Is there a possibility to process Roaccutane caps in a magistal preparation for a patient who cannot swallow capsules? Or a galenic formula with Isotretinoin?

Given that isotretinoin is not available I only see the possibility of cutting the capsules by using tweezers and a bistouri and letting them be expressed in a tarred dish. Washing out becomes a problem considering water is not usable. So there will be loss on it. After having treated the desired number of capsules in this way to gather a certain mass of isotretinoin I would then try to make a syrup type of water-soluble vitamins. So the isotretinoin is solubilized with Tween 80. An example of such a vitamin syrup is described on the website for vitamin E (question about processing of Vit. E in syrup). I think this example can be followed provided any adjustments. Given no data available on stability I would not make large quantities and pack in a bottle wrapped in aluminum foil and keep it in the fridge.

A less time-consuming solution is to ask the client to cut the capsules themselves open for intake and to squeeze out the contents in e.g. a little yogurt for easier intake.