Acitretin

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Approved Treatment Indication:

Psoriasis

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Summary

What conditions is Acitretin used for?
Acitretin is used to treat severe forms of psoriasis, including erythrodermic and pustular psoriasis that are resistant to other treatments. It's also used for severe congenital ichthyosis and severe Dariers disease.
How does Acitretin work in the body?
Acitretin works by slowing the growth of skin cells, reducing the scaling, thickness, and redness associated with severe psoriasis and other skin disorders. It's a retinoid, related to vitamin A, and affects the way skin cells develop and shed.
What are the usual dosages and routes of administration for Acitretin?
For adults, the usual daily dose of Acitretin is 25 to 50 mg taken once daily with the main meal. For children, Acitretin is generally not recommended due to potential severe side effects.
What are the most commonly observed adverse effects of Acitretin?
Common side effects of Acitretin include dry skin, chapped lips, hair loss, and dry eyes. Serious side effects can include liver damage, increased blood lipids, and depression.
What are the important safety warnings and contraindications for Acitretin?
Acitretin is highly teratogenic and must not be used by women who are pregnant or may become pregnant within 3 years after stopping the medication. It's also contraindicated in patients with severe liver or kidney impairment, and those taking methotrexate or tetracyclines.

Government Approvals

US(FDA), UK(BNF)

WHO Essential Medicine

NO

Known Teratogen

Definite

Pharmaceutical Class

Retinoid

Controlled Drug Substance

NO

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Drug Ingredient

Acitretin

Learn more about this medicine -

Summary

What conditions is Acitretin used for?
Acitretin is used to treat severe forms of psoriasis, including erythrodermic and pustular psoriasis that are resistant to other treatments. It's also used for severe congenital ichthyosis and severe Dariers disease.
How does Acitretin work in the body?
Acitretin works by slowing the growth of skin cells, reducing the scaling, thickness, and redness associated with severe psoriasis and other skin disorders. It's a retinoid, related to vitamin A, and affects the way skin cells develop and shed.
What are the usual dosages and routes of administration for Acitretin?
For adults, the usual daily dose of Acitretin is 25 to 50 mg taken once daily with the main meal. For children, Acitretin is generally not recommended due to potential severe side effects.
What are the most commonly observed adverse effects of Acitretin?
Common side effects of Acitretin include dry skin, chapped lips, hair loss, and dry eyes. Serious side effects can include liver damage, increased blood lipids, and depression.
What are the important safety warnings and contraindications for Acitretin?
Acitretin is highly teratogenic and must not be used by women who are pregnant or may become pregnant within 3 years after stopping the medication. It's also contraindicated in patients with severe liver or kidney impairment, and those taking methotrexate or tetracyclines.

Indications and Purpose

What is Acitretin used for?

Acitretin is indicated for the treatment of severe psoriasis, including erythrodermic and pustular psoriasis, which are resistant to other forms of therapy. It is also used for severe congenital ichthyosis and severe Darier's disease. Acitretin is prescribed when other treatments have not been effective or are contraindicated.

How does Acitretin work?

Acitretin works by slowing the growth of skin cells, which helps reduce the scaling, thickness, and redness associated with severe psoriasis and other skin disorders. It is a retinoid, related to vitamin A, and affects the way skin cells develop and shed. This action helps improve the appearance and symptoms of the skin condition.

Is Acitretin effective?

Clinical trials have shown that Acitretin is effective in treating severe psoriasis, with significant improvements observed in scaling, thickness, and erythema of the skin. In double-blind, placebo-controlled trials, patients treated with Acitretin showed marked improvements compared to those on placebo. However, it may take 2-3 months to see the full benefits, and psoriasis often relapses after discontinuation.

How does one know if Acitretin is working?

The benefit of Acitretin is evaluated through regular follow-up appointments with your doctor, who will assess the improvement in your psoriasis symptoms, such as scaling, thickness, and erythema. Blood tests may also be conducted to monitor liver function and lipid levels, ensuring the medication is working effectively without causing harmful side effects.

Directions for Use

What is the usual dose of Acitretin?

