How do you approach use of Doxy PEP in a patient taking isotretinoin, as both drugs are (rarely) associated with pseudotumor cerebri, which is very uncommon in clinical practice?

Pseudotumor cerebri (IIH) is a devastating problem. I have seen a number of cases, usually neurosurgical shunt infections, over the years. These patients often have persistent headaches and may require VP shunting over and over again. Since doxy is sometime implicated in IIH (and has other side effe...

I do not use doxycycline in almost all circumstances if a patient is on isotretinoin. That would certainly include using it as post-exposure prophylaxis (PEP). An exception to this combination would be treating a life-threatening disease such as Rocky Mountain spotted fever. Of course, a health care...