviewVallerand et al. (2018). Efficacy and adverse events of oral isotretinoin for acne: a systematic review · British Journal of Dermatology (Q1)
Official sources
- FDA labelAccutane (isotretinoin) Capsules Label · FDA
Background
- EncyclopediaIsotretinoin · Wikipedia