Tretiva is used for the treatment of severe recalcitrant nodular acne. Nodules are inflammatory lesions with a diameter of 5 mm or more. The nodules may become suppurative or hemorrhagic. Due to the risk of significant adverse effects associated with its use, Generic Isotretinoin should be assigned for patients with severe nodular acne who are not responsive to conventional therapy, including systemic antibiotics. In addition, Tretiva capsules should be used by only those female patients who are not pregnant, because Generic Accutane (Tretiva capsules) can cause severe birth defects. Tretiva capsules are manufactured by Intas Pharmaceuticals Ltd.