Soriatane (acitretin) for Psoriasis: Side Effects & Dosage

What is Soriatane (acitretin)?

Acitretin is an oral medication used to treat psoriasis.

What are the uses for Soriatane (acitretin)?

• Acitretin is used for treating
  severe psoriasis in adults.
• Acitretin
  should be prescribed only by doctors who have experience in the systemic use of
  retinoids because it has serious side effects.

Is Soriatane (acitretin) available as a generic drug?

Yes

Do I need a prescription for Soriatane (acitretin)?

Yes

What is the black box warning for Soriatane (acitretin)?

• Acitretin is harmful to the fetus. It must not be used while pregnant, or by
  women who intend to be pregnant during therapy or within 3 years following
  discontinuation of therapy. It should also not be used by women who do not use
  reliable contraception. Patients must use 2 effective forms of contraception
  (birth control) simultaneously for at least 1 month prior to starting acitretin
  therapy, during therapy, and for at least 3 years after stopping treatment.
• Alcohol increases conversion of acitretin to
  etretinate
  (Tegison), which remains in the
  body much longer and is also harmful to the fetus. Therefore, women should not
  consume alcohol during treatment with acitretin and for 2 months after stopping
  therapy.
• Acitretin may cause
  liver damage. Acitretin should be discontinued if liver
  damage is suspected during treatment.

What are the side effects of Soriatane (acitretin)?

Common side effects of Soriatane include:

• Inflammation of the lips (cheilitis)
• Hair loss
• Increased triglyceride levels
• Skin peeling
• Dry skin (25%-50%)
• Itching
• Cold symptoms
• Joint pain
• Dry mouth

Other side effects of Soriatane include:

• Increased levels of liver enzymes
• Changes in phosphorus, potassium, sodium, and magnesium levels
• Nosebleeds
• Rash
• Increased sun sensitivity

Other less common side effects of Soriatane include:

• Water retention
• Headache
• Nausea
• Vomiting
• Insomnia
• Diarrhea
• Flushing
• Depression
• Fatigue
• Gingivitis
• Increased appetite
• Possible serious side effects include:
• Birth defects
  (Please see the pregnancy and breastfeeding safety section.)
• Liver toxicity

• Dry eyes (xerophthalmia)

• Pancreatitis
• Pseudotumor cerebri (increased pressure of the fluid in the
  brain)
• Skeletal abnormalities

Since acitretin can cause liver damage, liver function tests should be
performed before treatment at 1- to 2-week intervals until stable, and
thereafter at intervals as clinically needed

What is the dosage for Soriatane (acitretin)?

• The recommended dose for acitretin is 25 to 50 mg daily given as a single dose with the
  main meal.

Is Soriatane (acitretin) safe to use during pregnancy or while breastfeeding?

• Acitretin is harmful to the fetus, and it must not be used during pregnancy.
  Women must use 2 effective forms of contraception (birth control) simultaneously
  for at least 1 month prior to starting acitretin therapy, during therapy, and
  for at least 3 years after stopping treatment. Major human fetal abnormalities associated with acitretin and/or etretinate include:
  • Meningomyelocele
  • Meningoencephalocele
  • Multiple synostoses
  • Facial dysmorphia
  • Syndactyly
  • Absence of terminal phalanges
  • Malformations of hip, ankle, and forearm
  • Low-set ears
  • High palate
  • Decreased cranial volume
  • Cardiovascular malformation
  • And alterations of the skull and cervical vertebrae
• Acitretin should not be used by women who are breastfeeding because acitretin
  can pass into breast milk and harm the infant.

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Which drugs or supplements interact with Soriatane (acitretin)?

• Combining acitretin with alcohol increases the formation
  of etretinate. Etretinate remains in the body for a longer period than acitretin
  and it is very harmful to a fetus.
• Acitretin may increase the effects of glyburide (Micronase) on blood glucose
  and potentially cause hypoglycemia.
• Acitretin reduces the effect of the microdose progestin minipill. The two
  drugs should not be combined.
• Acitretin should not be combined with methotrexate
  (Rheumatrex,
  Trexall) due to the increased risk
  of liver failure.
• Combining tetracycline with acitretin increases intracranial pressure.
• Taking

  vitamin A supplements may increase side effects of acitretin because
  acitretin and vitamin A have similar chemical structures.

• If phototherapy also is being used as treatment, the doses of phototherapy
  should be reduced to avoid excessive burning of the skin.

Psoriasis causes the top layer of skin cells to become inflamed and grow too quickly and flake off.
See Answer

What else should I know about Soriatane (acitretin)?

What preparations of Soriatane (acitretin) are available?

• Capsule: 10 and 25 mg

How should I keep Soriatane (acitretin) stored?

• Acitretin should be stored between 15 C and 25 C (59 C and 77 F) and
  protected from light.
• Exposure to high temperatures and humidity should be
  avoided after the bottle is opened.

How does Soriatane (acitretin) work?

• The mechanism of
  action of acitretin is unknown. It is chemically related to retinoic acid and
  retinol (vitamin A), and it reduces skin cell production and shedding. It takes
  several weeks to see its effects, up to 6 months to see a full response, and
  psoriasis may worsen before improvement is seen.

When was Soriatane (acitretin) approved by the FDA?

• The FDA approved acitretin in October 1996.