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Patients are Going Online for Isotretinoin

In a recent article called, “Isotretinoin Online: Avoid Risk and Assure Safe Access,” Neal Bhatia, MD, discusses a recent interaction with one of his patients who scheduled an appointment to have her dry lips examined. However, after several minutes of discussion, he uncovered that she was three months into a course of isotretinoin, which she ordered online. Dr. Bhatia was shocked and dismayed to learn that isotretinoin is now easily accessible from the web. He did a quick Google search and found that anyone can buy a 6-month supply of isotretinoin from a slew of foreign distributers, without a prescription and without routine health care supervision. All it takes is a credit card.

Dr. Bhatia stresses that when patients are unaware of the risks and the adverse symptoms of taking isotretinoin, let alone the proper dosage protocol, their disregard of important details puts providers at risk as well. Dr. Bhatia poses a number of good questions:  Who will be responsible for any bad outcomes? How will these patients be brought under iPledge supervision? How can we educate the public about the dangers about self-medicating with isotretinoin? He asserts that “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.”

Meanwhile, the American Academy of Dermatology (AAD) is reestablishing their points concerning isotretinoin and reinforcing their support of the iPledge program. The AAD has also reiterated the need for continuing education about the risks of the drug and they have stringently opposed online dispensing without a prescription. According to Dr. Bhatia, “A warning about the need to have a prescription to purchase isotretinoin now appears on the AAD’s Dermatology A to Z entry page right after the content about the new app with links to the “Isotretinoin,” “Acne diagnosis and treatment,” and “BeSafeRx: Know your online pharmacy” pages. A warning also appears on the AAD’s isotretinoin entry page, which states, “Warning: You put your health at serious risk when you buy this medicine from an online site that does not require a prescription.”

As health care providers it’s important to know that your patients are able to order isotretinoin (and other drugs) online without a prescription, and to talk to them about the dangers of managing their acne with isotretinoin without supervision. While some patients may chafe under the strict iPledge requirements, we know that it is an important and necessary program that is designed to prevent serious health issues from arising. 


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Image: Andronicusmax

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