Accutane
Patient Instructions

Mandatory iPLEDGE Registration

iPLEDGE is a mandatory Accutane safety program designed to prevent pregnancy while taking Accutane (Isotretinoin) due to the risk of severe birth defects. Every patient (regardless of sex), prescriber, and pharmacy involved in Accutane treatment must be registered in iPLEDGE and follow strict guidelines.

Before Starting Accutane

For all patients: Lab Tests & Monitoring

• Your doctor will order baseline blood tests before starting and at least once during treatment to check cholesterol and liver function.

Pregnancy Prevention (for any patient who could become pregnant)

• You must use two forms of birth control while on Accutane and for one month after stopping if you are sexually active.
• You will need to take monthly pregnancy tests before each refill.
  • Your first TWO pregnancy tests must be in office.
  • After that you can elect to do a virtual visit. If you elect to do a virtual visit, you must submit a photo of a home pregnancy test. Instructions on how to submit at home pregnancy test can be found at here.

How to Take Accutane

Take your dose with a fatty meal (e.g., avocado, nuts, peanut butter) to improve absorption. Swallow the pill whole with a full glass of water.

Refill & Appointment Requirements

• You must be seen every month (either in-office or via teledermatology) to receive your next prescription.
• Please schedule your next appointment as soon as possible after each visit.
• Visits should be scheduled as close to 30-35 days apart as possible. Occasionally, due to scheduling restrictions, you may run out of medication for a few days. Missing occasional doses will not impact your final results. Just continue as normal—do not double up on medication.
• Prescriptions must be filled within 7 days of approval, or a new visit may be required.
• Treatment typically lasts 5-6 months, depending on your weight and cumulative dose goal.
• Be patient—improvements often take a few months!
• Missing an appointment will delay your prescription refill.

After Each Appointment

• Patients who can get pregnant: Log on to iPLEDGE and answer questions relating to your birth control methods. Visit www.ipledgeprogram.com or call the iPLEDGE hotline (866-495-0654) for any questions.
• Most scripts are sent to Summit Pharmacy: 720-370-1121

Managing Common Side Effects

Dry Skin & Lips (Most Common Side Effect!)

• Use a thick moisturizer (e.g., CeraVe, Vanicream, Aquaphor) on your face and body daily.
• Keep lip balm (Aquaphor or Vaseline) on at all times. Dr Dan’s Cortibalm is excellent and sold in the office.
• Avoid harsh skincare products (retinoids, exfoliants, alcohol-based toners).
• Extreme dryness resulting in a red, scaly rash can be treated with prescription creams.

Dry Eyes & Sensitivity to Contact Lenses

• Use preservative-free artificial tears throughout the day.
• Consider switching to glasses if contacts become uncomfortable.

Sun Sensitivity

• Wear broad-spectrum SPF 30+ sunscreen (Core Ultra Shield, EltaMD, Supergoop, etc) daily, even on cloudy days.
• Avoid excessive sun exposure and use hats/sunglasses when outdoors.

Joint & Muscle Pain

• Stay hydrated and incorporate gentle stretching or yoga.
• Over-the-counter pain relievers (like ibuprofen) may help. Avoid Tylenol.
• Fish Oil supplements may help (2,000–3,000 mg of combined EPA + DHA divided daily.)

Nosebleeds & Dry Nose

• Apply Ocean Ayr Nasal gel (or similar) inside nostrils to keep them moisturized.
• Use a humidifier in your bedroom, especially in winter.

Lifestyle Adjustments While on Accutane

• Avoid alcohol (Accutane can impact liver function).
• No waxing or laser treatments (your skin is more sensitive and can scar easily).
• Drink plenty of water (helps with dryness and overall health).
• Do not donate blood while on Accutane.
• Ask your dermatologist before starting any new medications or supplements.

Symptoms to be Concerned About

Call Your Doctor (303-355-3000 or Text 720-704-1186) or seek urgent care in the ER if you experience any of the following:

• Severe headaches or vision changes
• Mood changes, depression, or suicidal thoughts
  
• Yellowing of skin/eyes (signs of liver issues)
  
• Severe stomach pain, nausea, or vomiting
  
• Uncontrollable nosebleeds

Can My Accutane Appointment Be Virtual?