Acitretin

Acitretin is an FDA-approved medication for treating severe psoriasis and other skin disorders. It is also effective in alleviating symptoms associated with skin overgrowth and thickening. The prescription medication is available in capsule form, with strengths of 10 and 25 mg, and should be taken once daily with the main meal. It is not approved for use in individuals less than 18 years of age. However, after determining if the medication is right for you and the benefits of the medication outweigh the potential risks, your doctor may prescribe you Acitretin. The medication dosage depends on the patient’s condition and body’s response to treatment. You should not take the medication more frequently, in more quantities, and for longer than prescribed, as it may cause unwanted side effects. For personalized advice and recommendations, consult a licensed healthcare professional and ask them in case of any query or concern.

Acitretin is an oral medication primarily used to manage severe psoriasis and other skin disorders. As a retinoid, it is structurally related to vitamin A and functions by normalizing the growth rate of skin cells, thereby helping to alleviate symptoms associated with skin overgrowth and thickening. Acitretin is available in capsule form, with strengths of 10 mg & 25 mg, and should be taken once daily with the main meal. This medication is suitable for adults and is not approved for individuals under 18 years of age.

Taking Acitretin requires careful adherence to prescribed doses to avoid potential side effects, such as back pain, joint or bone pain, severe headaches, and nausea. More adverse reactions may include liver damage and psychiatric effects like depression or suicidal thoughts. It is crucial for patients, especially women of childbearing age, to follow specific precautions due to the high risk of severe congenital disabilities. Women must use effective contraception during and for three years after treatment. Acitretin should not be combined with alcohol or certain other medications to avoid harmful interactions.

If a dosage is missed, it should be taken as soon as you remember, unless the next dose is almost due, in which case it should be skipped. In cases of overdose, immediate medical attention is necessary. Acitretin should be stored in its original container at room temperature, away from light and moisture. Patients are advised to consult regularly with their healthcare provider to monitor the drug’s effectiveness and manage any side effects.

• It is used to treat skin disorders such as severe psoriasis.

Acitretin is available as a capsule and can be taken orally daily with the main meal. It is available in strengths of:

• 10 mg
• 25 mg

Recommended Dosage for Different Patients

For severe psoriasis

• Adults: Initially, 25 to 50 milligrams should be given once daily as a single dose. Gradually, your doctor may adjust your dose as needed. The dosage typically depends on how your body responds to the medication and what condition is being treated.
• Children: The doctor must determine the dose and use for pediatric patients. Acitretin is not approved for use in individuals younger than 18 years of age.

[Note: These recommendations may vary from person to person. Discuss them with your doctor; they’ll customize your dosage accordingly.]

• Read and follow the instructions given in the patient information leaflet that comes with the prescription before taking Acitretin.
• Take Acitretin as prescribed by your doctor. Do not take it in more quantity, frequently, or longer than recommended. Doing so may increase your risk of unwelcome side effects.
• Ask your physician or a licensed healthcare professional for any queries or concerns.
• You will receive information about the Do Your P.A.R.T. program, also known as the Pregnancy Prevention Actively Required During and After Treatment program.
• This is crucial information regarding how to prevent pregnancy while taking this medication. If you have any questions regarding this program, speak with your doctor.
• Taking this medication with your main meal of the day is essential.
• The dosage of Acitretin depends on the condition being treated and how the body responds to the medication.
• Do not change your dosage without consulting a licensed healthcare professional. Your recovery will not speed up with increased dosage, but it may increase the likelihood of side effects.
• It may take around two to three months before the benefits of this medication are noticeable.
• To get optimal results from the medication, it is recommended that you maintain consistency in dosage and take it around the same time every day.

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

Acitretin is typically prescribed for long-term use when other psoriasis medications are ineffective or unsuitable for an individual. It belongs to a class of drugs called retinoids. These retinoids are related to retinol, a form of vitamin A. Acitretin functions by binding to receptors in the body, which play a crucial role in normalizing the speed of skin cell growth. It also helps reduce the overgrowth and thickening of skin cells. This effect is particularly beneficial in managing conditions like psoriasis.

