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Tuesday, October 18, 2022
Accutane and hip pain. Analysis of musculoskeletal side effects of oral Isotretinoin treatment: a cross-sectional study
Accutane and hip pain.A patient with chronic sacroiliitis undiagnosed for three years after isotretinoin use
The pain in her back and right buttock sometimes also radiated to the thighs. Her back pain increased with rest and decreased with activity. She also had no history of infection that could cause reactive arthritis, psoriasis, uveitis, conjunctivitis or peripheral arthritis inconsistent with ankylosing spondylitis, enteropathic arthropathies and psoriatic arthropathy. She had no family history of axial spondyloarthropathy.
On the physical examination, the range of lumbar flexion was limited and painful. It was found that the results of sacroiliac compression test and flexion-abduction-external rotation FABER test were positive for the right side.
There was no peripheral arthritis or enthesopathy finding. The examination of other systems was unremarkable. In the blood test, HLA-B27 and anti-nuclear antibody were negative. C-reactive protein was 4. Other rheumatologic tests and cell blood count were unremarkable. Magnetic resonance imaging MRI revealed the presence of bilateral chronic sacroiliitis Fig. Cortical irregularity, erosions and subchondral changes were observed on the iliac surfaces adjacent to the joint bilaterally, especially the right side.
There were oily changes in the opposite bone surfaces, more prominent at the right sacroiliac joint. No bone marrow edema was detected at the sacroiliac parts of the joints, consistent with chronic sacroiliitis. A home-based exercise program was added to the medical treatment. The patient was symptom-free after six months. Coronal T1 image of sacroiliac joints. Arrow shows irregularity and subchondral sclerosis at the right side.
More severe forms of acne such as acne conglobata and acne fulminans are associated with musculoskeletal syndromes; however, acne vulgaris has no relationship with musculoskeletal symptoms [ 3 ].
ISO is commonly used in the treatment of severe acne vulgaris. Sacroiliitis, enthesopathy, polyneuropathy, rhabdomyolysis, hyperostosis, and ligament calcification may also be seen, albeit rarely, due to ISO treatment.
Our patient had no history of a rheumatologic or metabolic disease. There are various studies on the prevalence of ISO-induced sacroiliitis. However, the authors did not evaluate HLA-B Another study included 42 patients using ISO and 32 patients using tetracycline for the treatment of acne vulgaris. There was unilateral sacroiliitis in only one patient in the ISO group 2.
No HLA-B27 positivity was observed in any patient in that study [ 6 ]. Sacroiliitis generally develops days or weeks after the beginning of ISO therapy. Sacroiliac pain may progress with mild or moderate acute phase elevation and findings of bone marrow edema in the sacroiliac joint on MRI.
It is typically self-limited and resolves within months after the cessation of the drug. Glucocorticosteroids and non-steroidal anti-inflammatory drugs NSAIDs are effective in improving the symptoms. The mechanism involved in sacroiliitis induced by ISO has not yet been clearly explained. It is considered that the detergent-like characteristic of ISO alters the structure of the liposomal membrane and induces hypersensitivity reactions on the synovial cells which then become sensitive to degeneration with minor or mild trauma.
This view is supported by cases of arthritis and sacroiliitis that develop during ISO therapy with an increase in exercise. Matrix metalloproteinases MMP , activated by inflammatory cytokines, are known to be the reason for the destruction of the extracellular matrix in rheumatoid arthritis. Retinol and retinoic acid can stimulate MMP-2 activity.
Since it is a derivative of retinoic acid, ISO activates MMP-2 activity and causes membrane damage in the joints [ 7 , 8 ].
In previous studies on sacroiliitis conducted with patients receiving ISO for acne vulgaris, researchers were not able to conclusively relate the condition to either ISO or acne [ 2 , 3 , 7 ]. SAPHO synovitis, acne, pustulosis, hyperostosis, osteitis syndrome is a rare inflammatory condition with pustular skin disorders and osteoarticular inflammation. The axial skeleton spine, sacroiliac joint and peripheral bones may also be involved in SAPHO syndrome. Therefore, systemic steroids or long-term combination therapy is required for a successful treatment [ 9 ].
