What is the best way to reduce birth defects caused by the acne drug isotretinoin?

But the drug can also cause severe birth defects if it is taken by pregnant women. What is the best way to prevent pregnant women from taking the drug, and to prevent women taking it from getting pregnant?

A debate article in PLoS Medicine considers the pros and cons of a new Internet-based system, called iPLEDGE (www.ipledgeprogram.com), which tries to tries to ensure that the drug is dispensed only when there is documentary proof that the patient is not pregnant and is using two forms of birth control.

Citation: Abroms L, Maibach E, Lyon-Daniel K, Feldman SR (2006) What is the best approach to reducing birth defects associated with isotretinoin? PLoS Med 3(11): e483.

– Caption: The iPLEDGE Logo – iPLEDGE is a “comprehensive program to help you get prepared, plan your treatments, and ensure you don't get pregnant during the course of isotretinoin therapy” (https://www.ipledgeprogram.com/). Figure: Covance Inc.