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 BRAND NAMES
 MECHANISM OF ACTION
Acitretin helps to normalize keratinocytes differentiation
Acitretin is indicated for the treatment of severe psoriasis in adults.
Acitretin therapy should be initiated at 25 to 50 mg per day, given as a single dose with the main meal. Maintenance doses of 25 to 50 mg per day may be given dependent upon an individual patient’s response to initial treatment. Relapses may be treated as outlined for initial therapy.
- Pregnancy and in women who might get pregnant during Acitretin treatment or at any time for at least 3 years after stoping Acitretin treatment.
- Breast feeding
- Severe liver or kidney disease
- Chronic abnormally elevated blood lipid values
- Hypersensitivity to Acitretin or to other retinoids
- The combination of Methotrexate with Acitretin is contraindicated
- The combination of tetracyclines with Acitretin is contraindicated
 WARNINGS AND PRECAUTIONS
- Patients should not donate blood during and for at least 3 years following Acitretin therapy because women of childbearing potential must not receive blood from patients being treated with this drug.
- Patients should avoid the use of sun lamps and excessive exposure to sunlight (non-medical UV exposure) because the effects of UV light are enhanced by retinoids.
- Decreased night vision has been reported with Acitretin therapy. Patients should be advised of this potential problem and warned to be cautious when driving or operating any vehicle at night.
- Liver Function Tests: Elevations of AST (SGOT), ALT (SGPT) or LDH were experienced by approximately 1 in 3 patients treated with Acitretin.
- Alcohol: Concurrent ingestion of acitretin and Alcohol has been associated with the formation of etretinate, which has a significantly longer elimination half-life than acitretin. Because the longer elimination half-life of etretinate would increase the duration of teratogenic potential for female patients, alcohol must not be ingested by female patients either during treatment with Acitretin or for 2 months after cessation of therapy.
- Acitretin interferes with the contraceptive effect of microdosed progestin preparations. Microdosed “minipill” progestin preparations are not recommended for use with Acitretin
- Methotrexate: An increased risk of hepatitis has been reported to result from combined use of methotrexate and etretinate (Acitretin is a metabolite of etretinate). Consequently, the combination of methotrexate with acitretin is also contraindicated
- Tetracyclines: Since both acitretin and tetracyclines can cause increased intracranial pressure, their combined use is contraindicated.
- Concomitant administration of vitamin A and/or other oral retinoids with acitretin must be avoided because of the risk of hypervitaminosis A.
 PREGNANCY AND LACTATION
- Pregnancy Category X (US). Major human fetal abnormalities have been reported with the administration of Acitretin, therefore, it must not be used by females who are pregnant, or who intend to become pregnant during therapy or at any time for at least 3 years following discontinuation of therapy. Acitretin also must not be used by females who may not use reliable contraception while undergoing treatment and for at least 3 years following discontinuation of treatment (2 effective forms of contraception (birth control) should be used simultaneously). Acitretin should also be considered only for women with severe psoriasis unresponsive to other therapies or whose clinical condition contraindicates the use of other treatments.
 SIDE EFFECTS
Adverse reactions are dose-related and generally typical of hypervitaminosis A. Alopecia (Hair loss) and mucocutaneous symptoms such as cheilitis and drying of the mucous membranes (Dry mouth, Dry eyes) are particularly prevalent. Hypertriglyceridemia and elevation of cholesterol levels, joint pain and tight muscles also occur.
Serious side effects. These do not happen often, but they can lead to permanent harm, or rarely, to death:
- Bad headaches, nausea, vomiting, blurred vision. These symptoms can be signs of increased brain pressure that can lead to blindness or even death.
- Decreased vision in the dark (night blindness). This problem usually goes away when Acitretin treatment stops.
- Depression. There have been some reports of patients developing mental problems including a depressed mood, aggressive feelings, or thoughts of ending their own life (suicide).
Acitretin can cause also severe birth defects