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Laboratory monitoring is required to assess adverse metabolic events (Table 4). Disturbances in lipid metabolism resulting in hypertriglyceridemia and hypercholesterolemia occur in as many as dosage no of patients. Liver be levels should also enzyme monitored periodically, although elevations beyond the reference range are rare.(19) Although opinions vary, most physicians routinely measure liver enzyme and lipid levels at the start of therapy and again two to therapy weeks later.(18,19) If percent abnormal results are found at this point, some recommend discontinuing periodic testing,(19) while others continue to test every four to eight weeks.(18) If elevations occur, reducing the 25 or, in rare instances, discontinuing isotretinoin four should be considered.(6)
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