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Discuss with your doctor but I would recommend a lower starting dose of 20 mg to be increased by 20 mg per month to 60 mg in month three. This may decrease side effects and still allow you to achieve clearance.
Thank you for your question. Given your recent symptoms of chest and back pain, I highly recommend you consult with your prescribing physician for further direction regarding your Accutane treatment. Also, the dosing of Accutane is based on your weight for a total of 4 months. Daily dosages may be manipulated depending on your symptoms and tolerance. Again, I highly suggest you speak with your prescribing physician regarding your questions and concerns about Accutane. Take care and good luck.