Acitretin is a medication used to treat severe psoriasis that cannot be treated with other medications. It is also used to treat lichen planus, congenital ichthyosis, and Darier’s disease.
Acitretin is a drug in the retinoid class of drugs . It works by slowing the growth of new skin cells and reducing inflammatory symptoms, including redness and swelling in psoriasis.
Please note that acitretin is not a cure for psoriasis. This medicine is available in capsule form and should only be taken according to a doctor’s prescription.
Acitretin brand names: Neotigason, Novatretin
What is Acitretin?
| Group | Prescription drugs |
| Category | Retinoid |
| Benefit | Relieves symptoms of severe psoriasis, lichen planus , congenital ichthyosis, and Darier’s disease. |
| Consumed by | Mature |
| Acitretin for pregnant women | Category X: Studies in animals and humans have demonstrated fetal abnormalities or fetal risk.Medicines in this category should not be used by pregnant women or women who may be pregnant. |
| Acitretin for breastfeeding mothers | Acitretin passes into breast milk. If you are breast-feeding, do not use this medication without consulting your doctor. |
| Drug form | Capsule |
Warnings Before Taking Acitretin
Acitretin should only be used as prescribed by a doctor. There are several things to consider before taking this drug, including:
- Do not take acitretin if you are allergic to it or any other retinoid medications, such as tretinoin or isotretinoin. Tell your doctor about any allergies you have.
- Acitretin should not be used by women who are pregnant or breast-feeding. Tell your doctor if you are pregnant, breast-feeding, or planning to become pregnant.
- During treatment with acitretin and for up to 3 years afterwards, always use effective contraception to prevent pregnancy.
- Tell your doctor if you have liver failure, kidney failure, or hyperlipidemia. Acitretin should not be used in patients with these conditions.
- Do not donate blood while undergoing treatment with acitretin for up to 3 years afterwards.
- Tell your doctor if you have heart disease, diabetes, liver disease, mental disorders, such as depression, or are currently undergoing or have ever had phototherapy procedures.
- Do not drive or engage in activities that require alertness after taking acitretin, as this medication may cause visual disturbances.
- Tell your doctor if you are taking any medications, supplements, or herbal products.
- Limit activities that expose you to direct sunlight while taking acitretin, as this medication can make your skin more sensitive to sunlight.
- See a doctor immediately if you experience an allergic reaction to the drug, serious side effects, or an overdose after taking acitretin.
Acitretin Dosage and Directions for Use
The following are the general doses of acitretin for adults based on the condition to be treated:
- Conditions: Severe psoriasis, severe lichen planus, congenital ichthyosis
Initial dose 25 mg or 30 mg, daily, for 2–4 weeks, adjusted according to patient response to treatment. Maintenance dose 25–50 mg daily for 6–8 weeks. Maximum dose 75 mg daily. - Condition: Darier’s disease
Initial dose 10 mg, daily, for 2–4 weeks. If needed, the dose may be increased to 25–50 mg daily according to the patient’s response to treatment.
How to Take Acitretin Correctly
Follow your doctor’s instructions and read the instructions on the packaging before taking acitretin. Do not increase or decrease the dose, and do not use the medicine for longer than the time recommended by your doctor.
Before undergoing treatment with acitretin, patients will be asked to undergo blood tests, a complete cholesterol check, and a kidney function test. For female patients, a pregnancy test will be performed before starting treatment with acitretin.
Take acitretin capsules once a day, during or after meals. Acitretin capsules can be swallowed with a glass of milk. It is recommended to take acitretin capsules at the same time every day for maximum benefits.
If you forget to take acitretin, it is recommended to take it immediately if the gap with the next schedule is not too close. If it is close, ignore and do not double the dose.
Treatment results may only be visible after 2–3 months of taking this medication. Do not stop treatment without first consulting your doctor. See a doctor immediately if skin irritation occurs or psoriasis symptoms do not improve after 2 months of treatment.
During treatment, you will be asked to have regular check-ups and undergo regular blood tests to monitor the patient’s condition.
Avoid wearing contact lenses while taking acitretin, as this medication can cause dry eyes. Use eye drops prescribed by your doctor to treat dry eye symptoms.
Store acitretin capsules in a closed place at a cool temperature. Protect this medication from direct sunlight and keep out of reach of children.
Acitretin Interactions with Other Drugs
The use of acitretin with other drugs can cause several drug interaction effects, such as:
- Increased risk of hepatitis if used with methotrexate
- Increased pressure inside the brain (intracranial) if used with tetracyclines
- Increased risk of hypervitaminosis A if used with other vitamin A supplements or retinoid medications.
- Decreased effects of phenytoin
- Increased blood sugar lowering effect of glyburide
- Decreased effectiveness of birth control pills containing progestin
In addition, consuming acitretin with alcoholic beverages can increase the risk of fatal side effects.
Acitretin Side Effects and Dangers
Some side effects that may appear after taking acitretin are:
- Dry mouth
- Itchy, red, dry, and flaky skin
- Dry or irritated eyes
- Swollen lips
- Sneezing
- Hair loss
- Nosebleeds or dry nose
- Sleep disorders
- Thickened, discolored nails, or nails that are brittle and break easily
See a doctor if the above side effects do not subside or get worse. See a doctor immediately if you experience an allergic reaction to the drug or more serious side effects, such as:
- Confused, depressed, or having suicidal thoughts
- Fever, chills, joint pain, or muscle pain
- Chest pain, irregular heartbeat, or shortness of breath
- Continuous vomiting
- Body is stiff and difficult to move
- Swollen hands or feet
- Visual disturbances, such as blurred vision, night blindness, double vision
- Impaired kidney function, which can be characterized by a very small amount of urine when urinating. Impaired liver function, which can be characterized by yellow eyes and skin (jaundice).
Reference
Pai, V., Phadke, D., Shukla, P., & Naik, K. (2019). Fixed Tapering Dosage of Acitretin in Patients with Psoriasis: A Short-Term Analysis of Clinical Efficacy and its Effects on Biochemical Parameters. Indian Journal of Dermatology, 64 (3), pp 213–216.
National Intitute of Health (2021). Medline. Acitretin.
National Intitute of Health (2020). Medline. Darier Disease.
American Academy of Dermatology Association. Psoriosis.
American Academy of Dermatology Association. Psoriosis Treatment: Oral Retinoids.
Mayo Clinic (2021). Acitretin (Oral Route).
Hickman, R. Verywell Health (2019). What to Know About Soriatane (Acitretin).
Medscape (2018). Acitretin (Rx).
MIMS Indonesia (2021). Acitretin.
MIMS Malaysia (2021). Neotigason.
MIMS Singapore (2021). Novatretin.
Multum, C. Drugs (2020). Acitretin.
WebMD (2021). Acitretin.