MedlinePlus Drug Information: Acitretin

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Other drug names:	A-Am An-Az B C-Ch Ci-Cz D-Dh Di-Dz E F G H I-J K-L M-Mh Mi-Mz N-Nh Ni-Nz O P-Pl Pm-Pz Q-R S-Sn So-Sz T-To Tp-Tz U-V W-Z 0-9

Acitretin

a si tre' tin

Brand name(s): Soriatane

Contents of this page:
Why is this medication prescribed? How should this medicine be used? Other uses for this medicine What special precautions should I follow? What special dietary instructions should I follow?	What should I do if I forget a dose? What side effects can this medication cause? What storage conditions are needed for this medicine? In case of emergency/overdose What other information should I know?

IMPORTANT WARNING:

For female patients: Do not take acitretin if you are pregnant or plan to become pregnant within the next 3 years. Acitretin may harm the fetus. You should not begin taking acitretin until you have taken two pregnancy tests with negative results. You must use two acceptable forms of birth control for 1 month before you begin taking acitretin, during your treatment with acitretin, and for 3 years after treatment. Your doctor will tell you which methods of birth control are acceptable. You do not need to use two methods of birth control if you have had a hysterectomy (surgery to remove the womb), if your doctor tells you that you have finished menopause (change of life), or if you practice total sexual abstinence.If you plan to use oral contraceptives (birth control pills) while taking acitretin, tell your doctor the name of the pill you will use. Acitretin interferes with the action of microdosed progestin ('minipill') oral contraceptives (Ovrette, Micronor, Nor-QD). Do not use this type of birth control while taking acitretin.If you plan to use hormonal contraceptives (birth control pills, patches, implants, injections, and intrauterine devices), be sure to tell your doctor about all the medications, vitamins, and herbal supplements you are taking. Many medications interfere with the action of hormonal contraceptives. Do not take St. John's wort if you are using any type of hormonal contraceptive. You will need to take pregnancy tests regularly while taking acitretin. Stop taking acitretin and call your doctor immediately if you become pregnant, miss a menstrual period, or have sex without using two forms of birth control. In some cases, your doctor can prescribe emergency contraception ('the morning after pill') to prevent pregnancy.Do not consume foods, drinks, or prescription or nonprescription medications that contain alcohol while taking acitretin and for 2 months after treatment. Alcohol and acitretin combine to form a substance that remains in the blood for a long time and can harm the fetus. Read medication and food labels carefully and ask your doctor or pharmacist if you are not sure whether a medication contains alcohol.Your doctor will give you a Patient Agreement/Informed Consent to read and sign before you begin treatment. Be sure to read this carefully and ask your doctor if you have any questions.For male patients:A small amount of acitretin is present in the semen of male patients who take this medication. It is not known whether this small amount of medication can harm the fetus. Talk to your doctor about the risks of taking this medication if your partner is pregnant or plans to become pregnant.For male and female patients:Do not donate blood while taking acitretin and for 3 years after treatment.Acitretin may cause liver damage. Tell your doctor if you have or have ever had liver disease. If you experience any of the following symptoms, call your doctor immediately: upset stomach, extreme tiredness, unusual bruising or bleeding, lack of energy, loss of appetite, pain in the upper right part of the stomach, yellowing of the skin or eyes, dark urine, or flu-like symptoms.

Why is this medication prescribed?

Actitretin is used to treat severe psoriasis (abnormal growth of skin cells that causes red, thickened, or scaly skin). Acitretin is in a class of medications called retinoids. The way acitretin works is not known.

How should this medicine be used?

Actitretin comes as a capsule to take by mouth. It is usually taken once a day with the main meal. Take acitretin at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take acitretin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Your doctor may start you on a low dose of acitretin and gradually increase your dose.

Acitretin controls psoriasis but does not cure it. It may take 2-3 months or longer before you feel the full benefit of acitretin. Your psoriasis may get worse during the first few months of treatment. This does not mean that acitretin will not work for you, but tell your doctor if this happens. Continue to take acitretin even if you feel well. Do not stop taking acitretin without talking to your doctor.

After you stop taking acitretin, your symptoms may come back. Tell your doctor if this happens. Do not use leftover acitretin to treat a new flare-up of psoriasis. A different medication or dose may be needed.

