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At a glance Drug / isotretinoin (Accutane), oral retinoid for severe nodular acne Supplement / green tea extract (GTE), standardized to EGCG (epigallocatechin gallate) Primary concern / additive hepatotoxicity at GTE doses 400 mg EGCG/day Secondary concern / CYP1A2 and CYP3A4 modulation may shift isotretinoin metabolism Dietary green tea risk / low, typical brewed cup contains 50 to 100 mg EGCG Monitoring required / LFTs (ALT, AST) at baseline and weeks 4, 8 per iPLEDGE protocol FDA DILI signal / GTE linked to drug-induced liver injury in 29 case reports reviewed by NIH LiverTox Recommendation / avoid concentrated GTE supplements during isotretinoin

Native polyphenols, such as flavonoids, ellagitannins, phenolic acids, and lignans, are poorly absorbed in their original form and undergo substantial microbial biotransformation in the colon [149, 150]

1,2-Dibromoethane soil fumigation is used for the control of plant parasitic nematodes on high value crops

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