Oral Retinoids and Pregnancy

Retinoids taken by pregnant women pose a significant risk for severe birth defects in the unborn child. Pregnant or nursing women or those planning to become pregnant should not use these drugs. Women of childbearing age who take retinoids should have regular pregnancy tests. There are some differences in retinoid effects, however.

• Acitretin is cleared from the body in about three or four weeks, so the agent does not to appear to pose a for birth defects beyond that time. There is one important exception: Drinking alcohol converts acitretin to etretinate, which is a retinoid that is stored in fat cells for three years. Therefore, it may have the potential for causing birth defects during that time. Therefore, if a woman drinks alcohol while taking acitretin or any time during the two months after she stops, she must wait three years to conceive. Note some cooking products and over-the-counter preparations, such as cough syrup, may contain alcohol and be inadvertently ingested. Some experts, then, advise that acitretin not be given to any woman-regardless of alcohol use, who may become pregnant within three years of taking it.
• Isotretinoin is safer for women who wish to become pregnant since it is safely gone from the body within a month. The interaction with alcohol is not totally known, but the wisest route is to avoid alcohol and all alcohol-containing products when taking it.