Should I stop accutane due to elevated liver enzyme levels?

Question

female, 24 My dermatologist put me on accutane 4 months ago, i should mention that im also on keppra 500 mg and topamax 50 mg, i started my first month with 40 mg a day, then dropped to 20 mg a day the following months, my blood tests seemed fine except for my last one i did yesterday, my ALT level went up to a 113 U/L, i went to see my doctor and she stopped the accutane immediately, my face is not where i want it to be, should i really be worried and stop or should i continue my accutane treatment :(?

Michael A. Greenberg, MD · Answer

The first question is how are you going to continue if your doctor thinks it unsafe and has stopped you?We see elevated enzymes and cholesterol all the time with Accutane.  It's not a disaster, nor is it necessarily the end of the treatment.  I send my patients to their internists for an evaluation and repeat tests after a few weeks.  Often, with the OK from their primary care doctor, the treatment can be continued at a lower dose with careful monitoring of enzymes.And, I always like to look at the "worst case scenario."   If you absolutely cannot have more Accutane because it would be dangerous, you did get some improvement before the plug was pulled.  A little bit of something is much better than a lot of nothing.   I'm glad that your enzymes were tested and caught.   Your life and general health comes before clearing your acne, which is probably not very comforting at this point, but is the truth.

Alim R. Devani, MD, FRCPC · Answer

Thanks for your question. This is a question that we
get asked often by our patients. Your enzymes are 2.5 times upper limit of normal and I would stop right away. As you are on other meds, this is likely contributing to your mild tranaminitis and you don't want this to get worse. Your liver will recover fully but you should avoid accutane in the future.

Should I stop accutane due to elevated liver enzyme levels?

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Should I stop accutane due to elevated liver enzyme levels?

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Everything you need to know about Accutane

Our mission is to create a world where every investment in modern beauty is Worth It.