Isotretinoin is a synthetic derivative of retinol (vitamin A) that has been approved to treat severe recalcitrant nodular acne. To my knowledge, there has been 1 reported case of atrial tachycardia linked to isotretinoin use1; herein, I report a second case of this linkage.
A 22-year-old man with nodular acne presented to our emergency department (ED) with symptomatic heart palpitations of 1 week's duration. He had undergone 2 complete courses of isotretinoin treatment without sequelae and was 3 weeks into his third course. Findings of a review of his systems were negative except for his feeling of his heart racing. His other medications included metronidazole, vitamin B complex (thiamine, riboflavin, niacin, pantothenic acid, pyridoxine, biotin, folic acid, and cobalamin), vitamin E (alfa-tocopherol), and fish oil, and he had no known drug allergies. His medical history was notable for depression that was in remission.
Dresden G. Atrial Tachycardia Associated With Isotretinoin Use. Arch Dermatol. 2007;143(8):1073-1087. doi:10.1001/archderm.143.8.1084