Acitretin : Uses, Side Effects, Interactions & More
For female patients:
Do not take acitretin if you are pregnant or plan to become pregnant within the next 3 years. Acitretin can harm the fetus. You should not start taking acitretin until you have had two negative pregnancy tests. You should use two acceptable forms of contraception for 1 month before you start 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 forms of birth control if you have had a hysterectomy (surgery to remove the uterus), if your doctor tells you that menopause has ended (life change), or if you are totally abstinent.
If you plan to use oral contraceptives (birth control pills) while taking acitretin, tell your doctor the name of the pill you will be using. Acitretin interferes with the action of progestin micro-management oral contraceptives (‘minipill’). Do not use this type of contraceptive 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 perform pregnancy tests regularly during your treatment with acitretin and for at least 3 years after taking acitretin. Stop taking acitretin and call your doctor right away if you become pregnant, miss a period, or have sex without using two methods of birth control. In some cases, your doctor may prescribe emergency contraception (‘the morning-after pill’) to prevent pregnancy.
Do not consume food, drinks, or prescription or over-the-counter medications that contain alcohol while you are 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. Carefully read the labels on medicines and foods and ask your doctor or pharmacist if you are not sure whether a medicine contains alcohol.
Your doctor will give you a Patient Agreement / Informed Consent to read and sign before starting 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 taking this medication. It is not known whether this small amount of medicine 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 you are taking acitretin and for 3 years after treatment.
Acitretin can 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: nausea, vomiting, loss of appetite, pain in the upper right part of the stomach, yellowing of the skin or eyes, or dark urine.
Your doctor or pharmacist will provide you with the manufacturer’s patient information sheet (Medication Guide) when you start treatment with acitretin and each time you fill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Safety/MedWatch/SafetyInformation/ucm388814.htm) or the manufacturer’s website to obtain the Medication Guide.
Why is this medication prescribed?
Acitretin is used to treat severe psoriasis (abnormal growth of skin cells that causes red, thickened, or scaly skin). Acitretin belongs to a class of medications called retinoids. The way acitretin works is unknown.
How should this medicine be used?
Acitretin 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 or take it more often than prescribed by your doctor.
Your doctor may start with a low dose of acitretin and gradually increase your dose.
Acitretin controls psoriasis but does not cure it. It may take 2 to 3 months or more before you feel the full benefit of acitretin. Your psoriasis may worsen during the first months of treatment. This does not mean that acitretin does not work for you, but tell your doctor if this happens. Keep taking 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 traces of acitretin to treat a new psoriasis outbreak. A different medication or dose may be needed.
Other uses for this medicine
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 have had a severe allergic reaction (difficulty breathing or swallowing, hives, itching or swelling of the face, throat, tongue, lips or eyes) to acitretin, to other retinoids such as adapalene (Difference, in Epiduo), alitretinoin (Panretin), isotretinoin (Absorica, Accutane, Amnesteem, Claravis, Myorisan, Sotret, Zenatane), tazarotene (Avage, Fabior, Tazorac), tretinoin (Atralin, Avita, Renova, Retin-A), or any of The ingredients in acitretin capsules. Your doctor will probably tell you not to use acitretin. Consult your pharmacist or consult the Medication Guide for a list of ingredients.
• Tell your doctor if you are taking any of the following medications: methotrexate (Trexall) or tetracycline antibiotics such as demeclocycline, doxycycline (Doryx, Monodox, Oracea, Periostat, Vibramycin), minocycline (Dynacin, Minocin, Solodyn) and tetracycline (Sumycin , in Helidac, in Pylera) while taking acitretin. Your doctor will probably tell you not to take acitretin if you are taking one or more of these medications.
• Tell your doctor and pharmacist what other prescription and over-the-counter 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, in Glucovance), phenytoin (Dilantin, Phenytek), and vitamin A (in multivitamins). 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 and if you have high cholesterol or triglyceride levels, a family history of high cholesterol levels, or kidney disease. Your doctor may tell you that you should not take acitretin.
