All prescriptions for Accutane must come from a certified prescriber, and everyone who takes Accutane is carefully monitored through an online service called iPledge. The pharmacy will not fill a prescription for Accutane unless all of the monthly iPledge requirements are fulfilled. Their main focus is the prevention of pregnancies, but even male patients have specific monthly steps, and all patients receive an iPledge ID number and password. Female patients are required to show a monthly negative pregnancy test. The first prescription cannot be filled until two pregnancy tests are negative. Additionally, most female patients must agree to two forms of contraception (typically oral birth control and a barrier form) or complete abstinence.

The iPledge system can be frustrating. If everything occurs on a timely basis, it typically flows without hassle. At MASC, every prescription for Accutane is treated very seriously. Each visit includes reviewing the iPledge requirements and even going online to complete all the loose ends!