A mandatory laboratory package is required for the regular monitoring of patients taking isotretinoin (Roaccutane or similar medications) for the treatment of severe nodular acne. This package focuses on monitoring the most common side effects of the drug: liver effects, measured by assessing liver enzymes (ALT and AST), elevated blood triglyceride levels (hypertriglyceridemia), and kidney function (creatinine and urea nitrogen). These tests are performed before starting treatment and monthly during treatment, in accordance with international guidelines.