Although SAPHO syndrome is classified among seronegative spondyloarthropathies, sacroiliitis is generally unilateral and accompanies hyperostosis, and its association with HLA-B27 is unknown [ 10 ].
It is possible that the use of synthetic retinoids may cause mesenchymal stem cell proliferation and differentiation to form osteoblasts in the entheses, leading to ossification, and prolonged retinoid therapy is associated with diffuse idiopathic skeletal hyperostosis [ 11 ].
The only exceptions to this requirement are if you have chosen not to have intercourse with a male abstinence or have had a hysterectomy surgery to remove your uterus. As you can see, there are many risks linked with isotretinoin use. If you have more questions about these side effects, talk with your doctor. Questions you may ask include:. Your doctor can help you decide if isotretinoin is the right drug for you. They can also help you manage any side effects you have. Isotretinoin belongs to a class of drugs called retinoids.
Less oil on your skin gives the acne-causing bacteria less to feed on. With fewer clogged pores, bacteria have fewer places to grow. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Accutane was the brand name of a drug for severe acne treatment called isotretinoin.
Understanding the risks and knowing the signs of common STDs is crucial for men who are sexually active. Learn how to spot the main symptoms. While some types of acne scarring are best treated by a dermatologist, others may benefit from over-the-counter topical products.
Ice therapy is routinely used for injuries. But can ice facials help reduce puffy eyes and acne? Learn more about its purported benefits and how to…. Nodules, pustules, whiteheads, and more. Here's what you need to care for it all. Differin Gel uses retinoid to clear up acne and scarring. Here's everything you need to know about the over-the-counter medication. Dairy, chocolate, gluten, and fried foods all get a bad rap for causing acne in adults and teens, but are the claims valid? This article breaks down 5….
Teenagers tend to experience breakouts and acne due to hormonal changes. There are treatments and skin care habits that can help. What can you do about acne scars? While the AAD suggest things like surgery and laser resurfacing, you might also find relief through less invasive…. While it may be tempting to pop your own pimple, experts recommend that you resist the urge. This medicine may affect blood sugar levels. If you or your child are diabetic and notice a change in the results of your blood or urine sugar tests, check with your doctor.
Pancreatitis may occur while you are using this medicine. Tell your doctor right away if you or your child have sudden and severe stomach pain, chills, constipation, nausea, vomiting, fever, or lightheadedness.
Isotretinoin may cause some people to have hearing problems within a few weeks after they start using it. Check with your doctor right away if you or your child have hearing loss, a continuing ringing or buzzing, or any other unexplained noise in the ears.
Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin.
These could be symptoms of a serious liver problem. Tell your doctor right away if you or your child have abdominal or stomach pain, rectal bleeding, or severe diarrhea. These may be symptoms of a serious condition called inflammatory bowel disease. This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, redness, soreness, or itching skin, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.
This reaction is more often seen in people who also have an allergy to aspirin. This medicine lowers the number of some types of blood cells in your body. Because of this, you or your child may bleed or get infections more easily. To help with these problems, avoid being near people who are sick or have infections. Wash your hands often. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Brush and floss your teeth gently.
Be careful when using sharp objects, including razors and fingernail clippers. Do not take other medicines without checking first with your doctor. This includes vitamins, herbal products, and prescription or nonprescription over-the-counter [OTC] medicines. Some medicines or nutritional supplements eg, St. John's wort may cause your birth control pills to not work as well. There is a problem with information submitted for this request. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID, plus expertise on managing health.
A detailed anamnesis was obtained and a careful dermatological and physical examination was performed by both of the specialists. It was queried that whether myalgia, arthralgia and low back pain occurred after starting isotretinoin treatment. Data were recorded on a standardized pre-prepared evaluation form.
