Accutane is dispensed only under the rules of iPledge, a government regulated prescription program. The rules of iPledge are very inflexible, so it’s important to follow the detailed instructions so that are you are able to get your medication. Due to the risks associated with pregnancy, the rules for females are particularly strict.

This page contains some useful hints and tips for Accutane. However, for complete information about this medication, please reference the iPledge booklet and instructions that you were provided at your appointment.

Registration in iPledge Program

  • Females – Registration occurs at your office visit, at the time of signing consent forms, taking a pregnancy test, and receiving contraceptive counseling. A prescription is issued during your second office visit which occurs after a 30-day waiting period, with documentation of two pregnancy tests (no less than 30 days apart) and lab results (liver testing, baseline cholesterol, general health panel).
  • Males – Registration and prescription offered after lab results; no waiting period required.

Monthly Lab Tests

  • Obtain fasting labs (nothing by mouth except water for 8 hours prior to test) 1-2 days prior to monthly visits.
  • If labs are not reviewed in the office, you will be contacted in 2-3 days with your results and prescription information.
  • Females – Pregnancy tests are required for registration, each prescription, at the end of the treatment course, and 30 days after treatment. They must be repeated whenever prescriptions are not picked up in a timely manner.

Filling Your Prescription

  • After notification of normal test results (including two pregnancy tests over 30 days for females), the first prescription is sent to your pharmacy. Insurance authorization may be required prior to filling your prescription.
  • Females – You must go online to to complete a questionnaire, using your iPledge ID number (from wallet cards or iPledge book) and password (sent to you in the mail).
  • FemalesCRITICAL: Your prescription will expire 6 days from pregnancy test date, so pick up your medicine at the pharmacy immediately. Delays in filling the prescription (regardless of reason) may cause a 19-day lockout in iPledge. This will require additional pregnancy tests and a delay in filling your prescription.
  • For cash pay patients (or patients with high out-of-pocket costs), consider discount pharmacies, such as Costco, Sam’s Club, or WalMart. (There is an additional 40% discount for Sam’s Business Club members.)

What to Expect

  • Monthly labs and medical visits for an approximately six- month course Accutane treatment.
  • Most common side effects: Dry lips, dry skin, and dry eyes are typical.
  • Possible side effect: Muscle aches after exercising may be more pronounced.
  • Acne below the surface may erupt faster initially, then decrease in amount and severity over 2-6 months.
  • Most patients see improvement over the course of treatment, but about 1/3 will have some recurrence of acne at some point in the future.

Tips for Improving Effectiveness and Minimizing Side Effects

  • Discontinue all other acne medications, including over-the-counter creams and washes.
  • Take your medication as directed and with a fatty meal.
  • Maintain a healthy diet (avoiding fatty sweets, for instance) to minimize lipid increases.
  • Avoid alcohol and Tylenol (acetaminophen) to reduce liver irritation; ibuprofen is acceptable.
  • Use caution with nighttime driving, initially, due to possible night vision changes.
  • Do not share medication with others or donate blood for 30 days after the course of treatment due to birth defect risks.
  • Gentle cleansers, moisturizers, and lip balm (such as Dr. Dan’s, available in office) help dry, itchy skin and chapped lips.
  • Use sunscreen consistently due to photosensitivity, and reapply every two hours with sun exposure.
  • Females – Maintain two forms of birth control throughout treatment, and for 30 additional days after completing treatment, in order to prevent severe birth defects.

When to Call the Doctor

  • If you think you may be pregnant.
  • If you experience a severe headache, vision changes, yellowing of the eyes or skin, or muscle aches that inhibit normal activity.
  • If you experience bloody diarrhea or other significant gastrointestinal issues, or any significant new symptom or change in your health.
  • Any concerns about changes in mood, signs of depression, or suicidal thoughts. Concerns about suicide should be considered a medical emergency.