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if the patient has unprotected heterosexual intercourse at any time 1 month before, during, or 1 month after therapy, she must stop taking accutane isotretinoin immediately, if on therapy have a pregnancy test at least 19 days after the last act of unprotected heterosexual intercourse start using 2 forms of effective contraception simultaneously again for 1 month before resuming accutane isotretinoin therapy have a second pregnancy test after using 2 forms of effective contraception for 1 month as described above depending on whether she has regular menses or not.