acitretin

Generic Name: acitretin (A si TRE tin)
Brand Name: Soriatane, Soriatane CK

What is acitretin?

Acitretin is a retinoid, which is a form of vitamin A.

Acitretin is used to treat severe psoriasis in adults. Acitretin is not a cure for psoriasis, and you may relapse after you stop taking this medication.

Acitretin may also be used for purposes not listed in this medication guide.

What is the most important information I should know about acitretin?

Acitretin can harm an unborn baby or cause birth defects. Do not use acitretin if you are pregnant or plan to become pregnant within 3 years after you stop taking acitretin. Before and during treatment, and for 3 years after treatment, you must have negative pregnancy tests at regular intervals to make sure you are not pregnant.

Slideshow: Psoriasis - Treatment Options to Manage Your Symptoms

Do not donate blood while taking acitretin and for at least 3 years after you stop taking it. Donated blood may be given to a pregnant woman and could cause birth defects if the blood contains acitretin.

Women taking acitretin must not drink alcohol during treatment and for at least 2 months after treatment ends. Alcohol can cause acitretin to convert to another substance in your body that can take 3 years or longer to clear from your body. Read the labels of all foods and medicines you consume to make sure they do not contain alcohol.

Acitretin is available only under an agreement that you will use birth control and undergo required pregnancy testing, and that you will not consume alcohol while you are taking acitretin and for 2 months after you stop taking it.

What should I discuss with my healthcare provider before taking acitretin?

You should not take this medicine if you are allergic to acitretin or similar medications (such as Accutane, Altinac, Avita, Renova, Retin-A, and others), or if you have:

  • severe liver or kidney disease;

  • high levels of triglycerides (a type of fat) in your blood;

  • if you are pregnant or breast-feeding;

  • if you are also using methotrexate (Rheumatrex, Trexall); or

  • if you are also using a tetracycline antibiotic, including demeclocycline (Declomycin), doxycycline (Adoxa, Doryx, Oracea, Vibramycin), minocycline (Dynacin, Minocin, Solodyn, Vectrin), tetracycline (Brodspec, Panmycin, Sumycin, Tetracap), and others.

Acitretin is available only under an agreement that you will use birth control and undergo required pregnancy testing, and that you will not consume alcohol while you are taking acitretin and for 2 months after you stop taking it.

To make sure acitretin is safe for you, tell your doctor if you have:

  • kidney or liver disease;

  • heart disease;

  • high cholesterol;

  • diabetes (you may need to check your blood sugar more often);

  • depression;

  • if you receive phototherapy;

  • if you drink large amounts of alcohol; or

  • if you have ever taken etretinate (Tegison or Tigason).

Acitretin can cause birth defects. Do not use if you are pregnant or plan to become pregnant within 3 years after you stop taking acitretin. You must use 2 effective forms of birth control starting at least 1 month before treatment with acitretin, and for at least 3 years after you stop taking this medication. Use both forms of birth control together every time you have sex.

The first birth control method should include one of the following forms: birth control pills (but not the "mini-pill"), an intrauterine device (IUD), birth control shots, inserts, skin patches, or implants, a tubal ligation, or your male partner's vasectomy.

The second birth control method should include one of the following forms: a latex condom, or a diaphragm or cervical cap used together with a spermicide cream or gel.

For women taking acitretin: Before using acitretin, you must have 2 negative pregnancy tests. The first test is given when your doctor prescribes acitretin. The second test must be given during the first 5 days of your menstrual period just before you start taking acitretin. No testing is needed if you have had a hysterectomy or have gone completely through menopause.

You will need monthly pregnancy tests while you are taking acitretin. If you are not menstruating, your pregnancy test should be done at least 11 days after you last had sex without using 2 effective forms of birth control.

Do not miss a scheduled pregnancy test or you may not be able to continue taking acitretin.

You will also need pregnancy tests every 3 months for at least 3 years after you stop taking this medication.

Call your doctor right away if you think you might be pregnant, if you miss a period, or if you have had sex without using the 2 recommended forms of birth control within 3 years of taking acitretin.

Acitretin can pass into breast milk and harm a nursing baby. Do not take acitretin if you are breast-feeding a baby.

How should I take acitretin?

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Take acitretin with food.

Your psoriasis may seem to get worse at the start of therapy. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve after one course of acitretin treatment.

To be sure this medication is not causing harmful effects, your blood may need to be tested often. Your liver function and cholesterol may also need to be tested.

Never share this medicine with another person, even if they have the same symptoms you have.

Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking acitretin?

Women taking acitretin must not drink alcohol during treatment and for at least 2 months after treatment ends. Alcohol can cause acitretin to convert to another substance in your body that can take 3 years or longer to clear from your body. Read the labels of all foods and medicines you consume to make sure they do not contain alcohol.

Do not donate blood while taking acitretin and for at least 3 years after you stop taking it. Donated blood may be given to a pregnant woman and could cause birth defects if the blood contains acitretin.

Avoid taking vitamin supplements that contain vitamin A. Acitretin is a form of vitamin A, and taking too much can cause side effects similar to overdose symptoms.

Avoid exposure to sunlight or tanning beds. Acitretin can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Acitretin may impair your vision, especially at night. Be careful if you drive or do anything that requires you to see clearly.

Acitretin side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using acitretin and call your doctor at once if you have:

  • blurred vision, headache or pain behind your eyes, sometimes with nausea and vomiting;

  • sudden decrease in night vision;

  • depressed mood, aggression, unusual thoughts or behavior, thoughts of hurting yourself;

  • loss of feeling in your hands or feet, trouble moving, pain in your back, joints, muscles, or bones;

  • mouth sores, swollen or bleeding gums;

  • high blood sugar--increased thirst, increased urination, hunger, dry mouth, fruity breath odor, drowsiness, dry skin, weight loss;

  • heart attack or stroke symptoms--chest pain or pressure, sudden numbness or weakness (especially on one side of the body), sudden severe headache, problems with speech or balance, swelling or warmth in one or both legs;

  • liver problems--nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

  • severe skin reaction--itching, redness, pain, or swelling of your skin; red skin rash that spreads and causes blistering and peeling; or

  • signs of a blood vessel problem--sudden swelling, rapid weight gain, fever, muscle pain, feeling light-headed.

Common side effects may include:

  • dry eyes;

  • dry or runny nose, nosebleeds;

  • chapped lips, dry mouth;

  • peeling skin on your hands and feet, hair loss;

  • mild itching, scaling or sticky feeling on your skin;

  • weak nails, fragile skin; or

  • mild joint pain, muscle stiffness.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Acitretin dosing information

Usual Adult Dose for Psoriasis:

Initial dose: 25 to 50 mg orally per day, given as a single dose with the main meal
Maintenance dose: 25 to 50 mg orally per day; dosage should be individualized according to patient's response

What other drugs will affect acitretin?

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with acitretin, especially:

  • etretinate;

  • glyburide;

  • methotrexate;

  • phenytoin;

  • St. John's wort; or

  • hormone replacement therapy or birth control pills (especially "minipills").

This list is not complete. Other drugs may interact with acitretin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about acitretin.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 5.02. Revision Date: 2014-08-28, 7:50:19 AM.

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