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.
Plecanatide
Plecanatide is being marketed by a sales force of nearly 250, and marketing is targeting the top 70% of brand name drug prescribers. SGYP reports that 60% of adult patients with CIC and commercial insurance have unrestricted access to Trulance. However, Express Scripts recently announced they would not include Trulance on its 2018 preferred drug formulary and SGYP has since taken a hit.