Before starting isotretinoin therapy, which precaution should the adolescent be informed is required?

Before starting isotretinoin therapy, which precaution should the adolescent be informed is required?

• A. One negative pregnancy test
• B. Pregnancy test after starting therapy
• C. No pregnancy testing is needed
• D. Two negative pregnancy tests prior to starting this medication

Answer: (D)

Isotretinoin is extremely teratogenic, so it must only be started when you can be absolutely sure the patient is not pregnant. The safe protocol requires two separate negative pregnancy tests before beginning treatment to confirm there is no pregnancy at the start. This minimizes the risk of exposing a fetus to the drug during the very early stages of pregnancy, when defects can begin to develop. One negative test wouldn’t provide as strong a guarantee, testing after starting would not prevent exposure if pregnancy exists at initiation, and no testing is unsafe. Therefore, two negative pregnancy tests before starting isotretinoin are required.

Isotretinoin is extremely teratogenic, so it must only be started when you can be absolutely sure the patient is not pregnant. The safe protocol requires two separate negative pregnancy tests before beginning treatment to confirm there is no pregnancy at the start. This minimizes the risk of exposing a fetus to the drug during the very early stages of pregnancy, when defects can begin to develop. One negative test wouldn’t provide as strong a guarantee, testing after starting would not prevent exposure if pregnancy exists at initiation, and no testing is unsafe. Therefore, two negative pregnancy tests before starting isotretinoin are required.