Supplements and isotretinoin: vitamin A, St. John's wort and what to ask

Short answer: The prescribing information for Absorica, one brand of isotretinoin (others include Amnesteem, Claravis and Myorisan), says to avoid supplements containing vitamin A during treatment, because the medicine is closely related to vitamin A. MedlinePlus also lists St. John's wort as a product that may interact. Before you add or keep any supplement during a course, show your prescriber or pharmacist the full label.

This guide explains why vitamin A is named on the label, where it tends to appear in supplements, and the questions worth bringing to your next appointment. It does not replace your Medication Guide or your prescriber's instructions.

Why vitamin A is on the label

Isotretinoin is in a class of medicines called retinoids. MedlinePlus says it is used for a certain type of severe acne that has not been helped by other treatments, and that it is usually taken for 4 to 5 months at a time. That course length matters here, because it is the window during which the label's supplement instructions apply.

The Absorica prescribing information describes isotretinoin as 13-cis-retinoic acid, "related to both retinoic acid and retinol (vitamin A)." Its drug-interaction section puts it plainly:

• "Avoid concomitant use of ABSORICA/ABSORICA LD with supplements containing vitamin A."
• The reason given is that the medicine "is closely related to vitamin A," so using the two together "may lead to ABSORICA/ABSORICA LD-associated adverse reactions."

The patient Medication Guide on the same DailyMed page says the same thing in everyday words: "Do not take the following medicines during treatment with ABSORICA or ABSORICA LD," followed by two items, "vitamin A supplements" and "tetracycline antibiotics." The label also lists an allergy to vitamin A among the reasons the medicine is not used, and MedlinePlus asks you to tell your doctor and pharmacist if you are allergic to isotretinoin or vitamin A.

Different isotretinoin products have their own labels. Read the Medication Guide that came with your prescription, and ask your pharmacist if anything in it differs from what you read here.

Where vitamin A shows up

Vitamin A is easy to take without meaning to, because it often sits inside a product bought for something else. MedlinePlus's vitamin A page says that in supplements it most often comes as retinyl acetate or retinyl palmitate (preformed vitamin A), as beta-carotene (provitamin A), or as a mix of the two. The body converts beta-carotene and other provitamin A carotenoids into vitamin A.

Places to look on a label include:

• Multivitamins. Many list vitamin A near the top of the Supplement Facts panel. Our guide to what's in a multivitamin explains how to read one.
• Fat-soluble vitamin blends. Products sold as "D complex," "ADEK" or similar combinations can include vitamin A alongside vitamin D, E or K.
• Ingredient names. Look for "vitamin A," "retinyl acetate," "retinyl palmitate," "retinol" and "beta-carotene."
• Cod fish oil and other fish oils. MedlinePlus lists cod fish oil among the foods highest in vitamin A, so read the label of any fish oil product too.

If you take more than one product, read them side by side. Vitamin A can appear in a multivitamin and again in a blend, so it helps to check every label for vitamin A before your appointment.

One question deserves a direct answer from your prescriber or pharmacist: does beta-carotene count as a "supplement containing vitamin A" for your medicine? The label names vitamin A supplements and does not mention beta-carotene separately, so ask rather than assume either way.

Food is a separate topic. The label's wording is about supplements. If you have questions about your diet during treatment, ask the person who prescribed your medicine.

St. John's wort and hormonal birth control during treatment

MedlinePlus names two nonprescription or herbal products that may interact with isotretinoin: St. John's wort and vitamin A supplements. It asks you to tell your doctor and pharmacist if you take either one before you begin, and not to start either during treatment without discussing it with your healthcare provider.

The concern MedlinePlus raises is tied to birth control. MedlinePlus says many medications interfere with hormonal contraceptives and states: "Do not take St. John's wort if you are using any type of hormonal contraceptive." NCCIH says St. John's wort can weaken the effects of many medicines, and it lists birth control pills among them.

Isotretinoin comes with strict pregnancy-prevention requirements through a program called iPLEDGE. Follow your program and your label, and bring any question about birth control to your prescriber. The practical step for this article is simple: if St. John's wort appears on any product you take, including a mood or sleep blend, show that label to your prescriber or pharmacist.

What to ask your prescriber or pharmacist

Bring a list of every prescription medicine, nonprescription medicine and supplement you take or are thinking about, with photos of the Supplement Facts panels. Our guide to what to review before starting a new supplement can help you put it together. Then ask:

• Do any of my current products contain vitamin A, under any of its names?
• Does beta-carotene count as vitamin A for my medicine?
• Is there anything in my multivitamin or other blends I should set aside during treatment, and when could I go back to it?
• Does anything I take contain St. John's wort, and how does that fit with my birth control plan?
• Are there other products on my list, prescription or not, that my label asks me to avoid?
• Who should I contact if I have questions between appointments?

Write down what you agree on, including any product you are pausing, and keep it with your Medication Guide. If no change is needed, record that too.

Where VitOptics fits

VitOptics builds a personalized daily supplement pack from a free, three-minute assessment. The free assessment asks which prescription medicines you take, along with the supplements you already use. Automated checks review the recommendation; some profiles need additional review by a person on our team. A second automated check reads the whole pack before release. Your result lists every formula, the amount of each ingredient and the reason it is there, so you can look for vitamin A, retinyl acetate or beta-carotene yourself and show the full list to your prescriber or pharmacist before you start.

If you are taking isotretinoin, that conversation comes first. Personalized vitamin packs can wait until you have your prescriber's or pharmacist's answer about vitamin A.

From $59 a month, priced by what’s in your pack and the same every month · free standard U.S. shipping · 30-day first-pack guarantee · pause or cancel online · U.S. only

Your prescription comes first

Every VitOptics pack is checked against the medications you enter before anything goes in, and your result explains why each item is there.

Start my free assessment.

Sources

1. DailyMed: Absorica and Absorica LD (isotretinoin) capsules, prescribing information and Medication Guide
2. MedlinePlus: Isotretinoin
3. MedlinePlus: Vitamin A
4. NCCIH: St. John's Wort

Read more in the VitOptics learning hub.

This article is for educational purposes and is not medical advice. Supplements are not intended to diagnose, treat, cure or prevent any disease.

Prepared with AI assistance using the sources linked in this article.

Last updated: October 2026