Accutane in Pregnancy
Accutane is a prescription oral medication also known by the generic name isotretinoin. Physicians and dermatologists commonly prescribe this medication for severe and nodular acne that does not respond well to other medications. Isotretinoin is a potent drug that has a high success rate in treating acne, but it can also cause several side effects. These including serious birth malformations in the fetuses of pregnant women who have recently taken or are taking the medication.
Isotretinoin drastically decreases sebum production of the sebaceous glands in the skin. Overproduction of sebum causes oily skin that leads to clogged, irritated pores and decreases the natural exfoliation of dead skin cells. The excess oil and dead skin cells create pores that trap bacteria, leading to infection and inflammation. Isotretinoin is a vitamin A derivative, and the elevated level of vitamin A is responsible for the serious birth defects that can develop in a fetus if a woman takes it during pregnancy or close to the time of conception.
Isotretinoin is a known human teratogen that can cause severe malformation in developing embryos, according to the Centers for Disease Control. These severe, multiple deformities usually occur in the first trimester of pregnancy and include malformations of the head and face, cardiac structure and central nervous system. The risk of birth defects is very severe, because women who are taking the drug may not be aware that they are in the early stage of pregnancy. Those taking the medication cannot donate blood, as it may be given to a pregnant woman.
Because of the critical effects of taking isotretinoin during pregnancy, the Food and Drug Administration's Medication Guide advises physicians to counsel all women, particularly those who are sexually active, to undergo a pregnancy test before beginning treatment and to use two forms of birth control while completing treatment. In the United States, both the patient and the doctor sometimes sign a pledge covering the importance of avoiding pregnancy while taking isotretinoin.
Cause of Pregnancy Risk
Isotretinoin can cause birth defects because it contains large quantities of vitamin A. For this reason, taking large amounts of vitamin A during pregnancy can cause the same birth defects as taking isotretinoin, according to the American Osteopathic College of Dermatology. Vitamin A derived from food, however, is removed from the body more quickly than isotretinoin and does not pose as great a risk.
Should a Problem Develop
The website drugs.com advises calling a doctor immediately if you have unprotected sex, if you quit using birth control, if your period is late or if you think you might be pregnant. The website says it is not known whether isotretinoin passes into breast milk, so call your doctor if you are breastfeeding.
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