For adults, the usual daily dose of Acitretin is 25 to 50 mg, taken as a single dose with the main meal. The dose may be adjusted based on individual response and side effects. For children, Acitretin is generally not recommended due to potential severe side effects, but if prescribed, the dose is about 0.5 mg/kg per day, not exceeding 35 mg/day. Always follow your doctor's specific instructions.

How do I take Acitretin?

Acitretin should be taken once daily with the main meal to enhance absorption. Avoid alcohol during treatment and for 2 months after stopping the medication, as it can interact with Acitretin to form a harmful substance. There are no specific food restrictions, but always follow your doctor's advice regarding diet and medication use.

For how long do I take Acitretin?

The typical duration of Acitretin use varies depending on the condition being treated and the patient's response. For psoriasis, treatment may last 6 to 8 weeks initially, with adjustments made based on effectiveness and side effects. Continuous use beyond 6 months is generally not recommended due to limited data on long-term safety. Always follow your doctor's guidance on treatment duration.

How long does it take for Acitretin to start working?

Acitretin may take 2 to 3 months or longer to show its full benefits in treating psoriasis. Some patients may notice improvements within the first 8 weeks, but it's important to continue taking the medication as prescribed and attend regular follow-up appointments with your doctor to monitor progress.

How should I store Acitretin?

Store Acitretin in its original container, tightly closed, at room temperature away from excess heat and moisture. Do not store it in the bathroom. Keep it out of reach of children and pets. Unused medication should be disposed of properly, preferably through a medicine take-back program, to prevent accidental ingestion by others.

Warnings and Precautions

Who should avoid taking Acitretin?

Acitretin is highly teratogenic and must not be used by women who are pregnant or may become pregnant within 3 years after stopping the medication. Alcohol consumption is prohibited during treatment and for 2 months after due to the risk of forming a harmful substance. Acitretin is contraindicated in patients with severe liver or kidney impairment, and those taking methotrexate or tetracyclines. Regular monitoring of liver function and lipid levels is essential.

Can I take Acitretin with other prescription drugs?

Acitretin should not be used with methotrexate or tetracyclines due to the risk of increased intracranial pressure and liver damage. It can also interfere with the effectiveness of microdosed progestin contraceptives. Patients should inform their doctor of all medications they are taking, including over-the-counter drugs and supplements, to avoid potential interactions.

Can I take Acitretin with vitamins or supplements?

Acitretin should not be taken with vitamin A supplements or other retinoids due to the risk of hypervitaminosis A, which can cause serious side effects. Patients should inform their doctor of all supplements they are taking to avoid potential interactions. St. John's wort should also be avoided as it may reduce the effectiveness of hormonal contraceptives.

Can Acitretin be taken safely while pregnant?

Acitretin is highly teratogenic and must not be used by women who are pregnant or may become pregnant within 3 years after stopping the medication. Human studies have shown a high risk of severe birth defects if Acitretin is taken during pregnancy. Women of childbearing potential must use two forms of contraception and undergo regular pregnancy tests during and after treatment.

Can Acitretin be taken safely while breastfeeding?

Acitretin should not be used while breastfeeding, as it can pass into breast milk and may harm the nursing infant. Women who are breastfeeding should either discontinue the medication or choose to stop breastfeeding while taking Acitretin. Always consult your doctor for personalized advice.

Is Acitretin safe for the elderly?

Elderly patients may experience higher plasma concentrations of Acitretin, so dose selection should be cautious, usually starting at the low end of the dosing range. This reflects the greater frequency of decreased liver, kidney, or heart function, and of concomitant disease or other drug therapy in this population. Regular monitoring and adjustments may be necessary to ensure safety and effectiveness.

Is it safe to exercise while taking Acitretin?

Acitretin may cause joint pain, muscle tightness, and bone pain, which could potentially limit the ability to exercise. If you experience these symptoms, it's important to discuss them with your doctor. They may adjust your treatment plan or suggest ways to manage the symptoms. Always consult your healthcare provider before making changes to your exercise routine.

Is it safe to drink alcohol while taking Acitretin?

Drinking alcohol while taking Acitretin is strongly discouraged. Alcohol can interact with Acitretin to form a substance that remains in the body for a long time and can harm a fetus. This interaction can extend the teratogenic risk of Acitretin, making it unsafe for women of childbearing potential. Therefore, avoid alcohol during treatment and for 2 months after stopping Acitretin.