Isotretinoin
Isotretinoin is a teratogen; there is about a 20–35% risk for congenital defects in infants exposed to the drug "in utero", and about 30–60% of children exposed to isotretinoin prenatally have been reported to show neurocognitive impairment. Because of this, there are strict controls on prescribing isotretinoin to women who may become pregnant and women who become pregnant while taking isotretinoin are strongly advised to terminate their pregnancies.
Paracetamol/metoclopramide
Whilst the individual component drugs may be prescribed individually, as a combination, it is only available as the branded Paramax preparation in the UK. In the UK there are only two other combination analgesics with antiemetics (i.e., anti-nausea) products available: MigraMax (aspirin with metoclopramide) and the over-the-counter drug Migraleve (paracetamol and codeine for analgesia, with buclizine as the antiemetic). The role for these products is between just the use of simple analgesics (paracetamol or ibuprofen) and the triptan class of drugs; although the latter are not options during pregnancy. In the elderly although triptans are generally avoided, so too are antiemetics such as metoclopramide due to higher risks of side effects. In Australia and New Zealand, the combination is available without prescription from pharmacies.