RACGP Pushes for GPs to Prescribe Isotretinoin After TGA Decision
10 Nov 2026
The RACGP has expressed strong disappointment with the TGA's interim decision, which keeps the current restrictions on prescribing isotretinoin. The medication is commonly used to treat severe acne, but its initial prescription is currently limited to dermatologists.
The TGA raised concerns about possible birth defects, the complexity of treatment and the risk of increased prescribing through telehealth services.
The decision follows an application submitted by the RACGP in June last year. The college wanted qualified GPs to have the authority to start patients on the medication.
Dr Tracey Purnell, Chair of the RACGP Specific Interests Dermatology group, said the decision had caused frustration among GPs. She believes general practice already involves managing medicines with serious safety risks, including drugs that can cause birth defects.
Dr Purnell, who works in Wagga Wagga, regional New South Wales, said allowing GPs to start isotretinoin treatment could improve access for patients who face difficulties getting appointments with dermatologists.
She also pointed out that other countries, including New Zealand, allow GPs and nurse practitioners to prescribe isotretinoin. New Zealand introduced this arrangement in 2009.
The TGA issued additional safety warnings about isotretinoin last year. These included the need for mental health assessments before treatment and warnings about possible sexual health-related side effects.
However, Dr Purnell said GPs already manage many of these concerns as part of their regular work. She believes appropriate training and clear referral pathways could help GPs prescribe the medication safely.
The RACGP is encouraging doctors to contribute de-identified clinical examples to its response or make their own submissions to the TGA.
RACGP President Dr Michael Wright also expressed frustration over the TGA's decision and the lengthy delay in responding to the application. He said the issue was about making sure patients could access treatment without unnecessary delays and high costs.
He referred to a recent Grattan Institute report highlighting the high out-of-pocket costs associated with several medical specialties, including dermatology.
According to the TGA, it received 393 responses to the application. Of these, 383 opposed removing the current prescribing restrictions. Many respondents raised concerns that changing the rules could weaken existing safety measures.
Dr Wright said the RACGP would submit a stronger response addressing the TGA's concerns. The college has also requested an urgent meeting with the regulator to discuss the decision.
He encouraged GPs and patients to share their views so their experiences could be considered during the consultation.
RACGP Pushes for GPs to Prescribe Isotretinoin After TGA Decision
Source: RACGP newsGP; Therapeutic Goods Administration (TGA).
TGA consultation and interim decision