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    Accutane — the drug that cleared severe acne but was also linked to depression, suicidal thoughts and fetal deformities — is still on the market in its generic form, isotretinoin. How can this be, given that the original drug was discontinued by its manufacturer Hoffmann-La Roche, in part due to lawsuits relating to inflammatory bowel diseases and other issues? With intense patient screening, compliance protocols and careful monitoring, isotretinoin (eye-soh-tret-in-OH-in) can be effective and the risk of terrible side effects can be minimized. Isotretinoin is not without problems, however, so patients need to weigh the risks and the benefits before taking the drug. Here are 9 things you should know about isotretinoin. They can help you gauge whether it is a drug you want to take yourself or have prescribed for your teen to treat severe acne. In 1982, the US Food and Drug Administration () approved the active ingredient isotretinoin for use in treating severe nodular acne, under the brand name Accutane. Women must avoid becoming pregnant while taking this medication. Serious (sometimes fatal) birth defects, miscarriages, and premature births have occurred when this drug has been used during pregnancy. For female patients, two effective forms of birth control (or complete avoidance of sexual intercourse) must be used for 1 month before starting isotretinoin, during use, and for 1 month after stopping this drug. You must also have monthly pregnancy-avoidance counseling from your doctor. Do not use "minipills" for birth control (non-estrogen-containing pills) since they may not work as well with isotretinoin. If you are late in having your period, or if you have sexual intercourse at any time without using two effective forms of birth control, stop taking this medication and contact your doctor right away. (See also the Precautions section.)After December 31, 2005, only patients enrolled in the i PLEDGE program may obtain and use isotretinoin.

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