The pain severity of the participants was evaluated by visual analog scale VAS based on a chart numbered from 0 no symptom to 10 maximum severity. According to GAGS, the body was divided into six regions -forehead, nose, each cheek, chin and back. In each region, each type of lesion is given a number: zero for no lesion, one for comedones, two for papules, three for pustules and four for nodules.
It was investigated that whether there was a enthesitis by a detailed clinical examination. The following entheses were examined for tenderness and swelling bilaterally: common extensor tendon insertion on the lateral epicondyle of the humerus, quadriceps tendon, patellar tendon, tibial tuberosity, knee medial collateral ligament, Achilles tendon, and plantar fascia insertion on the calcaneus [ 23 ].
If there was a swelling and erythema, it was considered as inflammatory enthesitis. The absence of swelling or erythema was considered to be mechanical enthesitis. The ASAS criteria consist of commencement under the age of 40, insidious onset, relief with exercise, no relief with rest and nocturnal pain improving with rising up from bed.
These 4 items are essential in diagnosing inflammatory low back pain. The various imaging modalities, including conventional radiography, computed tomography CT , magnetic resonance imaging MRI and bone scintigraphy are used for investigation of inflammatory changes at the sacroiliac joints.
In early and acute stages of sacroiliitis the diagnosis can be difficult because conventional radiographs may be normal. Inflammatory back pain is not a specific indicator of sacroiliitis. Therefore, there is need for valuable imaging methods. Scintigraphy lacks specificity. CT is a very good method for visualization of established bony destruction or ossification. MRI can identify both inflammation and structural changes, localise different degrees of inflammation and bone marrow edema, and differentiate a possible septic sacroiliitis.
MRI is the most sensitive and specific modality for sacroiliitis by directly imaging changes in the synovium, articular cartilage, and subchondral bone [ 26 , 27 , 28 ].
In our study, the patients meeting ASAS criteria for inflammatory back pain were evaluated in detail and requested both sacroiliac radiography and sacroiliac MRI. Sacroiliac MRI was performed on 1. At least 12 slices of coronal oblique T1-weighted turbo spin-echo and short tau inversion recovery STIR sequences of the sacroiliac joints were acquired.
This images were interpreted by the same reader who had received standardized training and were blinded with regard to the study groups. In addition, laboratory blood tests including rheumatoid factor RF , erythrocyte sedimentation rate ESR and c-reactive protein CRP values were requested. Anti-nuclear antibody ANA was ordered to rule out other connective tissue diseases.
Data were analyzed using SPSS software version The normality of the data was tested by Kolmogorov-Smirnov test. For the comparison of the paired groups, the independent samples t-test normal distribution and the Mann-Whitney U test non-normal distribution were used for the quantitative data.
Chi-squared test was used to evaluate whether there was a difference in terms of musculoskeletal symptoms between the study groups. This case-control study included 94 71 women, 23 men patients with acne vulgaris receiving isotretinoin and 74 women, 26 men age- and sex-matched controls. The age and sex distributions of the study and control groups are presented in Table 1. All of the tendinopathies were mechanical feature, swelling or erythema was not observed.
The flow chart of the participants was presented in Fig. The median duration of treatment was 3 min. There was a total of 66 patients The clinical characteristics of both isotretinoin group and healthy controls can be seen in Table 2. The median duration of treatment was 3 IQR: 3, min. The comparison of the patients who had musculoskeletal symptoms or not in isotretinoin group regarding as total cumulative dose of drug were given in Table 3.
The results of linear regression analysis between the age, sex, duration of treatment and cumulative dose of drug with musculoskeletal side effects were shown in Table 4.
The sacroiliac radiography was normal in all of the patients with inflammatory back pain. In sacroiliac MRI, sacroiliitis was observed in 11 Semicoronal short tau inversion recovery STIR images show hyperintense lesions arrows consistent with bone marrow edema in bilateral sacroiliac joints.
