Summary
Highlights
Isotretinoin, a vitamin A derivative, is prescribed for severe acne unresponsive to other treatments. It carries significant adverse effects, with the two most critical being birth defects and suicide risk. These are frequently tested on nursing exams like the NCLEX.
Preventing pregnancy is paramount due to severe birth defects. Patients must use two forms of contraception, undergo two negative pregnancy tests before starting therapy, and a negative test before every refill. Contraception is required one month before, during, and one month after therapy. Female patients must sign an 'iPLEDGE' form. Blood donation is also prohibited to prevent harm to pregnant recipients.
Patients must report any depressed mood or suicidal thoughts. Other side effects include dry and fragile skin, cutaneous atrophy (requiring sun avoidance), and dry eyes (potentially affecting contact lens wear). There's also an increased risk of intracranial pressure, so tetracyclines should be avoided. However, contraception and suicide risk remain the highest priorities.