How Long To Wait Trying To Conceive On Accutane

Our pharmacist answers the latest question regarding how long you should wait on trying to conceive after stopping the acne drug Accutance (Isotretinoin).

Oct 02, 2017

Halder asked

I have taken the generic version for Accutane for 10+ years on and off...and I have now been off for 1 month....I plan on waiting 3 months to pursue pregnancy but I am trying to understand the accumulation/metabolism/elimination of this drug to set my mind at ease. I understand from researching that it is protein bound...can you tell me if the drug should be completely out of my system by 3 months time? And if the length of time I have been taking it matters in regards to this.

Answer

As you seem to know, Accutane (Isotretinoin) is contraindicated in pregnancy and is listed by the FDA as pregnancy category X. Although not every exposure to Accutane has resulted in a birth defect, there is an extremely high risk that birth defects can occur if pregnancy occurs while taking isotretinoin in any amount even for a short period of time. 

As I am sure you are aware of as well, in order to prevent isotretinoin exposure during pregnancy, the iPLEDGE program has been developed. This program requires prescribers, pharmacists and patients to comply with certain conditions prior to prescribing, dispensing or receiving Accutane. 
The rules of the iPledge program in terms of pregnancy AFTER therapy are as follows: Women who are, or might become, sexually active with a male partner must also select and use 2 forms of effective contraception simultaneously for at least one month following discontinuation of therapy, even when there has been a history of infertility. 
In terms of the metabolism of the drug, you are right, it is extensively protein bound. In fact, it is  99.9% bound to plasma proteins. The half-life of isotretinoin is about 10—20 hours. By 3 months time, it should absolutely be out of you system.

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