Semicoronal T1-weighted spin-echo image shows signal loss arrows in sacroiliac joints consistent with sacroiliitis. The patients who developed rheumatologic symptoms during isotretinoin usage were called to follow-ups by monthly. They were evaluated by a specialist and physical examination was performed at each time they came to control. VAS scores of the patients were also assessed at each follow-up.
In addition, routine biochemical blood tests were acquired from all of the patients in isotretinoin group. The patients who developed musculoskeletal symptoms such as mechanical back pain, arthralgia, myalgia or tendinopathy, except for sacroiliitis were initiated a nonsteroidal antiinflammatory drugs NSAID and continued a lower dose of isotretinoin. In patients who were diagnosed as sacroiliitis, the drug was discontinued immediately and a NSAID was prescribed.
We observed that the complaints of these patients were resolved within a month after cessation of the drug and VAS scores were also decreased dramatically. The symptoms were mostly disappeared by the third month. All the patients with sacroiliitis were completely symptom free at the sixth month of the discontinuation of the drug. Isotretinoin, or cis retinoic acid, is a vitamin A derivative used for severe recalcitrant acne since Although isotretinoin is a very effective drug, it may have many side effects.
It is essential that the clinician should be careful about the various side effects of the drug [ 30 ]. In this study, we focused on the musculoskeletal side effects of isotretinoin. Ninety-four patients treated with isotretinoin suffering from musculoskeletal pain were included. The patients were then examined in detail.
They were also compared with healthy controls. Isotretinoin has been associated with various musculoskeletal side effects in the recent literature. Some of these are original studies, while most of them are sporadic case reports [ 1 , 2 , 9 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ]. The onset of the musculoskeletal symptoms of the patients in these case reports was in the first few months. They have found myalgia in Acute sacroiliitis was determined in 8.
The authors concluded that the incidence of sacroiliitis in patients receiving isotretinoin is quite high [ 1 ]. In our study, the percentages of myalgia and sacroiliitis were similar to this study, however, the frequency of back pain was noticeably higher in isotretinoin group. This was one of the most important results of this study.
Other musculoskeletal side effects were not found to be statistically significantly related with the total cumulative dose of isotretinoin. The patients with low back pain using isotretinoin should be asked about the dosage and duration of their drug, and if necessary, the dose should be reduced. On the other hand, it is an interesting finding that sacroiliitis is not related with the total cumulative dose of the drug. In their study, Alkan et al.
Accutane is a brand-name version of the drug isotretinoin. The brand is no longer available in the United States. However, the generic version of isotretinoin and other brand-name versions, such as Absorica, are still available.
Isotretinoin is used to treat a type of severe acne called nodular acne. Nodular acne causes red, swollen, tender lumps to form in the skin. If untreated, nodular acne can lead to permanent scarring. While isotretinoin can help treat nodular acne, it can also cause many side effects. Some of these effects can be serious, especially if the drug is taken during pregnancy. These side effects may go away on their own. The more serious side effects of isotretinoin can have long-term or permanent effects.
However, apart from increased cholesterol and joint and muscle problems, these side effects are all quite rare. Isotretinoin can increase the levels of fats and cholesterol in your blood. During your treatment, your doctor may suggest regular blood tests to check your fat and cholesterol levels. This side effect, if you have it, typically goes away when you finish your treatment with isotretinoin. Learn more: What is metabolic syndrome?
Tell your doctor if you plan to do hard physical activity during treatment with isotretinoin. Isotretinoin can cause pain in your bones, joints, muscles, and ligaments. It can also stunt the growth of long bones in teens, which could have permanent effects.
If you have any of the following symptoms, call your doctor right away:. If you break a bone, be sure to tell all of the healthcare providers that care for you that you take isotretinoin.
If you have muscle weakness, with or without pain, stop taking isotretinoin and call your doctor right away. Muscle weakness can be a sign of serious muscle damage and could be a permanent effect. Rarely, isotretinoin can cause increased pressure on the brain. This can lead to permanent loss of eyesight and, in rare cases, death.
