Headaches occur with a frequency of about 16 per cent and often require no treatment; when appropriate they may need paracetamol. Headaches in conjuction with impaired concentration and blurred vision may herald the development of benign intracranial hypertension, the result of pseudo tumour cerebri.
In the presence of this complication (the incidence of which is around 0.5 per cent) the drug must be discontinued. Fortunately, however, as with other isotretinoin side-effects (except for the teratogenicity issue), the symptomatology disappears within a few days..
In most patients, the drug can be reinstituted at half the dose that was given originally and slowly increased. To date it has been possible to return most patients to the maximum dose required optimally to control the acne. God into the female: she is asked to sign a consent form indicating that she is not and must not become pregnant when on the drug and for a month afterwards.
Furthermore, she is persuaded to sign that, should pregnancy occur, then she would agree to an abortion..
In an attempt to prevent an isotretinoin disaster many months or even years after stopping therapy, the patient is asked to return any unused drug at the end of treatment. This avoids any temptation, some years later, to take the left-over drug, forgetting that it is teratogenic.
The teratogenic risk is of the order of 30-40 per cent. The main damage is to the heart, brain and the ear.
Home : Headaches