Concerns About Oral Accutane Use During Early Pregnancy

The issue of taking oral isotretinoin at the time of conception?

Hello, Doctor.
I would like to ask about the issue of pregnancy and oral isotretinoin.
My last menstrual period started on August 7, and I believe my husband and I did not have sexual intercourse during that time.
It is more likely that we had intercourse between August 26 and September 8, and I found out I was pregnant on September 22.
However, I suddenly recalled that during the period from September 1 to September 8, while we were on our honeymoon, I experienced increased oiliness on my face and took approximately three doses of oral isotretinoin (one each on September 2, September 4, and September 6).
I had not taken isotretinoin for a long time before this, and I did not take any more after that.
I am concerned because I read online that isotretinoin has teratogenic effects, and I would like to know if this dosage is considered high risk.
Thank you.

An Xiao Liu, 30~39 year old female. Ask Date: 2018/09/28

Dr. Huang Jianzhong reply Obstetrics and Gynecology

The last menstrual period started on August 7, and my husband and I believe that we likely had sexual intercourse between August 26 and September 8.
I took a pregnancy test on September 22 and found out I was pregnant.
However, I suddenly recalled that during the period from September 1 to September 8, while we were on our honeymoon, I experienced increased oiliness on my face and took about three oral doses of isotretinoin (one each on September 2, September 4, and September 6).
Prior to this, I had not used isotretinoin for a long time, and I did not take any more after those days.
I read online that isotretinoin has teratogenic effects and wanted to know if the dosage I took during that time is considered high risk.

Answer: Based on the timing and dosage, it is not considered high risk.

Reply Date: 2018/09/28

More Info

Concerns about the use of oral Accutane (isotretinoin) during early pregnancy are indeed valid and warrant careful consideration. Isotretinoin is a powerful medication primarily used to treat severe acne, and it is well-known for its potential teratogenic effects, meaning it can cause birth defects if taken during pregnancy.

The FDA categorizes isotretinoin as a Category X drug, which indicates that it is contraindicated in pregnancy due to evidence of fetal harm. The risks associated with isotretinoin include severe birth defects affecting the heart, brain, and face, as well as potential developmental issues. The critical period for these risks is during the first trimester, particularly in the early weeks of pregnancy when the fetus is most vulnerable to teratogenic agents.

In your case, you mentioned taking approximately three doses of isotretinoin between September 2 and September 6, while you may have conceived around that time. Although you stopped taking the medication shortly after, the timing of your exposure is concerning. The half-life of isotretinoin is relatively short, but its effects on fetal development can be long-lasting, especially if taken during the early stages of pregnancy when organogenesis (the formation of organs) occurs.

Given that you are currently pregnant and have concerns about the potential effects of isotretinoin on your developing fetus, it is crucial to consult with your healthcare provider as soon as possible. They can provide a thorough evaluation of your situation, including the timing of your medication use and the potential risks involved. Your provider may recommend additional monitoring during your pregnancy or refer you to a specialist in maternal-fetal medicine for further assessment.

In addition to discussing your isotretinoin use, it is also essential to consider other factors that may impact your pregnancy. For instance, maintaining a healthy lifestyle, including proper nutrition and prenatal care, can help mitigate some risks. Your healthcare provider can guide you on the best practices for a healthy pregnancy, including any necessary lifestyle modifications or supplements.

If you have not already done so, it is also advisable to discuss the possibility of genetic counseling. This can provide you with more information about the potential risks associated with isotretinoin exposure and help you make informed decisions regarding your pregnancy.

In summary, while the use of isotretinoin during early pregnancy poses significant risks, the best course of action is to seek professional medical advice. Your healthcare provider will be able to assess your specific situation, provide guidance, and ensure that you receive the appropriate care throughout your pregnancy. Remember, early intervention and open communication with your healthcare team are key to navigating any concerns you may have during this critical time.

Similar Q&A

Concerns About Accutane and Birth Defects: What You Need to Know

Hello, doctor. Last year, I had acne, and my doctor recommended that I take vitamin A acid. I have already stopped using it, but it seems that this medication carries a risk of teratogenicity. I heard that if the retinoic acid is not completely metabolized in the body, it could l...

Dr. Wu Zongcheng reply Obstetrics and Gynecology
For example, if a married woman is taking contraceptive pills and wishes to conceive, she should stop taking the medication for three months before trying to get pregnant. Vitamin A acid is a fat-soluble vitamin, and the metabolism of most medications does not exceed three months...

Concerns About Topical Medications During Early Pregnancy

Hello Doctor: My last menstrual period started on July 15, and I went to the hospital on August 17 for a pregnancy test, but an abdominal ultrasound could not detect the embryo at that time. Since three months ago, I have been experiencing severe acne, and although I have not tak...

Dr. Lü Lizheng reply Obstetrics and Gynecology
I have been applying acne treatment products (non-retinoid) on my face daily. After confirming my pregnancy, I stopped using them, but I am still concerned whether the topical products I used previously could cause any birth defects in the future. Most cosmetics have passed gover...

Concerns About Medication Use During Early Pregnancy

My last menstrual period was on June 7th. However, my cycle is irregular and was delayed by 6 days. Before the end of July, I took a lot of medication due to feeling unwell. I am concerned about potential harm to the fetus from the medications I took, which included a gastrointes...

Dr. Liu Yuhong reply Obstetrics and Gynecology
First, it should be noted that even in the absence of any medication, there is still a 3% chance of congenital anomalies during a normal pregnancy. The U.S. Food and Drug Administration (FDA) classifies medications based on their effects on the fetus into categories A, B, C, D, a...

Concerns About Medication Use During Early Pregnancy: What You Need to Know

Hello! My wife is 10 weeks pregnant. Recently, due to some itching and mouth sores, she applied some medications, and now I am very worried about whether it will affect the baby. The medications are as follows: clobetasol ointment, Leu sun ointment 32b, and Kenalog in orabase. Sh...

Dr. Chen Shuzi reply Pharmacology
Hello! Generally, topical ointments are used locally and have low concentrations, which makes it less likely to cause systemic effects. Therefore, the chance of the medication passing through the placenta and affecting the embryo is very small, so there is no need to worry too mu...