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Isotretinoin is a medication with several important safety warnings and precautions that you should be aware of. Please review the following information carefully and consult your healthcare provider if you have any concerns:

• Pregnancy Risks: Women who are pregnant must not use isotretinoin due to the risk of serious birth defects, miscarriages, and premature births. Women who can become pregnant should use two reliable forms of contraception or abstain from sexual intercourse for one month before, during, and one month after treatment. Monthly pregnancy tests and pregnancy-avoidance counseling are necessary. Do not use minipills as they may be less effective with isotretinoin. In the U.S., participation in the REMS or iPLEDGE program is required. Consult your doctor for specific requirements in other countries.

• Mental Health: Isotretinoin may cause depression, hallucinations, aggressive behavior, and suicidal thoughts. If you or someone around you notices mood changes, especially when starting or changing the dose, contact your healthcare provider immediately. Those with a history of mental health issues should be particularly cautious.

• Increased Brain Pressure: This medication can increase brain pressure, potentially leading to permanent vision loss or death. Avoid combining isotretinoin with tetracycline antibiotics. Emergency medical attention is required if you experience severe headaches, blurred vision, dizziness, nausea, seizures, or stroke symptoms.

• Severe Skin Reactions: There is a risk of life-threatening skin conditions like Stevens-Johnson syndrome. Seek emergency care if you develop a severe blistering rash, high fever, or difficulty breathing.

• Pancreatitis: Isotretinoin can cause inflammation of the pancreas. If you experience severe upper stomach pain, swelling, nausea, vomiting, or fever, contact your healthcare provider immediately.

• High Cholesterol and Triglycerides: Regular blood tests may be necessary to monitor cholesterol and triglyceride levels. If these levels become too high, isotretinoin may need to be discontinued. Risk factors include diabetes, larger body size, and regular alcohol consumption.

• Hearing Issues: Stop the medication and consult your healthcare provider if you experience hearing loss or ringing in the ears, as this may be permanent.

• Liver Health: Isotretinoin can cause liver inflammation. Your healthcare provider should monitor your liver function through lab tests. Symptoms of liver problems include yellowing of the skin or eyes, right-sided stomach pain, dark urine, and unusual bleeding or bruising.

• Inflammatory Bowel Disease: Rarely, isotretinoin may cause new onset inflammatory bowel disease. Discontinue use and seek medical advice if you experience stomach pain, rectal bleeding, or severe diarrhea.

• Bone and Muscle Health: The medication can lead to muscle weakness, joint pain, and bone fractures, especially in older adults or those with pre-existing bone conditions. Discuss preventative measures with your healthcare provider.

• Eye Concerns: Isotretinoin may worsen vision or cause dry eyes. Avoid driving at night until you understand how the medication affects you. If vision changes occur, discontinue use and have an eye exam promptly.

• Contraindications: Do not use isotretinoin if you are pregnant, as this poses serious health risks.

Always discuss the risks and benefits of isotretinoin with your healthcare provider to ensure it is safe for your individual circumstances.

When taking this medication, you might experience some common side effects, which are usually mild. These include dry skin, dry or chapped lips, dry eyes, blurry vision, nosebleeds, headaches, and cold-like symptoms. Some people may notice worsening acne at the start of treatment, along with minor swelling of the eyelids, lips, or crusty skin. Back or joint pain and thinning hair are also possible but generally not severe. If these effects persist or worsen, consult your healthcare provider.

There are other side effects that might occur, such as tiredness, changes in weight or appetite, and changes in heartbeat. Ringing in the ears and hair loss have also been reported. Although these side effects can be concerning, they are less common and should be discussed with your healthcare provider if they arise.

More serious side effects, though rare, require immediate medical attention. These include mental health changes like depression or suicidal thoughts, severe headaches, vision changes, or hearing loss. Severe allergic reactions, indicated by rash, itching, or difficulty breathing, also necessitate urgent care. This medication can rarely lead to pancreatitis, liver damage, or serious skin reactions. Symptoms such as severe stomach pain, yellowing of the eyes or skin, dark urine, or painful swallowing should prompt you to seek immediate medical help. Always consult your healthcare provider about any unusual or severe symptoms while on this medication.

Isotretinoin can interact with various medications and supplements, so it's important to inform your doctor and pharmacist about everything you're taking, including prescription drugs, over-the-counter medications, vitamins, and herbal supplements.

Interactions may occur with antibiotics like tetracyclines (such as Minocycline, tetracycline, doxycycline), which can affect isotretinoin's efficacy. Similarly, vitamin A-type drugs (such as Acitretin and Bexarotene), as well as vitamin A supplements, should be used cautiously, as they can increase the risk of side effects. Drugs that can lead to bone loss, including certain anti-seizure medications like Phenytoin and corticosteroids like Prednisone, may also interact with isotretinoin.

Additionally, isotretinoin can interact with various types of hormonal contraceptives, such as those containing Ethinyl Estradiol, levonorgestrel, and other similar components. These interactions can potentially reduce the effectiveness of your birth control, so you might need to use additional contraceptive methods. If you notice any unexpected bleeding or spotting, contact your doctor, as this could indicate that your birth control is not functioning properly. Always discuss with your healthcare provider before starting or adjusting any medication.