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.