Improving Patient Education and Reducing Risk

Marcia L. Buck, Pharm.D., FCCP

Pediatr Pharm. 2001;7(7) 

In This Article

Additional Adverse Effects

In addition to the two adverse events highlighted, isotretinoin has been linked to a number of other toxicities. Transient hypertriglyceridemia develops in approximately 25% of patients during treatment. Hepatotoxicity, while less common, has also been reported. Serum triglyceride levels and liver function studies should be evaluated prior to beginning treatment and at weekly intervals until the response to isotretinoin has been established (usually within 4 weeks).

Other adverse effects associated with isotretinoin use include photosensitivity, visual impairments, inflammatory bowel disease with severe diarrhea, skeletal changes, hearing impairments, pancreatitis, neutropenia, agranulocytosis, and hypersensitivity reactions. Rare reports have also linked isotretinoin with the development of pseudotumor cerebri. In several of these reports, the patients have also been taking tetracycline. Concomitant treatment with tetracycline is not recommended. Patients should be made aware of symptoms associated with this condition, including severe headache, nausea, vomiting, and visual disturbances.[2]