Common side effects of Acitretin may include:

• Back pain
• Bad, unusual, or unpleasant (after) taste
• Pain in the joint or bone
• Change in taste
• Continued ringing, buzzing, or other unexplained noise in the ears
• Difficulty with moving or walking
• Excessive muscle tone
• Feeling of warmth
• Severe or continuing headache
• Hair loss
• Hearing loss
• Insomnia
• Increased sensitivity to pain and touch
• Mood changes or depression
• Muscle stiffness, tension, or tightness
• Nausea (severe and continuing)
• Redness of the skin
• Thinning of the skin with easy bruising
• Tingling in the hands and feet
• Tongue irritation
• Trouble sleeping
• Severe vomiting

Mild side effects of Acitretin may include:

• Conjunctivitis
• Increased Liver Enzymes
• Mouth ulcer
• Blurred vision

Adverse side effects of Acitretin may include:

• Liver damage. Symptoms may include:
  • Dark urine
  • Loss of appetite
  • Nausea
  • Pain in the upper right part of the stomach
  • Vomiting
  • Yellowing of the skin or eyes
• Cardiovascular problems such as:
  • Flushing
  • Acute myocardial infarction
  • Thromboembolism
  • Stroke
• Immune System Disorders. Symptoms may include:
• Hypersensitivity reactions, including angioedema and urticaria
• Nervous System. Symptoms may include:
  • Headache
  • Pain
  • Rigors
  • Myopathy
  • Peripheral neuropathy, which improved after discontinuation of Acitretin.
• Psychiatric disorders: Instances of symptoms such as aggressive behavior, depression, insomnia, self-harm, and suicidal thoughts were reported. It is unclear if these are directly related to Acitretin due to other contributing factors.
• Vulvovaginitis

[Note: This list may not cover all possible side effects. Always consult with your healthcare provider for medical advice about side effects.]

• You should not use Acitretin if you are pregnant, suspect a pregnancy, or planning to become pregnant within three years of stopping this medication, as it may cause congenital disabilities.
• One month before taking this medication and after three years of stopping treatment, you should use two effective birth control methods.
• Females who are of childbearing age should not use this medication unless other treatment options have been tried and failed. Before using this medication, women should take two negative pregnancy tests.
• It is considered unsafe for women to consume alcohol while receiving treatment with Acitretin and for at least two months after the last dose.
• Avoid donating blood while taking the medication and for at least three years after your last dose.
• Acitretin may cause severe liver disease. Stop taking this medication if you notice signs and symptoms such as loss of vomiting, appetite, nausea, yellowing of your skin or eyes, and dark-colored urine.

Boxed Warning

For female patients

• You should not take Acitretin if you are pregnant, suspected of having pregnancy, or planning to become pregnant within the next three years. Acitretin may cause harmful side effects to the unborn baby.
• Use effective forms of pregnancy to prevent pregnancy. Let your doctor know about the type of birth control you are planning to use.
• If you are planning to use an oral contraceptive, tell your doctor and discuss with them the risks and benefits associated with its use.
• It is noteworthy to mention that Acitretin interferes with the working of microdosed progestin, also known as ‘mini pill’ oral contraceptives.
• You do not require two forms of birth control methods if you have had a hysterectomy.
• Let your doctor know immediately if you think you may be pregnant.
• Do not consume food items, beverages, and medications containing alcohol. Alcohol and Acitretin may combine to form a substance that takes a long time to get out of your body completely and can cause fetal harm if you become pregnant.
• Before you start treatment with Acitretin, your doctor may give you an informed consent/patient agreement. Make sure to read this carefully before you begin taking Acitretin. Ask your doctor if you have any queries or concerns.

For male patients

Men who take this medication have a small amount of Acitretin present in the semen. It is unknown if this small amount of drugs can cause harm to the fetus. Talk about the risks of taking this medication with your doctor if your partner is pregnant or is planning to become pregnant.

For male and female patients

• You should not donate blood while you are receiving treatment with Acitretin and after three years of treatment.
• Acitretin may cause liver damage. Let your doctor know if you have ever had a liver-related issue. Call your doctor immediately if you have the following symptoms:
  • Pain in the upper right part of the abdomen
  • Nausea/vomiting
  • Yellowing of the skin or eyes
  • Loss of appetite
  • Dark colored urine
• Do not donate blood while taking Acitretin and for three years after treatment.

