acitretin

Generic Name: acitretin
Overview Uses Side Effects Precautions Interactions Overdose

What is acitretin?

Acitretin is a form of vitamin A. The exact way that acitretin works is unknown.

Acitretin is used to treat severe psoriasis that has not responded to other treatments.

Acitretin may also be used for purposes other than those listed in this medication guide.

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

Before taking this medication, tell your doctor if you

  • have kidney disease;

  • have liver disease;

  • have diabetes or high blood sugar;

  • have a high level of cholesterol or triglycerides (types of fat) in your blood, or have a family history of high levels;

  • heart disease;

  • depression;

  • drink alcohol or have alcoholism;

  • have previously taken or currently take etretinate (Tegison); or

  • are taking any other medicines [especially a tetracycline antibiotic such as tetracycline (Sumycin, Achromycin V), minocycline (Minocin), doxycycline (Vibramycin, Vibra-Tabs, Doryx) or methotrexate (Rheumatrex)] or are receiving phototherapy.

You may not be able to take acitretin, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Avoid all drinks, food, and medicines (including over-the-counter products) that contain alcohol while taking, and for two months after stopping acitretin. Alcohol changes acitretin into another drug that may taken longer than 3 years to be eliminated from the body. This may be dangerous if pregnancy is desired or if blood is donated following treatment with acitretin.

Do not take acitretin if you are pregnant or intend to become pregnant within 3 years following treatment with acitretin. Acitretin is in the FDA pregnancy category X. This means that acitretin is known to cause serious birth defects in an unborn baby. You must have negative results from two pregnancy tests before starting treatment with acitretin. The first pregnancy test will be performed when it is decided that acitretin is a treatment option and the second during the first 5 days of the next menstrual period, just before you start taking acitretin. Two reliable forms of contraception must be used for one month before, during, and 3 years following treatment with acitretin, unless you have had a hysterectomy, your doctor determines that you have completely gone through menopause, or you practice abstinence (you are 100% sure you will not have sex with a male partner).

Contact your doctor immediately if pregnancy is suspected, you miss your period, or you have had sex without using 2 forms of birth control, before starting, during, or within 3 years following treatment with acitretin.

Do not take acitretin without first talking to your doctor if you are breast-feeding a baby. Acitretin may pass into breast milk and harm a nursing baby.

How should I take acitretin?

Take acitretin exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain the instructions to you.

Take each dose with a full glass of water.

Take acitretin with food.

Your doctor may want you to have blood tests (e.g., liver function monitoring, cholesterol and triglyceride levels, and others) or other medical evaluations before starting and during treatment with acitretin to monitor progress and side effects.

Your psoriasis may seem to get worse at the start of therapy, but should then begin to improve. For the best results, finish all of the medication that your doctor has prescribed for you. You may require more than one course of therapy with acitretin.

It is important to take acitretin regularly to get the most benefit.

After stopping treatment with acitretin, symptoms of psoriasis may return. Do not treat new symptoms with leftover acitretin. Contact your doctor for new treatment recommendations as your situation may have changed.

Store acitretin at room temperature away from moisture and heat.

What happens if I miss a dose of acitretin?

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and only take the next regularly scheduled dose. Do not take a double dose of acitretin.

Where can I get more information about acitretin?
Your pharmacist has information about acitretin written for health professionals that you may read.
What are the possible side effects of acitretin?

Stop taking acitretin and seek emergency medical attention or contact your doctor immediately if you experience any of the following serious side effects:

  • an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);

  • signs of heart attack, blood clot, or stroke such as shortness of breath, nausea, dizziness, chest pain, weakness, trouble speaking, or swelling of a leg;

  • signs of liver problems such as yellowing of the skin or eyes, abdominal pain, dark urine, decreased appetite, or nausea or vomiting;

  • changes in vision, blurred vision, or decreased vision (especially night vision);

  • depression, aggressive feelings or behavior, or suicidal thoughts;

  • aches or pains in the bones, joints, muscles, or back; difficulty moving; or loss of feeling in the hands or feet; or

  • noticeable increase in urination, hunger, or thirst which may indicate high blood sugar levels (acitretin may cause increased blood sugar even if you do not have diabetes).

Other, less serious side effects may be more likely to occur. Continue to take acitretin and talk to your doctor if you experience

  • inflammation, dryness, or cracking of the lips;

  • scaly skin;

  • itching;

  • dryness of the eyes, mouth, or nose;

  • increased sensitivity of the skin to sunlight; or

  • peeling skin (especially fingertips, palms, and soles); or

  • loss of hair.

