Safety issues in isotretinoin therapy.
Isotretinoin (Accutane, Roche Laboratories Inc, Nutley, NJ) is an important drug, not only for the treatment of severe acne, but also for other diagnoses and in chemoprevention settings. Because the use of isotretinoin is increasing, it is important for physicians to be aware of the adverse events, toxicities, and management issues related to its use. The most important issue is that of congenital defects, which has resulted in new pregnancy prevention policies and programs implemented by the manufacturer. A relatively new concern is that of depression associated with isotretinoin use, also resulting in new policies placed by the manufacturer and the FDA. The most common adverse effects observed during treatment are mucocutaneous and ocular in nature, but laboratory abnormalities and effects in the nervous, musculoskeletal, gastrointestinal, pulmonary, hematologic, and other systems are also described. Additionally, potential drug interactions, follow-up, and toxicity prevention measures are discussed.
Hanson
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Department of Dermatology and Huntsman Cancer Institute, University of Utah Health Sciences Center, Salt Lake City 84112, USA.
Leachman
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D000014:Abnormalities, Drug-Induced / Q000209:etiology; D000152:Acne Vulgaris / Q000188:drug therapy* / Q000503:physiopathology; D002613:Cheilitis / Q000139:chemically induced; D003879:Dermatologic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D004347:Drug Interactions; D005128:Eye Diseases / Q000139:chemically induced; D006801:Humans; D015474:Isotretinoin / Q000009:adverse effects* / Q000627:therapeutic use; D008111:Liver Function Tests; D001523:Mental Disorders / Q000139:chemically induced; D009061:Mouth Mucosa; D009140:Musculoskeletal Diseases / Q000139:chemically induced
D003879:Dermatologic Agents; D015474:Isotretinoin