Check liver function before & 1 mth after the start of treatment & subsequently at 3-mthly intervals. Check serum lipids before & 1 mth after the start of treatment & also at the end of the 3-4 mth treatment period. Frequently check high risk patients (w/ diabetes, obesity, alcoholism or lipid metabolism disturbances). Not to be used w/ any medicine known to enhance liver metabolism or interfere w/ enterohepatic circulation. Discontinue use if uncontrolled hypertriglyceridaemia or symptoms of pancreatitis occur. Monitor for development of keratitis particularly in patients w/ dry eyes. Supplementary treatment w/ tetracyclines is contraindicated due to rare cases of benign intracranial HTN. Myalgia & arthralgia may occur & may be associated w/ reduced tolerance to vigorous exercise. Hyperostosis (w/ higher doses & long-term administration). Avoid aggressive dermabrasion for a period of 5-6 mth after treatment; wax epilation during therapy & at least for a period of 6 mth thereafter. Inflammatory bowel disease (including regional ileitis) in patients w/o a prior history of intestinal disorders. Immediately discontinue use if patients experience severe (haemorrhagic) diarrhoea. Psychiatric disorders (eg, depression, depression aggravated, anxiety, aggressive tendencies, mood alterations, psychotic symptoms, & very rarely, suicidal ideation, suicide attempts & suicide). Patients w/ a history of depression; monitor for signs of depression. Concurrent administration of other keratolytic or exfoliative anti-acne prep; radiation therapy w/ UV light. Avoid sun exposure. Decreased night vision during therapy & rarely persisted after discontinuation; patients driving or operating any vehicle at night. Carefully monitor visual problems. Male patients must not share their medication w/ anyone, particularly females. Blood donation to women of childbearing age by patients being or recently treated (1-2 wks) w/ isotretinoin is contraindicated. Not to be given to nursing mothers. Childn <12 yr.
Avoid concurrent therapy w/ vit A. Combination w/ tetracyclines is contraindicated due to increase in intracranial pressure. Concurrent administration of other keratolytic or exfoliative anti-acne prep; radiation therapy w/ UV light.
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