Since retinoids are extremely teratogenic1 all patients who can become pregnant must undergo a serum pregnancy test that quantitatively measures hCG levels or a urine pregnancy test that measures these qualitatively prior to initiation of therapy. The pregnancy test should be repeated monthly up to one month after ceasing systemic retinoid therapy. Meanwhile2 the patient should commit to a 3double4 contraception strategy5 a combination of an oral as well as another contraceptive 6e.g.7 barrier contraception8 IUD9. Contraception should start one month before isotretinoin therapy and be continued until one month after isotretinoin therapy is completed. Since the use of a retinoid is frequently associated with decreased liver function and hyperlipidemia10 regular liver function and lipid profile tests 11both before and during therapy12 are recommended.

Apuntes

Since retinoids are extremely teratogenic, all patients who can become pregnant must undergo a serum pregnancy test that quantitatively measures hCG levels or a urine pregnancy test that measures these qualitatively prior to initiation of therapy. The pregnancy test should be repeated monthly up to one month after ceasing systemic retinoid therapy. Meanwhile, the patient should commit to a "double" contraception strategy, a combination of an oral as well as another contraceptive (e.g., barrier contraception, IUD). Contraception should start one month before isotretinoin therapy and be continued until one month after isotretinoin therapy is completed. Since the use of a retinoid is frequently associated with decreased liver function and hyperlipidemia, regular liver function and lipid profile tests (both before and during therapy) are recommended.