Pregnancy After Cystic Acne Medications: is it Safe?

For women with cystic acne—painful, deep, and reddened acne blemishes—the oral medication isotretinoin can provide a solution for clear skin. However, this medicine is known to cause birth defects in babies born to women who use it during pregnancy. If you’ve taken a form of isotretinoin in the past and aren’t sure how that could affect pregnancy in the future, there are some considerations you should make. Consulting your obstetrician and dermatologist are also good places to start for determining if you can safely conceive.

Isotretinoin is a form of vitamin A that can reduce symptoms of cystic acne. Accutane is a well-known brand name for isotretinoin, but this medication hasn’t been available since 2009. While Accutane is no longer an option, doctors can prescribe similar medications, including Absorica, Amnesteem, Claravis, Myorisan, Sotret, and Zenatane.

When taken during pregnancy, these medications can increase a woman’s risk of experiencing a miscarriage or premature birth. Also, birth defects such as cleft palate, hydrocephalus, and congenital heart defects are associated with taking isotretinoin, in addition to some others.

The concerns for women taking isotretinoin are so severe that a physician and pharmacy will not give the medication to women of childbearing age unless they agree to participate in the iPLEDGE program. This program requires the following pledges:

A woman must use at least two forms of birth control at least one month before starting to take isotretinoin.

A woman must take a pregnancy test at an approved lab once every 30 days to confirm she is not pregnant. Doctors will only prescribe 30-day supplies of isotretinoin.

A woman can only pick up her isotretinoin prescription within seven days of taking her pregnancy test. A pharmacy will not dispense the medication beyond this required window.

But what about when you decide that it’s time to try and become pregnant and you are already using these medications? While each case can vary, the general rule of thumb is that you should not try to get pregnant until you have stopped taking isotretinoin medications for at least a month. This gives the medication time to leave your bloodstream so you can safely conceive without fear or risk that your child will have birth defects. Other no-no’s related to pregnancy include to not donate blood while taking isotretinoin as this could pass on to a pregnant woman who receives the blood donation. Breastfeeding while taking isoretinoin is also absolutely not recommended.

If you are taking isotretinoin and become pregnant, stop taking the medication immediately and call your doctor. Men taking the drug whose partners may become pregnant should also talk to a physician to discuss ways to minimize risks for passing the medication along via the semen.

Sources:

• American Academy of Dermatology: Why Dermatologists Prescribe Isotretinoin
  Drugs.com: Isotretinoin Pregnancy and Breastfeeding Warnings
  FDA.gov: Accutane Medication Guide
  March of Dimes: Smoking, Alcohol and Drugs
  MayoClinic.com: Cystic Acne
  MedlinePlus: Isotretinoin
  Organization of Teratology Information Specialists: Isotretinoin (Accutane) and Pregnancy

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