Compliance with pregnancy prevention measures during isotretinoin therapy

Mary Katharine Collins, Jacqueline F. Moreau, Dan Opel, James Swan, Noel Prevost, Matthew Hastings, Eleanor Schwarz, Laura Korb Ferris

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Background Approximately 150 women annually become pregnant while taking isotretinoin despite participation in the iPLEDGE program. Noncompliance with the requirement to be abstinent or use 2 contraceptive methods may be a contributing factor. Objective We sought to determine the degree of adherence to contraception or abstinence among women taking isotretinoin. Methods We conducted an anonymous survey of women of childbearing potential taking isotretinoin for at least 2 months. Results Among 75 participants, 21 (28%) chose abstinence as their primary means of pregnancy prevention, of whom 4 (19%) were sexually active during treatment. The most commonly chosen contraceptive methods among the 39 women who were sexually active were condoms (35, 90%) and oral contraceptive pills (18, 46%). Twelve women (31%) admitted to having intercourse at least once using 1 or fewer forms of contraception; 10 failed to use condoms, and 1 reported completely unprotected intercourse. Among sexually active oral contraceptive pill users, 7 (39%) reported missing 1 or more pills in the previous month. Limitations Data were self-reported, thus participants may have inaccurately reported contraception use. Conclusions Encouraging the use of highly effective, patient-independent contraception and limiting abstinence to women who have never been sexually active may further reduce the rate of isotretinoin-exposed pregnancies.

Original languageEnglish (US)
Pages (from-to)55-59
Number of pages5
JournalJournal of the American Academy of Dermatology
Issue number1
StatePublished - Jan 1 2014
Externally publishedYes


  • acne
  • condoms
  • contraception
  • intrauterine device
  • isotretinoin
  • oral contraceptive pills

ASJC Scopus subject areas

  • Dermatology


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