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Special precautions for women considering oral isotretinoin


Birth defects can be caused if you use oral isotretinoin:

  • while you are pregnant;
  • become pregnant while using oral isotretinoin;
  • become pregnant within one month of stop taking oral isotretinoin

Before a woman of childbearing age (when periods start) is prescribed isotretinoin, she (and her family) needs to be carefully counselled about the risks involved.

You must use strict birth control for:

  • at least one month before you start isotretinoin treatment;
  • during the entire isotretinoin treatment; and
  • for at least one month after you stop taking the isotretinoin treatment.

You should wait until the second or third day of your next menstrual period before you can start taking isotretinoin. This is an extra check to make sure you are not pregnant.

To avoid pregnancy while on the drug and for one full reproductive cycle after ceasing the drug, very effective contraceptive measures are necessary. The use of two effective forms of birth control (such as the oral contraceptive pill and use of a condom) is often recommended as even the oral contraceptive pill occasionally fails.

There are many issues involved in choosing and taking the oral contraceptive pill, such as the importance of taking the pill at the same time each day.

Irrespective of what contraceptive measures are chosen, two negative pregnancy tests are usually required before starting isotretinoin. One may occur early, for example while discussing treatment options and a second test will be taken during the first five days of the menstrual cycle just before starting isotretinoin.

Anyone concerned that they have become pregnant while on isotretinoin should contact their doctor and dermatologist immediately.

An emergency oral contraceptive pill is available from hospital emergency departments and over-the-counter at pharmacies. If this option is considered, it must be taken within 72 hours after unprotected sex to be effective. It's best to see a doctor to discuss the options that are available.

A dermatologist will provide information on pregnancy prevention strategies. For more information on contraceptive options, contact a local doctor or family planning association.

Isotretinoin does not affect your fertility in the long-term.

If a female is considering pregnancy after oral isotretinoin, this can be attempted one month after all isotretinoin has been finished.
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