Stop taking isotretinoin and call your doctor right away if you have any of these symptoms:. Although rare, a rash caused by isotretinoin can be serious. Stop using isotretinoin and call your doctor right away if you have any of the following symptoms:. Isotretinoin can damage your internal organs. These organs include your liver, pancreas, intestines, and esophagus the tube connecting your mouth and stomach. The damage may not get better even after you stop taking isotretinoin.
This side effect is rare. Still, stop taking isotretinoin and call your doctor right away if you have any of the following symptoms:. Isotretinoin can cause serious hearing problems in rare cases.
Stop using isotretinoin and call your doctor right away if your hearing gets worse or if you have ringing in your ears. Any hearing loss may be permanent. Isotretinoin can cause vision problems such as blurry vision, double vision, and tunnel vision. This drug can also reduce your ability to see in the dark. Vision problems may fix themselves after you stop taking the drug or the damage may be permanent.
Isotretinoin can cause your eyes to produce more tears than normal. If you wear contact lenses, you may have trouble wearing them while taking isotretinoin. Like the other vision problems, this problem may go away after your stop treatment or it may be permanent. All of these vision and eye problems are rare. Nevertheless, stop taking isotretinoin and call your doctor right away if you have problems with your vision, an increased amount of tears, or painful or constant eye dryness.
Isotretinoin can cause serious allergic reactions in rare cases. Stop taking isotretinoin and call your doctor if you have a rash, red patches, or bruises on your legs or a fever. If you have any of the following symptoms, stop taking isotretinoin and call or go to the nearest emergency room:.
Isotretinoin may cause blood sugar problems, including diabetes. Call your doctor if you have any of the following symptoms:. Another rare, serious side effect is a decrease in blood cell levels. Low levels of red blood cells can cause problems such as anemia. Low levels of white blood cells raise your risk of infections. Rarely, isotretinoin can cause serious mental health problems. These include depression, psychosis losing touch with realityand suicidal thoughts or actions.
Taking isotretinoin during pregnancy carries an extremely high risk of severe birth defects. This is true if the drug is used in any amount and even for short periods of time. If you become pregnant during treatment with isotretinoin, stop taking the drug right away. A gynecologist can then give you further evaluation and counseling. Because of the risks it carries for pregnancies, isotretinoin can be prescribed only under a special restricted distribution program called iPLEDGE.
This program is approved by the Food and Drug Administration. Both males and females who take isotretinoin need to discuss this program with their doctor. Doctors who prescribe isotretinoin and pharmacies that dispense isotretinoin must be registered and activated with the iPLEDGE Program. The second pregnancy test must be done in a lab specified by your doctor.
The program also requires females to choose and agree to use two forms of effective birth control at the same time. This precaution goes along with the third requirement. That is, you must agree not to become pregnant while using isotretinoin and for one month before or after treatment. At least one of the birth control methods must be a primary form of birth control.
Examples of these forms are tubal ligation having your tubes tiedan IUD, and hormonal birth control. Another approach is for your partner to have a vasectomy. The only exceptions to this requirement are if you have chosen not to have intercourse with a male abstinence or have had a hysterectomy surgery to remove your uterus. As you can see, there are many risks linked with isotretinoin use. If you have more questions about these side effects, talk with your doctor.
Questions you may ask include:. Your doctor can help you decide if isotretinoin is the right drug for you. They can also help you manage any side effects you have.
Isotretinoin belongs to a class of drugs called retinoids. Less oil on your skin gives the acne-causing bacteria less to feed on. With fewer clogged pores, bacteria have fewer places to grow. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.
Accutane was the brand name of a drug for severe acne treatment called isotretinoin. Understanding the risks and knowing the signs of common STDs is crucial for men who are sexually active. Learn how to spot the main symptoms. While some types of acne scarring are best treated by a dermatologist, others may benefit from over-the-counter topical products. Ice therapy is routinely used for injuries.