• Do not take this medication if you think you may be pregnant or are planning to become pregnant within the next three years.
• Consult a licensed healthcare professional before taking Acitretin if you plan to breastfeed a baby.
• You should only take this medication after weighing the potential risks with benefits.
• Regularly visit your doctor to monitor your improvement and ensure the medication works properly. Your doctor may advise you to take some tests to look for unwelcome side effects.
• You should not take tetracycline or methotrexate to treat an infection while you are receiving treatment with Acitretin, as the interaction of these drugs may cause unwanted side effects.
• You should not take Vitamin A or any Vitamin A supplement while using this medication, as it may increase your risk of side effects.
• During the first few weeks of treatment, your skin condition may improve or get worse, and you may also notice some irritation on your skin. But if the condition does not improve within 8-12 weeks, let your doctor know.
• Acitretin may cause joint pain, difficulty moving, muscle pain, or stiffness. It may also make you get hurt more easily during rough sports and heal more slowly.
• The medication may cause blurred vision or night blindness. The decrease in night vision may occur suddenly. Do not drive, operate heavy machines, or engage in activities that require vision if you cannot see well. Call your doctor at once if you notice any vision changes.
• This medication may also cause dryness in the eyes, mouth, throat, and nose. You may become uncomfortable wearing contact lenses while using them. Check with your doctor if the symptoms do not improve or become worse.
• As your skin becomes more prone to dryness, irritation, and sunburn, avoid exposing it to cold weather, sunlight, and wind, even on cloudy days.
• Do not stop taking this medication abruptly or without consulting your healthcare provider or doctor, as it can cause side effects.
• Use sunblock and sunscreen lotions with an SPF of more than 15 daily.
• Wear protective clothing and avoid direct sunlight, especially during daylight hours.
• Avoid skin products that irritate your skin such as too dry and abrasive soaps, cosmetics, or skin cleansers.
• Acitretin may affect blood sugar levels in diabetic patients. Tell your doctor immediately if you notice any change in the blood glucose levels and urine tests.
• In some people, this medication may also cause changes in mood and behavior. If you notice any signs, such as suicidal thoughts and behavior, check with your doctor immediately.
• You should not take other medications without consulting your doctor or licensed healthcare professional. This includes all prescription medications, over-the-counter drugs, vitamins, and herbal products.

This medication is contraindicated for use in patients with the following conditions:

• Depression
• Diabetes
• Heart Disease
• High Cholesterol
• Kidney Disease
• Liver Disease

• Maintaining consistency and taking the dosage on time to get the best results from the medication is crucial.
• If you have missed a dose of Acitretin, take it as soon as you remember.
• However, if it is almost time for your next dose, you can omit the missed dose and take the next dose of Acitretin as per your regular dosing schedule.
• Do not take double or extra doses of Acitretin to compensate for the missed dose.

[Note: If you have missed a medication dose and are unsure when to take the next one, consult your doctor or pharmacist immediately.]

In case of an overdose of the medication, seeking emergency medical attention is crucial. If the victim has passed out, had a seizure, or has difficulty breathing, immediately call 911 or head to the nearest emergency room. Symptoms of an overdose include:

• Vomiting/ nausea
• Dizziness or light-headedness
• Vomiting
• Loss of appetite
• Pain in the joints and bone
• Headache
• Diarrhea
• Dry, itchy, and scaly skin

[Note: If you consumed more than the recommended dose, get medical help immediately or call the Poison Help line at 1-800-222-1222.]

• Keep the medication in the original container at room temperature, away from direct light, excess heat, and moisture.
• Keep Acitretin in a safe space out of sight and within reach of children.
• Do not keep medications that are no longer needed or outdated. Discard such medications safely.
• Do not throw the medication in the household garbage bin or wastewater.
• Do not flush the medication unless instructed to do so.
• Contact your pharmacist or the nearest local waste disposal company for more information on safely disposing unwanted medications.

[Note: Discuss with your healthcare professional the proper disposal of unused medicine and any questions you may have regarding its storage.]

Acitretin may interact with the following drugs and affect how it may work.

• Chlortetracycline
• Demeclocycline
• Doxycycline
• Eravacycline
• Ethanol
• Levonorgestrel
• Lymecycline
• Meclocycline
• Methacycline
• Minocycline
• Omadacycline
• Oxytetracycline
• Palovarotene
• Pexidartinib
• Rolitetracycline
• Sarecycline
• Tetracycline
• Tigecycline

[Note: This isn’t a complete list, and there could be other drugs that interact with Acitretin. Make sure to tell your doctor about any prescription, over-the-counter, or herbal products you’re taking.]

• Stelara (ustekinumab)
• Methotrexate (methotrexate)
• Triamcinolone topical (triamcinolone acetonide)
• Skyrizi (risankizumab)
• Remicade (infliximab)

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.]

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