Acitretin Brand Name– Soriatane
What is Acitretin
Acitretin (etretin or Ro 10—1670) is an aromatic, synthetic retinoid; approved for the treatment of severe psoriasis in adults.
Acitretin is the principal active component of etretinate, which is no longer available in the US.
Acitretin has a much shorter half-life (approximately 50 hours) than its parent etretinate (approximately 120 days); etretinate has been detected in serum up to 2 years after completing a course of therapy.
Although acitretin, like etretinate, is also teratogenic, women can conceive much earlier after discontinuing treatment with acitretin than after etretinate. Women must avoid becoming pregnant for at least 3 years after stopping acitretin therapy.
Ingestion of acitretin and alcohol has been associated with the formation of etretinate; therefore, patients should avoid alcohol-containing products including beverages and all medicines that contain alcohol.
In October 2007, the Do YourP.A.R.T. program (Pregnancy Prevention Actively Required During and After Treatment) was announced; the program was developed to prevent females who are pregnant from receiving acitretin and to prevent pregnancies from occurring during and for 3 years after treatment with acitretin.
A prescription for acitretin must not be given to any female of reproductive potential until pregnancy has been excluded.
Indications
- eczema
- lichen planus
- psoriasis
For the treatment of adults with severe, recalcitrant psoriasis, including plaque, guttate, erythrodermic, palmar-plantar and pustular types
Side Effects
- abdominal pain
- alopecia
- angioedema
- anorexia
- appetite stimulation
- arthralgia
- arthropathy
- back pain
- blepharitis
- blurred vision
- bone pain
- bullous rash
- capillary leak syndrome
- cataracts
- chalazion (meibomian cyst)
- cheilitis
- conjunctivitis
- cranial nerve palsies
- depression
- diabetes mellitus
- diabetic ketoacidosis
- diaphoresis
- diarrhea
- diplopia
- dysgeusia
- ectropion
- edema
- elevated hepatic enzymes
- epistaxis
- exfoliative dermatitis
- fatigue
- fever
- flushing
- gingivitis
- headache
- hepatitis
- hot flashes
- hyperbilirubinemia
- hypercholesterolemia
- hyperesthesia
- hyperglycemia
- hyperlipidemia
- hyperostosis
- hypersalivation
- hypertonia
- hypertriglyceridemia
- hypervitaminosis A
- hypoalbuminemia
- hypoglycemia
- hypotension
- increased intracranial pressure
- infection
- insomnia
- jaundice
- lacrimation
- myalgia
- myocardial infarction
- myopathy
- nausea
- night blindness
- ocular hemorrhage
- ocular irritation
- ocular pain
- ocular pruritus
- otalgia
- pancreatitis
- papilledema
- paresthesias
- peripheral neuropathy
- photophobia
- photosensitivity
- pruritus
- pseudotumor cerebri
- psoriaform rash
- purpura
- rash
- rhabdomyolysis
- rhinitis
- seborrhea
- sinusitis
- skin atrophy
- skin ulcer
- spontaneous fetal abortion
- stomatitis
- stroke
- suicidal ideation
- teratogenesis
- thromboembolism
- tinnitus
- urticaria
- vaginitis
- visual impairment
- vomiting
- weight gain
- xerophthalmia
- xerosis
- xerostomia
Monitoring Parameters
- LFTs
- pregnancy testing
- serum lipid profile
Contraindications
- alcoholism
- blood donation
- breast-feeding
- cardiac disease
- children
- contact lenses
- depression
- diabetes mellitus
- driving or operating machinery
- ethanol ingestion
- hepatic disease
- hypercholesterolemia
- hyperglycemia
- hyperostosis
- hypertriglyceridemia
- increased intracranial pressure
- infants
- male-mediated teratogenicity
- neonates
- obesity
- pancreatitis
- papilledema
- pregnancy
- pregnancy testing
- renal failure
- renal impairment
- requires an experienced clinician
- retinoid hypersensitivity
- suicidal ideation
- sunlight (UV) exposure
- visual disturbance
Interactions
- Acetohexamide
- Aminolevulinic Acid
- Chlorpropamide
- Conjugated Estrogens; Medroxyprogesterone
- Elagolix; Estradiol; Norethindrone acetate
- Eravacycline
- Estradiol Cypionate; Medroxyprogesterone
- Estradiol; Levonorgestrel
- Estradiol; Norethindrone
- Ethanol
- Ethinyl Estradiol; Etonogestrel
- Ethinyl Estradiol; Levonorgestrel
- Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
- Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
- Ethinyl Estradiol; Norethindrone
- Ethinyl Estradiol; Norethindrone Acetate
- Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
- Ethinyl Estradiol; Norethindrone; Ferrous fumarate
- Ethinyl Estradiol; Norgestrel
- Etonogestrel
- Fosphenytoin
- Glimepiride
- Glimepiride; Pioglitazone
- Glimepiride; Rosiglitazone
- Glipizide
- Glipizide; Metformin
- Glyburide
- Glyburide; Metformin
- Leuprolide; Norethindrone
- Levonorgestrel
- Medroxyprogesterone
- Mestranol; Norethindrone
- Methotrexate
- Methoxsalen
- Norethindrone
- Norgestrel
- Orlistat
- Phenytoin
- Photosensitizing agents (topical)
- Porfimer
- Salicylic Acid
- Segesterone Acetate; Ethinyl Estradiol
- Sodium Thiosulfate; Salicylic Acid
- St. John’s Wort, Hypericum perforatum
- Sulfonylureas
- Tetracyclines
- Tolazamide
- Tolbutamide
- Verteporfin
