3 iPLEDGE Questions Before Starting Isotretinoin

Keep the prescriber’s instructions and pharmacy contact together before starting isotretinoin. Ask which dates and steps apply to your first prescription.

Three questions for the prescribing team

1. Which category and requirements apply to me? Ask the team to explain your category, enrollment and the steps required before dispensing. Make sure you understand the instructions you are agreeing to follow.¹
2. Where will pregnancy tests take place, if required? Pretreatment pregnancy tests must be completed in a medical setting. During and after treatment, prescribers may permit home testing under the FDA’s¹ current enforcement discretion. Ask which method your team accepts and how to submit results.²
3. Which prescription timing rules are in effect? As of October 6, 2026, the FDA¹ says implementation of the approved program modifications is delayed until November 15, 2026. Do not assume an announced change has already reached the prescribing system. Confirm current instructions with the prescriber and pharmacist.²

Use the program’s current instructions

The FDA¹ directs patients to the iPLEDGE website or contact center for detailed, up-to-date requirements. Ask your team what to do if a test, appointment or pharmacy pickup cannot happen as planned.¹²

Write the next action and its date beside the person responsible for it. This article covers questions to ask; it does not reproduce every requirement of the program.

Skin, Head to Toe includes a short-shelf planner and Skin Log. Use them to organize product details and observations for your dermatologist. See the book.