GLP-1RAs and Isotretinoin: A Risky Combination?
Recent reports on dermatologic side effects of GLP-1 receptor agonists (GLP-1RAs) have prompted a closer look at how these drugs interact with other treatments, especially isotretinoin, a powerful and highly teratogenic acne medication.
Isotretinoin comes with strict contraceptive requirements for patients who can become pregnant, but adherence isn’t always perfect. At the same time, GLP-1RAs—used for weight loss and diabetes—are known to boost fertility by promoting ovulation and improving insulin sensitivity, particularly in women with obesity or PCOS.
As patients lose weight on GLP-1RAs, their chances of conceiving, sometimes unexpectedly, may increase. This makes reliable contraception even more crucial when isotretinoin is in use. Compounding the issue, GLP-1RAs delay gastric emptying, which may reduce the absorption of oral medications, including isotretinoin and oral contraceptives—potentially compromising both acne treatment and pregnancy prevention.
Although no clinical studies have yet evaluated the combination of GLP-1RAs and isotretinoin, the overlap is growing—especially among adolescents. Until more data are available, dermatologists should counsel patients on the possible risks and consider recommending long-acting contraceptive options when isotretinoin is prescribed alongside GLP-1RAs.
J Drugs Dermatol. 2025;24(6):638.
