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Clinical Teaching

• Patients who can become pregnant must use 2 reliable forms of contraception for 1 month before therapy, during therapy, and for 1 month after therapy. Regular pregnancy tests are also required, as serious adverse fetal effects have been reported.
• Advise patient to not donate blood during therapy and for at least 1 month after discontinuation.
• Advise patient to use sunscreen and avoid sun and ultraviolet light.
• Advise patient to avoid wax epilation or skin resurfacing procedures (eg, dermabrasion laser) during treatment and for at least 6 months after discontinuation, as this may cause scarring.
• Instruct patient to avoid driving or other activities requiring clear vision until drug effects are realized as drug may cause decreased visual acuity, especially at night.
• Side effects may include cheilitis, dry skin, pruritus, arthralgia, back pain, epistaxis, headache, dizziness, or hearing loss.
• Instruct patient to report depression, suicidal ideation, or unusual changes in behavior.
• Advise patient to report symptoms of pseudotumor cerebri, hepatic dysfunction, pancreatitis, tinnitus, inflammatory bowel disease, or serious dermatologic reactions.
• Instruct patient to take drug with food and to swallow capsules whole with a full glass of liquid.
• Instruct patient to avoid additional vitamin A supplementation during drug therapy, as this may increase the risk of toxicity.