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Teratogenic medication contraception — DFSRH MCQ

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HardPharmacology of hormonal contraceptionTeratogenic medication contraceptionDFSRH

A 22-year-old is about to start isotretinoin for severe acne and may become pregnant. She does not want an intrauterine method and takes no interacting medicine. Which management is most appropriate?

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Correct answer: A — Follow MHRA programme with contraception and pregnancy testing

The best answer is “Follow MHRA programme with contraception and pregnancy testing”. Isotretinoin is highly teratogenic and current MHRA requirements retain a pregnancy-prevention programme for patients who may become pregnant. The plan must be individualised and documented, with pregnancy testing and effective contraception rather than an assumption that condoms, withdrawal, or repeated emergency contraception is sufficient. Isotretinoin does not make progestogen methods generally ineffective; eligibility and method choice should be assessed normally.

Reference: MHRA, Isotretinoin prescribing requirements updated with revised risk-minimisation measures: https://www.gov.uk/government/news/isotretinoin-prescribing-requirements-updated-with-revised-risk-minimisation-measures