Community pharmacists' knowledge of isotretinoin safety

Objective: To explore the practice and knowledge of community pharmacists in Saudi Arabia regarding dispensing isotretinoin-containing products. Methods: This was a cross-sectional study conducted in 2012 that included community pharmacists from 3 cities in Saudi Arabia. A validated and piloted self-administered survey collected demographics and information on the pharmacist's knowledge regarding isotretinoin precautions, as well as his dispensing, and counseling practices. Results: One hundred and sixteen questionnaires were returned with a 72.5% response rate. Only around half of the participants (56%) knew the correct pregnancy risk classification category for oral isotretinoin. Most participants (78%) correctly identified teratogenicity as the most serious risk associated with the use of oral isotretinoin. However, only 6.2% of the pharmacists recommended using 2 methods of contraception. Almost one-fifth of the pharmacists dispensed isotretinoin without a prescription. Finally, 11% of the pharmacists did not ask whether the patient performed a pregnancy test prior to dispensing oral isotretinoin. Conclusions: Pharmacists at community pharmacies are not adequately aware of the risks for female patients using isotretinoin. Additionally, an alarming proportion of pharmacists dispense isotretinoin without a prescription. It is essential to implement risk minimization plans for certain medications to limit and prevent adverse drug reactions.