Other uses for this medicine

Acitretin is sometimes also used to treat Darier's disease (a type of skin disease), palmoplantar pustulosis (pus-filled blisters and red patches on the hands and feet), lichen sclerosus et atrophicus of the vulva (redness, scaling, and easy bleeding of the genital area in females), palmoplantar lichen nitidus (clusters of bumps on the hands and feet), and lichen planus (red, itchy bumps in various places on the body). It is also used to treat lamellar ichthyosis (scaly patches of skin that fall off the body); Sjogren-Larsson syndrome (dry, scaling skin, mental retardation, and trouble walking); and bullous and nonbullous ichthyosiform erythroderma (red, blistering, or peeling skin) in children. Talk to your doctor about the possible risks of using this drug for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before taking acitretin,

tell your doctor and pharmacist if you are allergic to acitretin, other retinoids such as adapalene (Differen), alitretinoin (Panretin), etretinate (Tegison), isotretinoin (Accutane), tazarotene (Tazorac), tretinoin (Renova, Retin-A, Vesanoid), Vitamin A, or any other medications.
do not take methotrexate (Rheumatrex, Trexall) or tetracycline antibiotics such as demeclocycline (Declomycin), doxycycline (Doryx, Vibramycin), minocycline (Dynacin, Minocin), and tetracycline (Sumycin) while taking acitretin.
tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention the medications and herbs listed in the IMPORTANT WARNING section and any of the following: glyburide (Diabeta, Glynase, Micronase), other oral retinoids such as isotretinoin (Accutane) and tretinoin (Vesanoid), phenytoin (Dilantin, Phenytek), and vitamin A. Also tell your doctor if you have ever taken etretinate (Tegison). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
tell your doctor if you have or have ever had the conditions mentioned in the IMPORTANT WARNING section; if you drink large amounts of alcohol; if you have a family history of high cholesterol or diabetes; if you have or have ever had diabetes, high cholesterol or triglycerides, spinal problems, depression, or stroke or mini-stroke; or if you have or have ever had joint, bone, kidney, or heart disease.
do not breastfeed while taking acitretin or if you have recently stopped taking acitretin.
you should know that acitretin may limit your ability to see at night. This problem may begin suddenly at any time during your treatment. Be very careful when driving at night.
plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. Do not use sunlamps while taking acitretin. Acitretin may make your skin sensitive to sunlight.
if you need to have phototherapy, tell your doctor that you are taking acitretin.
you should know that acitretin may dry your eyes and make wearing contact lenses uncomfortable during or after treatment. Remove your contact lenses and call your doctor if this happens.

What special dietary instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I do if I forget a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Acitretin can cause low blood sugar (hypoglycemia) even in patients who are not diabetic. If you have any of these symptoms, eat or drink a food or beverage with sugar in it, such as hard candy or fruit juice, and call your doctor immediately; symptoms of low blood sugar include:

shakiness
dizziness
rapid heartbeat
sweating or confusion
blurred vision
headache
numbness or tingling of the mouth
weakness
fatigue
pale color
sudden hunger

Acitretin can also cause high blood sugar (hyperglycemia). If you have any of these symptoms, call your doctor immediately; symptoms of high blood sugar include:

thirst
dry mouth
tiredness
flushing
dry skin
frequent urination
loss of appetite
trouble breathing

Acitretin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

Peeling, dry, itchy, scaling, cracked, blistered, sticky or infected skin
brittle or weak fingernails and toenails
dandruff
sunburn
abnormal skin odor
excessive sweating
hair loss
changes in hair texture
dry eyes
loss of eyebrows or eyelashes
hot flashes or flushing
weak nails
chapped or swollen lips
swollen or bleeding gums
excessive saliva
tongue pain, swelling, or blistering
mouth swelling or blisters
stomach pain
diarrhea
increased appetite
difficulty falling or staying asleep
sinus infection
runny nose
dry nose
nosebleed
joint pain
tight muscles

Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them or those listed in the IMPORTANT WARNING section, call your doctor immediately:

rash
headache
upset stomach
vomiting
blurred vision
pain, swelling, or redness of eyes or eyelids
eye pain
eyes sensitive to light
swelling of hands, feet, ankles, or lower legs
redness or swelling in one leg only
depression
thoughts of hurting or killing yourself
bone, muscle, or back pain
difficulty moving any part of your body
loss of feeling in hands or feet
chest pain
slow or difficult speech
rash
tingling in arms and legs
loss of muscle tone
weakness or heaviness in legs
confusion
cold, gray skin
slow or irregular heartbeat
pale skin
dizziness
fast heartbeat
weakness
shortness of breath

Acitretin may cause bone problems and slowing or stopping of growth in children. Talk to your child's doctor about the risks of giving this medication to your child.

Acitretin may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

What storage conditions are needed for this medicine?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:

headache
dizziness
vomiting
upset stomach
dry, itchy skin
loss of appetite
bone or joint pain

If a female who could become pregnant takes an overdose of acitretin, she should take a pregnancy test after the overdose and use two forms of birth control for the next 3 years.

What other information should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to acitretin.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Last Revised - 01/01/2004

American Society of Health-System Pharmacists, Inc. Disclaimer