But can ice facials help reduce puffy eyes and acne? Learn more about its purported benefits and how to…. Nodules, pustules, whiteheads, and more. Here's what you need to care for it all. Differin Gel uses retinoid to clear up acne and scarring. Here's everything you need to know about the over-the-counter medication. Dairy, chocolate, gluten, and fried foods all get a bad rap for causing acne in adults and teens, but are the claims valid? This article breaks down 5…. Teenagers tend to experience breakouts and acne due to hormonal changes.
There are treatments and skin care habits that can help. What can you do about acne scars? While the AAD suggest things like surgery and laser resurfacing, you might also find relief through less invasive…. While it may be tempting to pop your own pimple, experts recommend that you resist the urge.
How Well Do You Sleep? Skin Care. More common side effects Serious side effects Pregnancy warning Takeaway Introduction Accutane is a brand-name version of the drug isotretinoin.
Isotretinoin may cause bone or muscle problems, including joint pain, muscle pain or stiffness, or difficulty moving. Back pain and joint pain are common occurrences, and studies have shown an association between high doses or long courses of isotretinoin. phy. Three patients with low back and hip pain, and lumbar stiffness after using isotretinoin for acne fulminans were described. Our cases. Isotretinoin (ISO) is a synthetic vitamin A derivative which has been At one-month follow-up, low back and hip pain was relieved and. Arthralgia and myalgia have been reported in 2–5% of patients receiving oral isotretinoin > mg/kg/day [4]. Musculoskeletal pains and. Google Scholar Semira FS. All the patients with sacroiliitis were completely symptom free at the sixth month of the discontinuation of the drug. Pancreatitis may occur while you are using this medicine. Isotretinoin may cause dryness of the mouth and nose. The limited extent bone marrow edema of sacroiliac joints is quite unspecific and can occur in various conditions, not related to axial spondyloarthropathy. Data were recorded on a standardized pre-prepared evaluation form.Drug information provided by: IBM Micromedex. It is very important that your doctor check your or your child's progress at regular visits to make sure this medicine is working properly.
Blood tests may be needed to check for unwanted effects. Isotretinoin causes birth defects in humans if taken during pregnancy. If you suspect that you may have become pregnant, check with your doctor right away.
Using this medicine while you are pregnant can cause very serious birth defects. Use two forms of effective birth control to keep from getting pregnant 1 month before beginning treatment, while you are using this medicine even if the medicine is temporarily stopped , and for at least 1 month after you stop taking the medicine. The most effective forms of birth control are hormone birth control pills, patches, shots, vaginal rings, or implants, an IUD, or a vasectomy for men.
One of these forms of birth control should be combined with a condom, a diaphragm, or a cervical cap. Isotretinoin must not be taken by women of reproductive age who may become pregnant unless 2 effective forms of birth control have been used for at least 1 month before the start of treatment.
Contraception must be continued during the period of treatment, which is up to 20 weeks, and for 1 month after isotretinoin is stopped. Be sure that you have discussed this information with your doctor. If you are a woman who is able to have children, you must have 2 pregnancy tests before beginning treatment with isotretinoin to make sure you are not pregnant.
The second pregnancy test must be taken at least 19 days after the first test and during the first 5 days of the menstrual period immediately before beginning treatment. In addition, you must have a pregnancy test each month while you are using this medicine and 1 month after treatment is completed.
Do not take vitamin A or any vitamin supplement containing vitamin A while using this medicine, unless otherwise directed by your doctor. To do so may increase the chance of side effects. During the first 3 weeks you are taking isotretinoin, your skin may become irritated. Also, your acne may seem to get worse before it gets better.
Check with your doctor if your skin condition does not improve within 1 to 2 months after starting this medicine or at any time your skin irritation becomes severe. Full improvement continues after you stop using isotretinoin and may take up to 6 months. Your doctor can help you choose the right skin products to reduce skin dryness and irritation.
You or your child should not donate blood to a blood bank while using isotretinoin or for 30 days after you stop using it. This is to prevent a pregnant patient from receiving blood that contains the medicine. In some patients, isotretinoin may cause a decrease in night vision. This problem may occur suddenly.
