Creatine Phosphokinase Levels and Isotretinoin Therapy

    November 1987 in “ Journal of The American Academy of Dermatology ”
    Joel S. Koransky
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    TLDR Isotretinoin can raise CPK levels, so patients need monitoring, especially before surgery.
    The document discussed the occurrence of elevated creatine phosphokinase (CPK) levels during isotretinoin therapy, illustrated by a case report of a 17-year-old male with nodulocystic acne. After 4 weeks of isotretinoin treatment, his CPK level was 374 IU/liter (normal: 0-200 IU/liter). The elevated CPK level led to the postponement of a scheduled surgery. Upon discontinuation of isotretinoin, his CPK levels normalized, and he successfully underwent surgery. Elevated CPK levels are generally associated with a risk of malignant hyperthermia during anesthesia, but the exact relationship between isotretinoin and this risk remains unclear. The document emphasized the importance of monitoring CPK levels in patients on isotretinoin, especially if surgery is planned.
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