Isotuf 20 Softgel Capsule contains isotretinoin 20mg, a retinoid derivative primarily indicated for the treatment of severe recalcitrant nodular acne that is unresponsive to conventional therapies such as systemic antibiotics and topical treatments. Isotretinoin acts by reducing sebaceous gland size and sebum production, inhibiting the growth of acne-causing bacteria, and exerting anti-inflammatory effects, thereby addressing multiple pathogenic factors of acne. The softgel formulation ensures optimal bioavailability and ease of administration. Due to its potent teratogenic potential, isotretinoin is contraindicated in pregnant women and requires strict adherence to pregnancy prevention programs during treatment. Common adverse effects include dry skin, cheilitis, conjunctivitis, and transient elevations in liver enzymes and lipid profiles, necessitating regular monitoring of hepatic function and lipid levels during therapy. Dose adjustments may be required based on clinical response and tolerability. Patients should be advised to avoid excessive sun exposure and use appropriate skin moisturizers. Isotuf 20 Softgel Capsule should be prescribed and used under specialist supervision, with careful consideration of contraindications and potential drug interactions. It is essential to counsel patients regarding the importance of adherence to dosing schedules and monitoring protocols to maximize therapeutic efficacy and minimize risks.