There seems to be no evidence that the reliability of the combined oral contraceptives is affected by acitretin, and they are the contraceptive method of choice with teratogenic drugs. Progestogen-only oral contraceptives are not generally considered reliable enough for use with teratogenic drugs.
Contraceptives should be started one month before acitretin and continued for 2 years after stopping acitretin. In the USA, it is standard practice to recommend that a second form of contraception, such as a barrier method, should also be used. This is because, even though hormonal methods of contraception are highly effective, they do, on rare occasions, fail.
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