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Acitretin
Acitretin is the generic version of Soriatane. It is an oral retinoid medication used to treat severe psoriasis, particularly in adults. Acitretin is part of the retinoid class of drugs, which are derived from vitamin A. It works by modulating skin cell growth and differentiation, helping to manage conditions where the skin grows too quickly, such as psoriasis. This drug is generally prescribed for cases that do not respond adequately to other treatments, and it helps reduce scaling, inflammation, and thickened plaques on the skin.
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Frequently Asked Questions
How long does it take for Acitretin to show results?
Most patients start to notice improvements in their skin after two to three months of treatment.
Can Acitretin cure psoriasis?
No, acitretin does not cure psoriasis but can help manage the symptoms. Once treatment stops, the condition may return.
Is it safe to take Acitretin if I plan to get pregnant in the future?
Acitretin can cause severe birth defects. Women must avoid pregnancy while taking it and for at least three years after stopping the medication.
Can I drink alcohol while taking Acitretin?
No, alcohol should be strictly avoided during treatment and for at least two months after stopping acitretin due to the risk of increased side effects and prolonged drug activity.
What should I do if I miss a dose of Acitretin?
If you miss a dose, take it as soon as you remember unless it is almost time for your next dose. Do not take two doses at once to make up for a missed dose.
Comprehensive Drug Guide
How Does Acitretin Work?
Acitretin works by normalizing the growth and differentiation of skin cells. In conditions like psoriasis, skin cells multiply too quickly, leading to thickened, scaly patches. Acitretin slows down the overproduction of these cells and reduces inflammation. It also helps restore the skin’s normal appearance by encouraging the development of healthy skin cells, making it particularly effective for severe, plaque-type psoriasis.
Common Dosages
- Capsules: 10 mg, 17.5 mg, and 25 mg strengths
Typical Dosing
- For adults with psoriasis: The typical dose is 25 mg to 50 mg taken orally once a day, with or after meals. The exact dosage depends on the patient’s condition and response to treatment.
- It is usually taken for several months, and dosage adjustments may be made depending on clinical response.
Typical Dosing
FDA Approved Indications
- Severe plaque psoriasis (especially in adults)
- Pustular psoriasis
- Other severe forms of psoriasis that are unresponsive to other treatments
Off-Label Uses
- Off-label uses of acitretin may include treatment of conditions like palmoplantar keratoderma and lichen planus, though these uses should be guided by a healthcare provider.
Who Shouldn't Take Acitretin?
- Pregnancy or plans to become pregnant within three years after stopping treatment
- Severe liver or kidney disease
- Chronic alcoholism
- Known hypersensitivity to retinoids or any of the components of the formulation
Advice From The Pharmacist
- Women of childbearing age must avoid pregnancy while taking acitretin and for at least three years after stopping the medication due to the high risk of birth defects.
- Regular blood tests will be required to monitor liver function and cholesterol levels.
- Avoid excessive sunlight exposure or artificial UV light, as acitretin can make your skin more sensitive.
- Do not donate blood while taking acitretin and for three years after discontinuing, as this could potentially harm a pregnant recipient.
- Alcohol should be avoided while taking acitretin and for at least two months after stopping treatment.
Side Effects of Acitretin
Common Side Effects
- Dry skin, lips, and eyes
- Hair thinning
- Elevated liver enzymes
- Increased cholesterol and triglyceride levels
- Joint and muscle pain
Uncommon/Severe Side Effects
- Severe liver damage
- Vision problems (including blurred vision or difficulty seeing in low light)
- Severe allergic reactions (swelling, rash, difficulty breathing)
Risks and Warnings of Acitretin
- Teratogenicity: Acitretin can cause severe birth defects if taken during pregnancy. Women must follow strict contraception protocols.
- Liver Damage: Regular monitoring of liver function is essential, as acitretin can cause elevated liver enzymes and even liver failure in severe cases.
- Lipid Levels: Acitretin can increase cholesterol and triglycerides, so periodic blood tests are required to monitor these levels.
Interactions with Acitretin
Common Drug Interactions
- Alcohol: Alcohol must be avoided during treatment and for two months after stopping, as it can prolong the effects of acitretin and increase the risk of side effects.
- Tetracycline antibiotics: Can increase the risk of intracranial hypertension when combined with acitretin.
- Vitamin A supplements: Avoid taking additional vitamin A supplements while on acitretin to prevent toxicity.
Alternatives to Acitretin
- Methotrexate: An immunosuppressant commonly used for severe psoriasis.
- Cyclosporine: Another immunosuppressant effective in severe psoriasis.
- Biologics such as Humira (adalimumab), Enbrel (etanercept), and Stelara (ustekinumab) are often used for moderate to severe psoriasis when retinoids are not effective or tolerated.