Although less common, the following side effects may also occur. Talk to your doctor if you experience

  • elevations in blood levels of cholesterol, triglycerides, or other substances produced by your liver (detected by blood tests);

  • intolerance to contact lenses;

  • cataract formation;

  • skin rash.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

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

Do not take acitretin if you are pregnant or intend to become pregnant within 3 years following treatment with acitretin. Acitretin is in the FDA pregnancy category X. This means that acitretin is known to cause serious birth defects in an unborn baby. You must have negative results from two pregnancy tests before starting treatment with acitretin. The first pregnancy test will be performed when it is decided that acitretin is a treatment option and the second during the first 5 days of the next menstrual period, just before you start taking acitretin. Two reliable forms of contraception must be used for one month before, during, and 3 years following treatment with acitretin, unless you have had a hysterectomy, your doctor determines that you have completely gone through menopause, or you practice abstinence (you are 100% sure you will not have sex with a male partner). Contact your doctor immediately if pregnancy is suspected, you miss your period, or you have had sex without using 2 forms of birth control, before starting, during, or within 3 years following treatment with acitretin.

Avoid all drinks, food, and medicines (including over-the-counter products) that contain alcohol while taking, and for two months after stopping acitretin. Alcohol changes acitretin into another drug that may taken longer than 3 years to be eliminated from the body. This may be dangerous if pregnancy is desired or if blood is donated following treatment with acitretin.

Do not donate blood while taking acitretin and for at least 3 years following the end of treatment with acitretin. Donated blood given to a pregnant woman may cause birth defects in the unborn baby.

Acitretin is a form of vitamin A therefore supplements that contain vitamin A should be avoided during treatment. Additional amounts of vitamin A could result in side effects.

Avoid prolonged exposure to sunlight or artificial ultraviolet (UV) light (e.g., sunlamps, tanning beds). Acitretin may increase the sensitivity of the skin to sunlight and sunburn may result. Use a sunscreen and wear protective clothing when exposure to the sun is unavoidable. Talk to your healthcare provider if you are receiving light therapy (phototherapy).

What should I avoid while taking acitretin?

Avoid all drinks, food, and medicines (including over-the-counter products) that contain alcohol while taking, and for two months after stopping acitretin. Alcohol changes acitretin into another drug that may taken longer than 3 years to be eliminated from the body. This may be dangerous if pregnancy is desired or if blood is donated following treatment with acitretin.

Do not donate blood while taking acitretin and for at least 3 years following the end of treatment with acitretin. Donated blood given to a pregnant woman may cause birth defects in the unborn baby.

Acitretin is a form of vitamin A therefore supplements that contain vitamin A should be avoided during treatment. Additional amounts of vitamin A could result in side effects.

Avoid prolonged exposure to sunlight or artificial ultraviolet (UV) light (e.g., sunlamps, tanning beds). Acitretin may increase the sensitivity of the skin to sunlight and sunburn may result. Use a sunscreen and wear protective clothing when exposure to the sun is unavoidable. Talk to your healthcare provider if you are receiving light therapy (phototherapy).

Avoid driving (especially at night) if you develop any vision problems or decreased night vision. Contact your healthcare provider if this occurs.

What other drugs will affect acitretin?

Before taking acitretin, tell your doctor if you are taking any of the following medicines:

  • a diabetes medicine such as chlorpropamide (Diabinese), glipizide (Glucotrol), glyburide (Micronase, Diabeta, Glynase), tolbutamide (Orinase), tolazamide (Tolinase), and others;

  • methotrexate (Rheumatrex);

  • a "progestin-only” birth control pill such as Micronor, Nor-Q.D., Ovrette, and others;

  • etretinate (Tegison) (tell your doctor if you have taken this in the past);

  • phenytoin (Dilantin, Phenytek) or fosphenytoin (Cerebyx);

  • a tetracycline antibiotic such as tetracycline (Sumycin, Achromycin V), minocycline (Minocin), doxycycline (Vibramycin, Vibra-Tabs, Doryx); or

  • the herbal supplement St. John’s wort.

You may not be able to take acitretin, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.

Avoid the use of topical preparations to treat psoriasis unless otherwise directed by your doctor. They may interfere with treatment with acitretin or increase irritation of the skin.

Acitretin is a form of vitamin A therefore supplements that contain vitamin A should be avoided during treatment. Additional amounts of vitamin A could result in side effects.

Drugs other than those listed here may also interact with acitretin. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.

What happens if I have an overdose of acitretin?

Seek emergency medical attention if an overdose is suspected.

Symptoms of an acitretin overdose are not known but might include nausea and/or vomiting.

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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. 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.
Content provided by Multum - Last Updated 2/11/2008