The drug should be prescribed only by doctors, preferably dermatologists with experience in the use of systemic retinoids and who are aware of the risk of teratogenicity of the drug. Patients, both female and male, must provide a copy of the brochure with information for the patient.In order to avoid accidental exposure of the drug to the body of other people, in patients who receive or shortly before they received the drug, you can not take donor blood during the course of treatment with the drug and 1 month after the end of treatment.
It is recommended to monitor liver function and hepatic enzymes before treatment, 1 month after its onset, and then every 3 months or according to indications. There was a transient and reversible increase in hepatic transaminases, in most cases within normal values. If the activity of hepatic transaminases exceeds the norm, it is necessary to reduce the dose of the drug or to cancel it.
The concentration of serum lipids in the serum should be determined before the treatment, 1 month after the start, and then every 3 months or according to the indications. Usually lipid concentrations are normalized after dose reduction or drug withdrawal, as well as dieting. It is necessary to monitor a clinically significant increase in triglyceride concentration, since their elevation above 800 mg / dL or 9 mmol / l may be accompanied by the development of acute pancreatitis, possibly fatal. With persistent hypertriglyceridemia or symptoms of pancreatitis, the drug should be discontinued.
In rare cases, at the beginning of therapy, there is an exacerbation of acne, which occurs within 7-10 days without correction of the dose of the drug.
Patients receiving the drug are recommended to use moisturizing ointment or body cream, lip balm to reduce dry skin and mucous membranes at the beginning of therapy.
Since some patients may experience a reduction in the severity of twilight vision, which sometimes persists after the end of therapy, patients should be informed about the possibility of this condition, recommending them to use caution when driving a car at night. The state of visual acuity needs to be carefully monitored.
Limit the effects of sunlight and ultraviolet rays. If necessary, use a sunscreen with a high protective factor of at least 15 SPF (sun protection factor).
Rare cases of development of benign intracranial hypertension ("pseudocarcinoma of the brain") are described, including. when combined with tetracyclines. Such patients should immediately cancel the drug.
The presence of drugs in the environment should be minimized.
Impact on the ability to drive vehicles and work with machines and mechanisms.
During the period of treatment, extreme care must be taken when driving vehicles, especially at night, and engaging in other potentially hazardous activities requiring increased attention and speed of psychomotor reactions.