In the end, we are dependent on creatures we have made. Goethe  Isotretinoin and iPledge  on the Global Stage by Ava Atri, B.A. and David J. Elpern, M.D. Keywords: isotretinoin, regulation, iPledge program, teratogen Introduction Isotretinoin has revolutionized the treatment of acne since it was approved by the U.S. Federal Drug Administration in 1982. Because it is teratogenic, some countries rigorously regulate its prescriptions.  In the United States, prescribers and patients must comply with the iPledge Program in order to write or fill isotretinoin prescriptions.1  A chance discussion with a colleague from Iran, where isotretinoin can now be purchased without a prescription, led us to survey a number of other … Continue reading →