In theory you have to eat with accutane as it is a fat absorbent drug, without fat to bind too it will just pass through your system. I say in theory as no one is really sure how the drug works. The packaging also indicates that you could get throat problems if the tablets were to get lodged and dissolve in it, that might suggest it could also cause irritation to your stomach lining if taken without food.
Generally, I dont think its a great idea.
Accutane has a significant food effect:2.5 : 1 ratio between Accutane (fed) and Accutane (fasted)
inconsistent eating habits lead to large within subject variability
between subject variability is less when administered with food
Taking Accutane without food significantly increases the risk of under exposure to isotretinoin, which could result in sub-optimal therapy (decreased efficacy)
From http://www.fda.gov/o...t#524,31,Plasma
It's important that you take Accutane with food. Look at the graph on slide #31 for reference.