I, like a growing number of health officials, now know that patients can get a six-month supply of istoretinoin without a prescription by just using their credit card and their mailing address.
Many offer a three-month supply and even give consumers discounts if they buy more than a three-month supply. The big issues here are how these patients are getting these drugs so easily and the risks to us as a specialty when patients present to us already having been on this drug for a couple months, as in this case.
There are risks to the patients and risks to the providers. Who is responsible for the bad outcomes if someone gets pregnant, for example, or if they have a liver issue or something else as a result of being on this drug without a prescription and without supervision?
Who is going to manage that? And more importantly, will there now be a discrepancy in how many dermatologists use the iPledge system? Are dermatologists who may be frustrated with the system and the requirements of iPledge going to tell their patients to go ahead and buy isotretinoin online and bypass the whole system, especially considering situations such as female patients who are on low-dose, long-term regimens, or patients who are using isotretinoin long-term for off-label indications such as treating rosacea?
Are these patients going to be going to the Internet and getting isotretinoin without regulation, and, if so, is there going to be an increase in the number of bad outcomes we will need to deal with?
We not only really need to protect our patients who may not know what's best for themselves, but we also need to protect ourselves. The iPledge program is an FDA-approved computer-based risk management program designed to restrict distribution of istotretinoin to ensure that no female patient starts isotretinoin therapy if pregnant and that no female patient on isotretinoin therapy becomes pregnant.
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Patients should be aware of other serious side effects, including problems with the skin, pancreas, liver, stomach, bones, muscles, hearing, vision, lipids, allergic reactions, blood sugar, or red and white blood cells.
The most common, less serious adverse events include dry skin, chapped lips, dry eyes, and dry nose that may lead to nosebleeds. Patients should be advised about these adverse events and routinely monitored by a doctor during treatment with isotretinoin. Please refer to the isotretinoin package inserts for full prescribing and dispensing instructions. An Adverse Event: If you or someone you know has experienced an adverse event, please call The tests can be obtained at drug store, grocery store, or online retailer.
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