Products
Acitretin is commercially available in capsule form (Neotigason, Acicutuan). It has been approved in many countries since 1990.
Structure and properties
Acitretin (C21H26O3, Mr = 326.4 g/mol) is an aromatic derivative of retinoic acid (= tretinoin). It is lipophilic and exists as a greenish yellow powder that is practically insoluble in water.
Effects
Acitretin (ATC D05BB02) normalizes proliferation, differentiation, and keratinization of epidermal cells in psoriasis and keratinization disorders. It has a long half-life of up to 60 hours or longer.
Indications
Severe cornification disorders of the skin:
- Psoriasis erythrodermica
- Localized or generalized pustular psoriasis
- Ichthyosis congenita
- Pityriasis rubra pilaris
- Darier’s disease
- Other severe cornification disorders of the skin that are otherwise resistant to therapy.
Dosage
According to the professional information. The capsules are usually taken once daily with a meal or with milk.
Contraindications
Acitretin is harmful to fertility and must not be administered during pregnancy or to women of childbearing potential without contraception. Do not donate blood during treatment and for one year beyond. Furthermore, Acitretin is contraindicated in hypersensitivity, severe hepatic and renal insufficiency, and elevated lipid levels. It must not be combined with tetracyclines, methotrexate, vitamin A, and other retinoids. For complete precautions, see the drug label.
Interactions
Drug-drug interactions have been described with tetracyclines, methotrexate, vitamin A, retinoids, anticoagulants, phenytoin, alcohol, and etretinate.
Adverse effects
Adverse effects are similar to hypervitaminosis A. Possible adverse effects include dry skin, dry mucous membranes, dry eyes, increase in lipid levels, headache, edema, flushing, and skin disorders.
