A patient with acne vulgaris is considering treatment with isotretinoin. Her acne has been refractory to oral antibiotics and topical washes. In addition to counseling regarding the teratogenic effects of this medication, which other side effect has been documented with isotretinoin for the treatment of acne vulgaris? (AIIMS Nov 2012)
1). Due to the well-known teratogenic effects of retinoic acid derivatives, all patients must be enrolled in a program designed to prevent pregnancy before initiation of a treatment regimen.
2). Moreover, negative pregnancy tests must be obtained prior to each prescription refill. In addition, patients with a personal or family history of hypertriglyceridemia or a personal history of diabetes should be cautioned about the risks of hypertriglyceridemia and poor glucose control.
3). Serum triglycerides should be followed during therapy.
4). Concerns regarding a link between isotretinoin use and developing depression have not been proven.
5). Tooth discoloration is a risk in children who receive tetracycline or related antibiotics. Wash out period of retinoits from fats is 1 months.