Isotretinoin
Brand: Absorica, Claravis
Boxed warning · ISMP high-alert drug
Life-threatening birth defects with even one dose in pregnancy; dispensed only through the iPLEDGE REMS.
- Caution
- Depression and suicidal thoughts, raised triglycerides and liver enzymes, and pseudotumor cerebri (especially with tetracyclines).
- Storage
- Protect from light; keep in the original blister packaging.
- Pregnancy
- Avoid: teratogenic (REMS/iPLEDGE); two forms of contraception and monthly pregnancy tests are required.
Common side effects
- Severe dry skin and lips
- Dry eyes
- Elevated triglycerides
- Mood changes
Key interactions
- Do not combine with tetracyclines: raised intracranial pressure risk
- Vitamin A supplements add toxicity
- Alcohol raises triglycerides
Counseling points
- Dispensed only through the iPLEDGE REMS: registration, pregnancy testing, and two forms of contraception
- Maximum 30-day supply with no refills
- Do not donate blood during therapy and for a month after
- Report mood changes or severe headache with vision change
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