• Tell your doctor if you drink large amounts of alcohol; if you have diabetes or high blood sugar levels, spinal problems, depression, stroke, or mini-stroke; or if you have or have ever had heart, bone, or joint disease.
• Do not breastfeed while taking acitretin or if you have recently stopped taking acitretin.
• You should know that acitretin can limit your ability to see at night. This problem can start suddenly at any time during your treatment. Be very careful when driving at night.
• Plan to avoid unnecessary or prolonged exposure to sunlight, and wear protective clothing, sunglasses, and sunscreen. Do not use sun lamps while you are taking acitretin. Acitretin can make your skin sensitive to sunlight.
• If you need to receive phototherapy, tell your doctor that you are taking acitretin.
• You should know that acitretin can dry out your eyes and make wearing contact lenses uncomfortable during or after treatment. Remove 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?
Skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed dose.
What side effects can this medication cause?
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
- hot flashes or flushing
- chapped or swollen lips
- swollen or bleeding gums
- excessive saliva
- tongue pain, swelling, or blistering
- mouth swelling or blisters
- stomach pain
- increased appetite
- difficulty falling or staying asleep
- sinus infection
- runny nose
- dry nose
- changes in hair texture
- dry eyes
- loss of eyebrows or eyelashes
- tight muscles
- changes in taste
- joint pain
- abnormal skin odor
- excessive sweating
- hair loss
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:
- extreme thirst, frequent urination, extreme hunger, blurred vision, or weakness
- dry mouth, nausea and vomiting, shortness of breath, breath that smells fruity, and decreased consciousness
- pain, swelling, or redness of eyes or eyelids
- eye pain
- eyes sensitive to light
- slow or difficult speech
- tingling in arms and legs
- loss of muscle tone
- weakness or heaviness in legs
- cold, gray, or pale skin
- slow or irregular heartbeat
- swelling of hands, feet, ankles, or lower legs
- redness or swelling in one leg only
- fast heartbeat
- shortness of breath
- ear pain or ringing
- 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
Acitretin can cause other side effects. Call your doctor if you have any unusual problems while taking this medicine.
If you experience a serious side effect, you or your doctor can submit an online report to the Food and Drug Administration (FDA) MedWatch Adverse Event Reporting program (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).
What should I know about storage and disposal of this medication?
Keep this medicine in its container, tightly closed and out of the reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).
Unnecessary medications must be disposed of in special ways to ensure that pets, children, and others cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to get rid of your medication is through a medication take-back program. Talk to your pharmacist or contact your local garbage / recycling department for information on return programs in your community. Check out the FDA’s Safe Drug Disposal website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.
It is important to keep all medications out of the sight and reach of children, as many containers (such as those for taking pills weekly and those used for eye drops, creams, patches, and inhalers) are not resistant to children and children. young children can easily open them. To protect young children from poisoning, always close the safety caps and immediately put the medicine in a safe place, one that is up and away and out of your sight and reach. http://www.upandaway.org
In case of emergency/overdose
In case of overdose, call the Poison Control Helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim collapsed, had a seizure, is having trouble breathing, or cannot wake up, call 911 immediately.
Symptoms of overdose may include:
- loss of appetite
- bone or joint pain
- upset stomach
- dry, itchy skin
If a woman who could become pregnant takes an acitretin overdose, she should have a pregnancy test after the overdose and use two methods of contraception 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 laboratory tests to check your body’s response to acitretin.
Do not let anyone else take your medicine. Ask your pharmacist any questions you have about refilling your prescription.
It is important to keep a written list of all prescription and over-the-counter (non-prescription) medications you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should carry this list with you every time you visit a doctor or if you are admitted to a hospital. It is also important information to take with you in emergencies.
Disclaimer: We have made every effort to ensure that all information is factually accurate, comprehensive and up-to-date. However, this article should not be used as a licensed health care professional’s choice of knowledge and expertise. You should always consult your doctor or other health care professional before taking any medication. The information given here is subject to change and it has not been used to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions or adverse effects. The lack of warning or other information for any drug does not indicate that the combination of medicine or medication is safe, effective or appropriate for all patients or all specific uses.