Isot 20 Soft Gelatin Capsule contains isotretinoin 20 mg, a retinoid derivative primarily indicated for the treatment of severe recalcitrant nodular acne that is unresponsive to conventional therapies, including systemic antibiotics. Isotretinoin acts by reducing sebaceous gland size and sebum production, normalizing follicular keratinization, and exhibiting anti-inflammatory properties, thereby addressing multiple pathogenic factors of acne. The capsule formulation ensures optimal bioavailability and patient compliance. Isotretinoin therapy requires careful patient selection and monitoring due to its potential for serious adverse effects, including teratogenicity, hepatotoxicity, and lipid abnormalities. Baseline and periodic laboratory evaluations of liver function tests, lipid profile, and complete blood count are recommended during treatment. Female patients of childbearing potential must adhere to strict contraceptive measures before, during, and after therapy to prevent fetal exposure. Common side effects include cheilitis, dry skin, and mucous membrane irritation. Isot 20 Soft Gelatin Capsule should be prescribed and used under the supervision of a qualified healthcare professional with appropriate patient counseling regarding risks, benefits, and necessary precautions. It is contraindicated in pregnancy and hypersensitivity to isotretinoin or any capsule components. This medication is not intended for use in mild to moderate acne or other dermatological conditions without specialist guidance.