It was soon placed by the SMART program (System to Manage Accutane Related Teratogenicity) that placed more emphasis on pregnancy testing and contraception. The FDA launched a new plan called the iPLEDGE with stricter requirements that required patients and doctors to register in an electronic database before the drug can be dispensed. It also includes the previously stated requirements regarding pregnancy tests and birth control.
A survey was conducted among 34 women who became pregnant while taking isotretinoin. These women had contacted a birth defect information service seeking information on the effects of isotretinoin. The purpose of the survey was to evaluate how the drug was dispensed in women who subsequently became pregnant and to identify possible reasons for failure in preventing conception.
The results of the OTIS survey show that the majority of women who participated were treated for less severe disease than is recommended in the SMART program. A total of 24 percent of the women reported receiving contraception counseling while taking the drug.
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