Brief Answer:
Doxycycline and Isotretinoin cannot be combined

Detailed Answer:
Hello. Thank you for writing to us

I have gone through your query and I have also reviewed the attachment.

You prescription contains the following active ingredients in the order that you mention:

-Oral Isotretinoin
-Oral Doxycycline
-Adapalene+clindamycin gel
-Body wash
-Face wash
-A multivitamin.

Oral isotretinoin is one of the most effective antiacne drug and the modes of its action is that it is sebostatic i.e decreases sebum production as well as it is antiinflammatory and comedolytic.
Oral doxycycline is an effective antiacne antibiotic. It is mainly prescribed for inflammatory acne i.e acne that it red, painful and pustular.
However doxycycline should never be combined with Oral Isotretinoin because together they can cause pseudotumor cerebri which manifest as headache and blurred vision.
If an Oral antibiotic need to be given along with Oral Isotretinoin, Azithromycin is preferred as it is devoid of this side effect.


Adapalene+clindamycin topical gel is an effective topical antiacne preparation.
It is quite normal to develop new acne early on during treatment with adapalene because previously unseen lesions/ deeper lesions come up to surface.
This flare up usually subsides with continued treatment and is not an indication for discontinuing with topical adapalene.

Besides these you have advised face wash and body wash and I don't see any issues with that.

You have also been prescribed a multivitamin which is probably because you will be taking antibiotics.

Therefore, the only thing that needs to be changed is that doxycycline cannot be given with Isotretinoin and therefore doxycycline should be replaced with azithromycin.
You can discuss about this with your treating doctor.

Regards

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Brief Answer:
Liver function test & lipid profile is routine before starting Isotretinoin

Detailed Answer:
Hi.

Liver function tests (Serum Bilirubin, SGOT, SGPT, ALP) & Serum Lipid profile (Total cholesterol and Triglyceride levels) are routinely done before starting Oral Iostretinoin and should be repeated again after 2-4 weeks to look for any changes.

Isotretinoin usually causes some rise in these levels and if the levels are already high prior to starting Isotretinoin then they need to be controlled first before starting on Isotretinoin.
Repeating these tests after 2-4 weeks of Isotretinoin is to ensure that the rise in levels is not too high.

Kidney function tests (Blood urea, Serum creatinine and uric acid levels) and Serum Calcium are not absolutely necessary but it depends on the treating doctor, if he or she wants to do it.

Regards

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