Are All Oral Contraceptive Pills Ok for the IPledge Requirement to Prescribe Isotretinoin?

Accutane is a go-to medication for patients with recalcitrant cystic acne. It can reduce pore size and also reduce sebum production in your skin, making it less oily; and in turn, dryer. Accutane can be used to control acne, but patients receiving the medication should be carefully monitored. In terms of skincare, always wear an appropriate sunscreen and reduce direct sun exposure. In my patients, I recommend a good ceramide moisturizer such as Elevase whenever they are on Accutane. This will keep the skin hydrated and reduce the oiliness of the skin that is associated with oil-based moisturizers.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Pregnancy is the biggest issue with Accutane, as the birth defects for women who get pregnant on Accutane or for two months after Accutane can be very severe.  The iPledge program was designed to prevent pregnancies on Accutane.  The requirement is two different birth control methods:  an oral contraceptive pill or IUD and a barrier method of contraception like a condom, diaphragm, etc.

Even if used appropriately the pill has a 2-3% failure rate, therefore the need for a second method of contraception.

IPLEDGE is the registry which regulates Accutane to prevent pregnancy while on this medicine.  Certain forms of oral contraceptives are not acceptable as a form of birth control.  Specifically, oral contraceptives without estrogen (progesterone only mini pills) are not acceptable.  Two examples of these are: Ovrette Tablets and Ortho Micronor Tablets.

Any oral contraceptive is fine for iPledge. The use of accutane revolves around iPledge rules. One of these rules is that you use two acceptable forms of contraception. OC's is one form and they do not specify what type. The choice of OC actually still remains between you and your doctor.