Oratane Use In Pregnancy & Lactation

Pregnancy (Category X): Isotretinoin is highly teratogenic and must not be given to women who are pregnant. Isotretinoin crosses the placental barrier in amounts that lead to congenital deformities. There is an extremely high risk that a deformed infant will result if pregnancy occurs while taking ORATANE in any amount even for short periods. Potentially all exposed foetuses can be affected.
Isotretinoin is highly teratogenic. It is, therefore, contraindicated not only in women who are pregnant or who may become pregnant while undergoing treatment but also in all women of childbearing potential. There is an extremely high risk that a deformed infant will result if pregnancy occurs while taking ORATANE in any amount even for short periods. Potentially all exposed foetuses can be affected.
Isotretinoin is contraindicated in women of childbearing potential unless the female patient meets all of the following conditions: The patient has severe disfiguring cystic acne resistant to standard therapies.
The patient must be reliable in understanding and carrying out instructions.
The patient is capable of complying with the mandatory contraceptive measures.
The patient is informed by the physicians of the hazards of becoming pregnant during and 1 month after treatment with isotretinoin and the patient is warned of the possibility of contraceptive failure.
The patient confirms that she has understood the warnings.
The patient has a negative pregnancy test within two weeks prior to beginning therapy. Monthly repetition of pregnancy testing is recommended.
The patient must use effective contraception without any interruption for 1 month before beginning isotretinoin therapy, during therapy and for 1 month following discontinuation of therapy. At least one and preferably two complementary forms of contraception including a barrier method should be used. Microdosed progesterone preparations (minipills) may be an inadequate method of contraceptive during isotretinoin therapy.
The patient starts isotretinoin therapy only on the second or third day of the next menstrual period.
In the event of relapse treatments the patient must also use the same uninterrupted and effective contraceptive measures 1 month prior to, during and for 1 month after isotretinoin therapy.
The patient must fully understand the precautions and confirm her understanding and her willingness to comply with reliable contraceptive measures as explained to her.
Even female patients, who normally do not employ contraception because of a history of infertility, should be advised to do so while taking isotretinoin, following the guidelines as previously mentioned. Should pregnancy occur in spite of these precautions during treatment with isotretinoin or in the month following, there is a great risk of very severe malformation of the foetus (involving in particular the central nervous system, the heart and the large blood vessels). If pregnancy does occur, the doctor and patient should discuss the advisability of continuing the pregnancy.
Major human foetal abnormalities related to isotretinoin administration have been documented, including hydrocephalus, microcephalus, abnormalities of the external ear (micropinna, small or absent external auditory canals), microphthalmia, cardiovascular abnormalities, facial dysmorphia, thymus gland abnormalities, parathyroid hormone deficiency and cerebellar malformation. There is also an increased risk of spontaneous abortion.
Use in Lactation: Owing to its lipophilicity, there is a high probability that isotretinoin is secreted into the breast milk. Isotretinoin must not be given to nursing mothers.