Isotretinoin

From dermwiki

Monitoring

Baseline alanine aminotransferase (ALT) and triglycerides should be obtained at baseline and once peak dosing is achieved.

Triglycerides 300–500 mg/dL: Recommend lifestyle modification, including increased physical activity, weight reduction, and a low-carbohydrate, low-fat diet.

Triglycerides >500 mg/dL: Consider isotretinoin dose reduction in addition to dietary modification. Persistent elevation despite intervention: Initiate lipid-lowering therapy.

Triglycerides >800–1000 mg/dL: Hold isotretinoin therapy due to increased risk of medication-induced pancreatitis until triglyceride levels are adequately controlled (A).