Isotretinoin - Accutane acne treatment and pregnancy

Accutane is one of several man-made drugs derived from vitamin A. The generic name for Accutane is isotretinoin. If Accutane is taken during pregnancy, it can cause Accutane embryopathy. Accutane embryopathy refers to the pattern of birth defects that may be caused in an embryo that is exposed to Accutane during pregnancy. Accutane-related birth defects typically include physical abnormalities of the face, ears, heart, and brain.

Accutane is in pregnancy category X. According to the Organization of Teratology Information Services (OTIS), approximately 25-35% of infants born to women exposed to Accutane during the first trimester of pregnancy showed a pattern of birth defects. This pattern includes craniofacial defects, heart defects, and central nervous system defects. There also is an increased risk of miscarriage and infant death associated with use of Accutane during pregnancy.

It is safe to use Accutane when you are not pregnant and have discussed certain guidelines with your health care provider:

* If you are in your childbearing years you must use two forms of birth control, beginning one month prior to starting Accutane through one month after stopping Accutane. If you are breastfeeding you should not take Accutane.
* You must be counseled about the possible ways that your chosen birth control may fail.
* You must have a negative pregnancy test one week prior to taking Accutane.
* You must start Accutane on the 2nd or 3rd day after the next normal menstrual period.

Before treatment with Accutane:

* Have two negative pregnancy tests, including one right before starting the drug
* Sign a patient information/consent form containing warnings about the risk of birth defects if the fetus is exposed to isotretinoin
* Agree to use two effective forms of birth control, which must be used at the same time (unless abstinence is the chosen method), for at least one month before and throughout treatment with the drug and for one month after stopping the drug

During treatment with Accutane:

Each month a woman receives a 30-day supply of isotretinoin. To refill her prescription, she must:

* Have a negative pregnancy test
* Using two types of birth control

After treatment with Accutane:

* Have a pregnancy test after her last dose
* Continue to use two forms of birth control for one month
* Have another pregnancy test one month after her last dose