acitretin

Generic Name: acitretin (A si TRE tin)Brand names: 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. It is usually given after other psoriasis medicines have been tried without successful treatment of symptoms.

Acitretin is not a cure for psoriasis, and you may relapse after you stop taking this medication.

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

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

This medication 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 forms of birth control together starting at least 1 month before treatment with acitretin, and for at least 3 years after you stop taking this medication. For women 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. No testing is needed if you have had a hysterectomy or have gone completely through menopause. 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 exposure to sunlight or artificial UV rays (sunlamps or tanning beds). acitretin can make your skin more sensitive to sunlight and sunburn may result. Use a sunscreen (minimum SPF 15) and wear protective clothing if you must be out in the sun. 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?

Do not use this medication if you are allergic to acitretin or similar medications such as Accutane, Altinac, Avita, Renova, Retin-A, and others. Do not use acitretin if you are pregnant, or if you have:

• severe kidney disease;
• severe liver disease;

• high levels of triglycerides (lipids) in your blood;

• 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.

If you have any of the following conditions, you may need a dose adjustment or special tests to safely take acitretin:

• kidney or liver disease;

• heart disease;

• high cholesterol;

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

• depression; or

• if you drink large amounts of alcohol.

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

How should I take acitretin?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Acitretin comes with patient instructions for safe and effective use. You will also be required to read and sign an agreement stating you will follow these directions carefully. Ask your doctor if you have any questions.

Acitretin is usually taken with your main meal of the day. Your doctor may occasionally change your dose to make sure you get the best results from this medication. 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 will need to be tested on a regular basis. Do not miss any scheduled appointments.

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

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

See also: Acitretin dosage in more detail

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include headache, dizziness or spinning sensation, and nausea or vomiting.

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 artificial UV rays (sunlamps or tanning beds). Acitretin can make your skin more sensitive to sunlight and sunburn may result. Use a sunscreen (minimum SPF 15) and wear protective clothing if you must be out in the sun. Acitretin can cause side effects that 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; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using acitretin and call your doctor at once if you have any of these serious side effects:

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

• sudden decrease in night vision;

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

• chest pain or heavy feeling, spreading to the arm or shoulder, sweating, shortness of breath;

• sudden headache, confusion, problems with speech or balance, numbness or weakness (especially on one side of the body);

• sudden cough, wheezing, rapid breathing, fast heart rate;

• pain or swelling in one or both legs;

• jaundice (yellowing of the skin or eyes); or

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

Less serious side effects may include:

• dry or irritated eyes, thinning eyebrows or lashes;

• chapped or peeling skin, hair loss;

• dry mouth, dry or runny nose, nosebleeds;

• warmth, redness, or tingly feeling under your skin;

• nausea, diarrhea, stomach pain, loss of appetite;

• mouth sores, swollen or bleeding gums;

• headache;

• sleep problems (insomnia); or

• ringing in your ears.

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.

Acitretin Dosing Information

Usual Adult Dose for Psoriasis:

Initial dose: 25 to 50 mg orally as a single dose with foodMaintenance dose: 25 to 50 mg/day; dosage should be individualized according to patient's response

What other drugs will affect acitretin?

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

• phenytoin (Dilantin); or

• St. John's wort.

This list is not complete and there may be other drugs that can interact with acitretin. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

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
• 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 1996-2006 Cerner Multum, Inc. Version: 3.02. Revision Date: 11/17/2009 3:29:41 PM.