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Regular testing when using isotretinoin possibly overdone

This expert opinion study used a Delphi Study.1 Consensus was achieved for the following:

"Check within a month prior to initiation and at peak dose but not monthly or after treatment completion (unless abnormalities): alanine aminotransferase and triglycerides.

Do not check complete blood cell count or basic metabolic panel parameters at any point during isotretinoin treatment.

Do not check other liver tests or lipid tests, or C-reactive protein. No doses were specified.” 

A systematic review on actual lab tests found that even with 40 mg or more per day, there were few laboratory abnormalities.2

Most NZ primary care clinicians rarely go above 10 mg per day.

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