Laboratory Monitoring

In addition to the laboratory tests that need to be performed to ensure that a woman is not pregnant, both men and women must get additional laboratory studies. A complete blood count, liver function test, and a lipid profile is checked at baseline and four weeks after starting isotretinoin. Elevated triglyceride levels occur in about 25-45% of patients (107). Those who have increased cholesterol during therapy often had elevated baseline cholesterol (108). Elevated liver function enzymes are also possible during isotretinoin but rarely does frank hepatitis develop. This elevation is reversible with discontinuation of isotretinoin. Other reversible changes during isotretinoin therapy include: leukopenia, thrombocytopenia, thrombocytosis, and an elevated erythrocyte sedimentation rate.