Isomiz 20 Soft Gelatin Capsule contains Isotretinoin 20 mg, a potent retinoid primarily indicated for the treatment of severe recalcitrant nodular acne that is unresponsive to conventional therapies such as antibiotics. Isotretinoin functions by reducing sebaceous gland size and sebum production, inhibiting comedogenesis, and exerting anti-inflammatory effects, thereby addressing multiple pathogenic factors of acne. The soft gelatin capsule formulation ensures optimal bioavailability and ease of administration. Isomiz 20 is prescribed under strict medical supervision due to its potential for serious adverse effects, including teratogenicity, hepatotoxicity, hyperlipidemia, and mucocutaneous reactions. Patients require regular monitoring of liver function tests, lipid profiles, and pregnancy status during therapy. The drug is contraindicated in pregnancy and in patients with hypersensitivity to isotretinoin or any capsule components. Dose adjustment may be necessary in hepatic impairment. Patient counseling on adherence to prescribed dosage, avoidance of vitamin A supplements, and implementation of effective contraception measures is essential to minimize risks. Isomiz 20 Soft Gelatin Capsule offers an effective therapeutic option for severe acne, improving dermatological outcomes when used appropriately within a comprehensive treatment plan.