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The side effects of isotretinoin, whether at 20 mg or 40 mg, are similar. However, a higher dosage, such as 40 mg, might increase the severity of side effects and the risk of experiencing them. Here are some common side effects associated with isotretinoin, regardless of dosage: Dry Skin and Lips: Isotretinoin is known to cause dry, peeling skin and chapped lips. Dry Eyes: Some people experience dry eyes, which can be alleviated with artificial tears. Mild Nosebleeds: Dry nasal passages can lead to occasional nosebleeds. Muscle and Joint Pain: Muscular and joint discomfort can occur. Increased Sensitivity to Sun: Skin may become more sensitive to sunlight, making you prone to sunburn. Mood Changes: In some cases, mood changes, including depression, have been reported. Elevated Cholesterol and Triglycerides: Isotretinoin can increase cholesterol and triglyceride levels. Liver Enzyme Elevations: Liver enzyme levels may rise in some individuals taking isotretinoin. Birth Defects: Isotretinoin is highly teratogenic, meaning it can cause severe birth defects. Women of childbearing age must use highly effective contraception or abstain from sexual intercourse. A higher dosage might increase the intensity of these side effects. It's crucial for anyone taking isotretinoin, especially at the isotretinoin 40 mg dosage, to have regular check-ups and blood tests to monitor side effects and adjust treatment as needed. Your healthcare provider will guide you on the dosage that's best for your specific situation while considering the potential risks and benefits. Always follow your healthcare provider's recommendations and report any side effects promptly.