Which of the following is a potential risk associated with isotretinoin therapy?

• A. Seizures
• B. Hyperkalemia
• C. Liver toxicity
• D. Teratogenicity

Answer: (D)

Teratogenicity is the main risk with isotretinoin therapy. This potent retinoid can cause severe birth defects if a pregnancy occurs during treatment, affecting the brain, heart, face, and other organs, and can even lead to fetal loss. Because of this, isotretinoin is prescribed only under strict pregnancy prevention measures, including negative pregnancy tests before starting, use of reliable contraception, and ongoing monitoring throughout therapy. While liver toxicity and lipid elevations can occur and should be watched for, they do not define the key safety concern in the same way that the risk to a developing fetus does. Seizures are not a typical major risk associated with this drug.