How severe was your acne before Accutane?

The most important aspect relating to dose is the cumulative dose of Accutane that you take, i.e. the overall/total amount of Accutane you take during your course. The optimal total dose to minimise the chance of relapse is 120-150mg/kg.

Since you are taking about 1mg/kg/day of Accutane, if you stay on it for 4 months (about 120 days) then your cumulative dose will be about 120mg/kg, just within the optimal range.

However, if you aren't completely (or almost completely) clear by the end of 4 months, I'd recommended you stay on Accutane until you are.

The duration of therapy should be adjusted to give at least 90% clearance of acne based upon initial clinical acne grade scoring techniques followed by 48 weeks of consolidation.

I've done two courses over the years. It will depend upon how well you're responding honestly. After the first course I was amazed. It cleared up/dried up everything including my back which was a disaster. The first week you'll be in heaven. You really don't know how it feels to have all your oil on your face finally go away. Of course this didn't last. After about 5 months after the program I started to get oily again. But my back never broke out again. But my face about a year later did so I did another course. Same thing, miracle in a pill. But again I'm now stuck with very oily face and breakouts and I'm very afraid to try it again. My lips have been cracking ever since Accutane and have remained that way even off it.

I suufered no ill effects other than lips dryness. Of course you'll need to get a blood test every few weeks but honestly that's a small price to pay. Your doctor will know the right amount to give you based upon your weight. They will most likely start you off slower the first week then increase it later on.