Before isotretinoin therapy, which statement is true?

• A. Positive pregnancy test
• B. No pregnancy test required
• C. Negative pregnancy test and informed consent are required
• D. Only a dermatology appointment needed

Answer: (C)

Isotretinoin is highly teratogenic, so starting treatment requires confirming the patient is not pregnant and obtaining informed consent that covers the risks and the need for strict contraception and ongoing pregnancy testing. A negative pregnancy test ensures there is no current pregnancy, and informed consent confirms the patient understands the serious risks and agrees to the required precautions. Therefore, a negative pregnancy test and informed consent are required before isotretinoin therapy. A positive pregnancy test would prevent starting treatment, and simply having a dermatology appointment does not address the essential safety and monitoring steps.