4 Steps to Starting Isotretinoin

Your provider would like to prescribe you isotretinoin (also known as accutane or claravis). To register for this medication, you need to complete these four steps:

Step 1: For your information and review:

  1. Guide to Isotretinoin for Female Patients Who Can Get Pregnant

  2. iPLEDGE Program Birth Control Information Sheet

  3. iPledge Fact Sheet

For a review of the side effects from isotretinoin and their associated prevalence, please click here

Step 2: Download, Fill, Save

Please fill out and save this form

Consent form

For patients under the age of 18 years, please also save and complete this authorization form

Authorization form

You will need to open and edit the form in Adobe Reader. You can download it free here

Save the filled forms onto your computer for upload (step 4)

Step 3: Obtain a pregnancy test

Please go to a Kaiser Permanente lab to have a urine or blood pregnancy lab drawn (this should be ordered by your clinician)

Step 4: Message Your Dermatologist

For Kaiser patients: Log into KP.org and go to message center. In message center select "Compose" and then choose "Doctor's Office." Select your dermatologist from the list of providers

  1. In the body of the message, please write your two forms of birth control (from this form, select a primary and a secondary). This may have been discussed and decided already at your recent virtual visit.

Example: Primary: Birth Control Pill, Secondary: Condom

If instead of birth control you choose to be abstinent during your treatment, please write "Remain 100% abstinent."

  1. Attach both completed forms from Step 2 (pdf files)

Journey Forward

Once your dermatology team receives all the completed information, you will be ready for your enrollment visit.

Once enrolled, you will need to get another pregnancy test at least 30 days after to complete the registration. Your dermatology team usually will schedule another appointment during the window in which you have to get your next pregnancy test. Most patients obtain a pregnancy the day before or the morning of their visit.

From there, if you have two negative pregnancy tests, then your dermatology team can update your iPledge account to permit you to obtain a 30 day supply of medication. Before you pick up the medication, you must answer a few comprehension questions at iPledgeProgram.com. You will also need to provide the iPledge website your primary and secondary forms of birth control (see Step 5). For the iPledge website, your iPledge number is your username; the password should have been mailed to you.

You have one week to pick up the medication. You will obtain a maximum of 30 days of medication. Your dermatology team will set up another appointment so you can refill the medication, for which you will need a monthly pregnancy test. If you run out of the medication a few days before your next appointment, that is fine. The medicine will still remain in your system for a little bit and you should not have a rebound of your acne.

To help better visualize the iPledge initiation process, please see this example of a timeline.

For subsequent medication refills, please see this example timeline.

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