Strenuous exercise with isotretinoin

Campo, Danilo V. Del

doi:10.1016/s0190-9622(84)80514-9

Cited by 7 publications

(3 citation statements)

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“…While two cases had notable additional factors (e.g. intense daily exercise training and attempted suicide) that potentially contributed to the CK elevations, there were no notable instigating factors in the third case . Of note, in that final case, the patient's CK of 11,053 IU/l began to normalize (CK 434 IU/l) within 6 days of discontinuation of isotretinoin…”

Section: Introductionmentioning

confidence: 82%

“…A majority of the case reports noted that elevated creatine kinase levels occurred in the setting of concurrent exercise/activity or had an additional instigator (i.e. ischemia, inherited myopathy) . Theoretically, the litany of elevated CK etiologies may also serve as second‐hit factors, though such events have yet to be reported (Table ) .…”

Section: Discussionmentioning

confidence: 99%

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The creatine kinase conundrum: a reappraisal of the association of isotretinoin, creatine kinase, and rhabdomyolysis

Marson

Baldwin

2019

Int J Dermatology

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Background Isotretinoin has been reported to elevate creatine kinase, which may lead to fatal rhabdomyolysis.Objective To review the literature and propose practice guidelines for management of elevated creatine kinase during isotretinoin therapy.Findings Patients have intrinsic and extrinsic qualities that may synergistically work with isotretinoin to elevate serum creatine kinase. Darker skin types and males on isotretinoin are more likely to have elevated creatine kinase. Isotretinoin may induce oxidative stress within muscle tissue, thereby leading to elevations in serum creatine kinase.Conclusion Evidence supports a tenuous correlation between isotretinoin, elevated creatine kinase, and exercise. Physicians should consider obtaining baseline creatine kinase on elite athletes and counseling patients on risk factors that may elevate creatine kinase. However, the potential for elevated CK is not a contraindication for isotretinoin therapy. Capsule Summary• Since 1982 there have been multiple reports of patients who had elevated creatine kinase levels during their course of isotretinoin, mostly with concurrent exercise.• Physicians should consider obtaining baseline creatine kinase in elite athletes and counseling patients that vigorous exercise and male gender are associated with elevated creatine kinase.

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Section: Introductionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

The creatine kinase conundrum: a reappraisal of the association of isotretinoin, creatine kinase, and rhabdomyolysis

Marson

Baldwin

2019

Int J Dermatology

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“…In the majority of cases, the abnormal CPK levels were increased two to four times the normal values 6–10 . Usually, they were found incidentally on routine blood tests because most patients were free of muscle symptoms 1–4,7,9,11 . Many of these patients had a recent history of strainful exercise or an intramuscular injection, and the elevation of CPK was not firmly established as directly resulting from this treatment 12 .…”

Section: Introductionmentioning

confidence: 99%

Creatine phosphokinase values during isotretinoin treatment for acne

Kaymak¹

2008

Int J Dermatology

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Side Effects and Long-term Toxicity of Synthetic Retinoids

Yob

Pochi²

1987

Arch Dermatol

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The observation that vitamin A (retinol) has antikeratinizing properties has led to the development of synthetic retinol derivatives (retinoids) for the treatment of a variety of skin disorders characterized by abnormal keratinization. The goal of research in this area is the synthesis of retinoids that would have a more favorable therapeutic: toxic ratio than retinol itself. A limiting factor in the use of any vitamin A analogue is that, even with a more favorable therapeutic: toxic ratio, large pharmacologic doses are required that produce side effects related to the drug's action in most individuals. With few exceptions, all of the side effects are those seen from mega-vitamin A ingestion, primarily affecting the mucocutaneous, skeletal, and central nervous systems. Most of the side effects from excess vitamin A are reversible, with notable exceptions being those involving hepatic and osseous tissues. In terms of reversibility from synthetic retinoids, the experience to date has been incomplete, so there remains imprecise information as to the incidence and the persistence of toxic effects after drug withdrawal.

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Strenuous exercise with isotretinoin

Cited by 7 publications

References 0 publications

The creatine kinase conundrum: a reappraisal of the association of isotretinoin, creatine kinase, and rhabdomyolysis

The creatine kinase conundrum: a reappraisal of the association of isotretinoin, creatine kinase, and rhabdomyolysis

Creatine phosphokinase values during isotretinoin treatment for acne

Side Effects and Long-term Toxicity of Synthetic Retinoids

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