1. Acne exacerbation: Temporary exacerbation of acne may occur in the first month of treatment, especially in patients with severe disease, significant acne may require adjustment of treatment. For mild acne, no treatment adjustment is necessary.
2. Skin and mucous membranes: Dry skin and mucous membranes are common during treatment. Especially cheilitis. This can be done with a generous amount of topical emollient, such as petroleum jelly or another lip moisturizer.
Patients with crusted or dry nasal cavity or epistaxis may choose to use saline nasal spray and petroleum jelly to smear the nostrils to improve symptoms. Artificial tears may help relieve symptoms of dry eyes. Try not to wear contact lenses while taking this medicine.
Patients should take sun protection measures to reduce the effects of Isotretinoina Valeant-induced photosensitivity. Patients should use sunscreen with a sun protection factor (SPF) of at least 30 daily and wear protective clothing during sun exposure. Sunscreen should be applied to exposed skin areas before sun exposure and reapplied every two to three hours.
3. Myalgia: Although checking creatine kinase (CK) levels is not recommended in the absence of severe muscle pain, approximately 15% to 50% of patients with isotretinoin-induced myalgia have elevated CK levels. Mild to moderate pain can usually be controlled with anti-inflammatory drugs. Isotretinoin should be discontinued if pain becomes severe or does not improve with anti-inflammatory medications.
4. Laboratory abnormalities—Hypertriglyceridemia, elevated liver transaminases, and elevated CK are common laboratory abnormalities during isotretinoin treatment.
Mildly or moderately elevated triglyceride levels (300 to 500 mg/dL) do not require changes in isotretinoin dosage and can be managed with lifestyle changes.
Triglyceride levels between 500 and 800 mg/dL require additional intervention, such as reducing the dose of isotretinoin and/or adding lipid-lowering agents.
Severe hypertriglyceridemia (eg, above 800 mg/dL) may require discontinuation of isotretinoin treatment
② Elevated liver transaminases:
Mild, transient elevations in liver transaminases occur early in treatment in approximately 15% to 20% of patients; levels usually return to normal within a few weeks. If liver transaminase levels reach more than three times normal, it is recommended to discontinue Isotretinoina Valeant
Despite efforts to minimize the risk of pregnancy during treatment with Isotretinoina Valeant, isotretinoin should be discontinued immediately if pregnancy occurs during treatment. Pregnant patients should be referred for management and counseling to an obstetrician experienced in reproductive toxicity.
Management of other extracutaneous adverse reactions of isotretinoin (eg, psychoactive effects, severe ocular symptoms) may require consultation with appropriate specialists to determine the best course of action for the individual patient.
Patients with signs and symptoms suggestive of pseudotumor cerebri (eg, headache with new-onset vision changes) require specialist evaluation and Isotretinoina Valeant should be discontinued.