If it does occur, do not drive or do anything else that could be dangerous until you know how this medicine affects you.
Also, check with your doctor. Isotretinoin may cause dryness of the eyes. If you or your child wear contact lenses, your eyes may be more sensitive to them during the time you are using isotretinoin and for up to 2 weeks after stopping it. To help relieve dryness of the eyes, check with your doctor about using a lubricating solution, such as artificial tears.
If eye inflammation occurs, check with your doctor right away. Isotretinoin may cause dryness of the mouth and nose. For temporary relief of mouth dryness, use sugarless candy or gum, melt bits of ice in your mouth, or use a saliva substitute. However, if dry mouth continues for more than 2 weeks, check with your medical doctor or dentist. Continuing dryness of the mouth may increase the chance of dental disease, including tooth decay, gum disease, and fungus infections. Avoid overexposing your skin to sunlight, wind, or cold weather.
Your skin will be more prone to sunburn, dryness, or irritation, especially during the first 2 or 3 weeks of treatment. However, you or your child should not stop using this medicine unless the skin irritation becomes too severe. Do not use a sunlamp or tanning beds.
To help isotretinoin to work properly, use sunscreen or sunblock lotions with a sun protection factor SPF of at least 15 on a regular basis. Also, wear protective clothing and hats. Isotretinoin may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you, your child, or your caregiver notice any of these side effects, check with you doctor right away.
This medicine may increase pressure in your head, which may lead to vision loss or serious brain problems. Check with your doctor right away if you have a bad headache, blurred vision, dizziness, nausea, vomiting, or seizures. Serious skin reactions can occur with this medicine. Check with your doctor right away if you or your child have any of the following symptoms while using this medicine: blistering, peeling, or loosening of the skin, chills, diarrhea, itching, joint or muscle pain, rash, red skin lesions, often with a purple center, sores, ulcers, or white spots in the mouth or on the lips, or unusual tiredness or weakness.
Isotretinoin may cause bone or muscle problems, including joint pain, muscle pain or stiffness, or difficulty moving. You may get hurt more easily during rough sports. You may also heal more slowly. If this medicine is for your child, tell the doctor if you think your child is not growing properly. It is very important that you or your child not use wax epilation to remove hair while you are taking isotretinoin and for 6 months after stopping it. Isotretinoin can increase your chance of scarring from wax epilation.
It is very important that you or your child not have any cosmetic procedures to smooth your skin eg, dermabrasion, laser while you are using isotretinoin and for 6 months after stopping it.
Isotretinoin can increase your chance of scarring from these procedures. This medicine may affect blood sugar levels. If you or your child are diabetic and notice a change in the results of your blood or urine sugar tests, check with your doctor. Pancreatitis may occur while you are using this medicine.
Tell your doctor right away if you or your child have sudden and severe stomach pain, chills, constipation, nausea, vomiting, fever, or lightheadedness.
Isotretinoin may cause some people to have hearing problems within a few weeks after they start using it. Check with your doctor right away if you or your child have hearing loss, a continuing ringing or buzzing, or any other unexplained noise in the ears. Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin.
These could be symptoms of a serious liver problem. Tell your doctor right away if you or your child have abdominal or stomach pain, rectal bleeding, or severe diarrhea. These may be symptoms of a serious condition called inflammatory bowel disease. This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, redness, soreness, or itching skin, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.
This reaction is more often seen in people who also have an allergy to aspirin. This medicine lowers the number of some types of blood cells in your body. Because of this, you or your child may bleed or get infections more easily. To help with these problems, avoid being near people who are sick or have infections.
Wash your hands often. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Brush and floss your teeth gently. Be careful when using sharp objects, including razors and fingernail clippers. Do not take other medicines without checking first with your doctor.
This includes vitamins, herbal products, and prescription or nonprescription over-the-counter [OTC] medicines. Some medicines or nutritional supplements eg, St. John's wort may cause your birth control pills to not work as well. There is a problem with information submitted for this request. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID, plus expertise on managing health.
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