title: Managing nonteratogenic adverse reactions to isotretinoin treatment for acne vulgaris.
abstract: Isotretinoin is the strongest, most effective oral treatment for patients with severe acne vulgaris, with remission rates of 89% and higher. Because of its potency, isotretinoin causes many adverse reactions. This article reviews common and severe adverse reactions to isotretinoin and how providers can best manage these reactions. Because of inconclusive research on the correlation between isotretinoin and depression and irritable bowel syndrome, providers should ask patients about symptoms monthly. Prescribing micronized isotretinoin and starting at the lowest dose with gradual upward titration also can help reduce the incidence of adverse reactions.
authors.affiliation: Bridget K. Reilly is a student in the PA program at the University of Nebraska Medical Center in Omaha, Neb. Tamara S. Ritsema is director of research in the PA program at the University of Nebraska Medical Center. The authors have disclosed no potential conflicts of interest, financial or otherwise.
authors.forename: Bridget K
authors.initials: BK
authors.lastname: Reilly
authors.forename: Tamara S
authors.initials: TS
authors.lastname: Ritsema
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy; D003863:Depression / Q000139:chemically induced; D003879:Dermatologic Agents / Q000009:adverse effects*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000139:chemically induced; D015474:Isotretinoin / Q000009:adverse effects*
chemical_list: D003879:Dermatologic Agents; D015474:Isotretinoin