Acitretin

Indications
 Oral
Darier's disease
Adult: Initially, 10 mg daily for 2-4 wk. Max: 50 mg/day.
Child: 500 mcg/kg/day. Max dose: 35 mg/day.
Oral
Congenital icthyosis
Adult: Initially, 25-30 mg daily for 2-4 wk before dose adjustments are done. Usual range: 25-50 mg daily for further 6-8 wk. Max: 75 mg daily for short periods.
Child: 500 mcg/kg/day. Max: 35 mg daily.
Oral
Severe psoriasis
Adult: Initially, 25-30 mg daily for 2-4 wk before dose adjustments are done. Usual range: 25-50 mg daily for further 6-8 wk. Max: 75 mg daily for short periods.
Child: 500 mcg/kg/day. Max: 35 mg daily.
Oral
Severe lichen planus
Adult: Initially, 25-30 mg daily for 2-4 wk before dose adjustments are done. Usual range: 25-50 mg daily for further 6-8 wk. Max: 75 mg daily for short periods.
Child: 500 mcg/kg/day. Max: 35 mg daily.
Contraindications
 Pregnancy (before the start, during and at least 2-3 yr after cessation of therapy), lactation. Hepatic and renal impairment. Hyperlipidaemia.
Warnings / Precautions
 Female patients to avoid alcohol during and 2 mth after treatment. Avoid blood donation during therapy or at least 1-3 yr after stopping therapy. Children. Radiographic treatment for prolonged therapy. Therapy should not last >6 mth. Monitor plasma lipid and glucose levels (especially diabetics) regularly. Monitor LFTs.
Adverse Reactions
 Dryness of mucous membranes and skin; conjunctivitis, dry sore mouth; ophth disturbances; raised lipid level, pancreatitis; sticky skin, dermatitis. Severe headache; GI disturbances; dermatologic reactions, oedema, paronychia, granulomatous lesions, bullous eruptions; reversible hair thinning and alopoecia; CNS disturbances; sweating; taste disturbance, gingivitis; benign intracranial hypertension; photosensitivity; skeletal hyperostosis; extraosseous calcification; premature epiphyseal closure in child.
Potentially Fatal: Phototoxicity, jaundice, hepatitis and hepatotoxity.
Overdose Reactions
 Symptoms are identical to acute hypervitaminosis A, ie, headache and vertigo.
Drug Interactions
 Concomitant use with keratolytics or high dose vitamin A. Reduces anticoagulant effect of coumarins e.g. warfarin. Concomitant use of microdised progestin oral contraceptives. Concomitant use of methotrexate can potentiate hepatotoxicty. Concomitant use with tetracycline.
See Below for More acitretin Drug Interactions
Lab Interactions
 Elevation of liver enzymes, lipids, triglycerides and cholesterol level in blood.
Food Interactions
 Co-administration with food may increase oral bioavailability.
Mechanism of Actions
 Acitretin is an active metabolite of etretinate but its mechanism of action is unknown.
Administration
 Should be taken with food. (Take w/ main meals or w/ a glass of milk.)
Storage Conditions
 Oral: Store below 25°C.
ATC Classification
 D05BB02 - acitretin ; Belongs to the class of systemic retinoids used in the treatment of psoriasis.
Storage
 Oral: Store below 25°C.
Available As
  • Acitretin 10 mg
  • Acitretin 25 mg

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