Acitretin: Do I Need Extended Contraception for Pregnancy?

Q: Acitretin: Do I Need Extended Contraception for Pregnancy?

Hello, sir： This medication (Acitretin) has a high teratogenic potential; therefore, "not only is it prohibited for pregnant women to use, but women who are currently taking the medication or have taken it within the past two years and may become pregnant are also prohibited from

Continuation #148993 Psoriasis Acitretin Issues

Hello~ Regarding the issue of psoriasis and Acitretin, if I have been using contraception for two years but had contact with the bodily fluids I mentioned earlier during that time, does that mean I should continue contraception for another two years? (I have plans for pregnancy soon.)

yu, 20~29 year old female. Ask Date: 2019/08/08

Dr. Hong Kunyi reply Pharmacology

Hello, sir: This medication (Acitretin) has a high teratogenic potential; therefore, "not only is it prohibited for pregnant women to use, but women who are currently taking the medication or have taken it within the past two years and may become pregnant are also prohibited from using it.
In fact, all women of childbearing potential should be advised against its use." The risk of giving birth to a child with congenital malformations is significantly high if this medication (Acitretin) is taken during pregnancy or prior to pregnancy, regardless of the duration or dosage.
As for exposure to bodily fluids, there is no clinical evidence to support this; however, due to the medication's high lipophilicity, a considerable amount is secreted into breast milk.
Therefore, it is presumed that trace amounts may still be present in bodily fluids.
If there is contact with bodily fluids, there is still a risk that should be noted.
If you are planning to become pregnant or have become pregnant while on this medication, please be sure to inform your physician during your visit.
If you are preparing for pregnancy, you may consult with your physician for further discussion.
Wishing you safety and health.

Reply Date: 2019/08/08

More Info

Acitretin is a medication primarily used to treat severe psoriasis and other skin disorders. It is a retinoid, which means it is related to vitamin A and has significant effects on skin cell growth and differentiation. However, one of the most critical aspects of Acitretin is its high teratogenic potential, meaning it can cause severe birth defects if taken during pregnancy.
The recommendation for women of childbearing potential is quite stringent. It is advised that women should avoid becoming pregnant while on Acitretin and for at least two years after discontinuation of the medication. This is due to the long half-life of Acitretin and its metabolites, which can remain in the body for an extended period. The risk of teratogenic effects is particularly high during the first trimester of pregnancy, a crucial period for fetal development when major organs and systems are forming.

In your case, if you have been using contraception for two years while on Acitretin, and there has been any potential exposure to bodily fluids that might contain the drug, it is prudent to consider extending your contraceptive measures. While the risk from incidental exposure to bodily fluids is not well-documented, the high lipophilicity of Acitretin suggests that it can be secreted in small amounts in various body fluids, including breast milk. Therefore, if you are planning to conceive soon, it is advisable to consult with your healthcare provider about your specific situation.

Given that you are considering pregnancy, it is essential to have a thorough discussion with your doctor. They may recommend a washout period of at least two years after stopping Acitretin before attempting to conceive. This recommendation is based on the need to ensure that the drug is completely eliminated from your system to minimize any risk to the developing fetus.

In addition to discussing the timing of pregnancy in relation to your Acitretin use, it is also important to consider other aspects of your health and any other medications you may be taking. Your healthcare provider can help you evaluate the overall risks and benefits of continuing or stopping any medications in the context of your pregnancy plans.

In summary, while you have been on contraception for two years, the potential risks associated with any exposure to Acitretin warrant a cautious approach. It is advisable to extend your contraceptive measures until you have confirmed that the drug is no longer in your system, ideally consulting with your healthcare provider to establish a safe timeline for attempting to conceive. Your health and the health of your future child are paramount, and taking these precautions can help ensure a safe and healthy pregnancy.

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 Oral Accutane Use During Early Pregnancy

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 Se...

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 Sept...

Impact of Taking Birth Control Pills During Unknowingly Pregnant

I unknowingly took the contraceptive pill Neovlar and Domperidone while pregnant. I found that the ingredients in Neovlar are Ethinylestradiol 50 μg and Levonorgestrel 0.25 mg. My last menstrual period started on August 28, and I took the medication from September 20 to October 4...

Dr. Hou Fangmin reply Pharmacology
Hello: Every prospective mother should be very cautious about the medications she takes, which is a good practice. Medications during pregnancy are classified into five categories. Below are the classifications for medications used by pregnant women: - Category A: No evidence of...

Managing Medication Before Pregnancy: A Guide for Women with IBS

Due to irritable bowel syndrome, I have been taking medication for over a year, including Loperamide, probiotics, and sedatives, all of which are classified as Category D drugs. I have been on these medications for more than a year, and I am now planning to conceive. How long sho...

Dr. Liu Yuhong reply Obstetrics and Gynecology
Except for a few medications, such as isotretinoin for severe acne, most commonly used drugs do not remain in the body for long periods. Therefore, there is generally no need to discontinue medication when preparing for pregnancy (with the exception of isotretinoin). For example,...