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Acitretin - Learn about Acitretin Side Effects and Precautions

Acitretin Information

The pharmacology action of Acitretin is unknown . Absorption is linear and proportional with increasing doses; approximately 72% is absorbed following a 50 mg dose. C max (mean 416 ng/mL) is achieved in 2 to 5 hr.

Acitretin must not be used by women who are pregnant or intend to become pregnant during therapy or at any time for at least 3 yr following discontinuation of therapy. Acitretin must not be used by women who may not use reliable contraception while undergoing treatment or for at least 3 yr following discontinuation of treatment. Women must sign a Patient Agreement/Information Consent Form that contains warnings about the risk of potential birth defects. An acitretin medication guide must be given to patients each time acitretin is dispensed, as required by law. If pregnancy occurs during therapy or at any time for at least 3 yr after stopping therapy, the prescriber and patient should discuss the possible effects on the pregnancy. Acitretin is used in treatment of severe psoriasis

Interaction and Contraindication of Acitretin

Interaction of Acitretin -
Ethanol:  Concurrent use of alcohol and acitretin may lead to the formation of etretinate, which increases the duration of teratogenic potential in women.
Glyburide:  The glucose-lowering effect of glyburide may be potentiated.
Methotrexate:  Because the risk of hepatitis may be increased, concurrent use is contraindicated.
Phenytoin:  Protein binding of phenytoin may be reduced.
Progestin "minipill":  Acitretin may interfere with the contraceptive effect.
Tetracyclines:  Because acitretin and tetracyclines can cause increased intracranial pressure, concurrent use is contraindicated.
Vitamin A, oral retinoids:  Because the risk of hypervitaminosis A is increased, concurrent use is contraindicated.

Contraindication of Acitretin - Pregnancy; severe liver or kidney function impairment; chronic abnormal elevation in blood lipid values; concurrent use of methotrexate or tetracyclines; hypersensitivity to other retinoids or any component of the product.

Side Effects of Acitretin

Here are the list of some common side effects of Acitretin :

• Rigors (10% to 25%); headache, pain, depression, insomnia, somnolence (1% to 10%); myopathy with peripheral neuropathy, aggressive feelings and/or suicidal thoughts (postmarketing).
• Alopecia, skin peeling (60% to 75%); dry skin, nail disorder, pruritus (25% to 50%); erythematous rash, hyperesthesia, paresthesia, paronychia, skin atrophy, sticky skin (10% to 25%); abnormal skin odor, abnormal hair texture, bullous eruption, cold/clammy skin, dermatitis, increased sweating, psoriasiform rash, purpura, pyogenic granuloma, rash, seborrhea, skin fissures, skin ulceration, sunburn, infection (1% to 10%); skin thinning, skin fragility and scaling (postmarketing).
• Increased triglycerides (50% to 75%); increased CPK, fasting blood glucose (25% to 50%); decreased fasting blood sugar, high occult blood (10 to 25%); anorexia, edema, fatigue, hot flashes, increased appetite, gingival bleeding, gingivitis, increased salivation, thirst, infection, decreased and increased iron, flushing (1% to 10%).
  

Precaution and Warning while taking Acitretin

The precaution and warnings of Acitretin drug is as follows:

• Explain name, dose, action, and potential side effects of drug.
• Advise patient that dose may be adjusted based on tolerance and effectiveness.
• Instruct patient to take prescribed dose qd with main meal. Advise patient that food increases absorption and beneficial effects.
• Advise patient that if a dose is missed to skip the missed dose and resume the normal schedule. Caution patient not to double the dose to try to catch up.
• Advise patient that psoriasis may worsen during the initial treatment period but that gradual improvement should follow and max benefit may not be noted for 2 to 3 mo. Advise patient to notify health care provider if symptoms do not improve as expected or continue to worsen.
• Caution women of childbearing potential not to consume alcohol or products containing alcohol during and for 2 mo following cessation of therapy.
• Instruct sexually active women who are not clearly menopausal or have undergone a hysterectomy to use 2 reliable forms of contraception beginning 1 mo before starting therapy, during therapy, and for 3 yr following cessation of therapy. Caution patient that micro-dosed progestin "minipills" are not recommended during therapy with acitretin.
• Advise women of childbearing potential to notify health care provider immediately if pregnant, miss a period, or have sex without using 2 effective forms of birth control either while taking acitretin or for 3 yr following cessation of therapy.
• Caution both men and women not to donate blood during and for at least 3 yr following cessation of therapy because women of childbearing potential must not receive blood from patients being treated with acitretin.
• Advise patient, family, or caregiver to inform health care provider of the following: persistent severe headache; persistent nausea and/or vomiting; yellowing of the skin or eyes; dark urine; persistent appetite loss; frequent urination; great thirst or unexplained hunger; sudden vision changes; severe skin or mucus membrane dryness; depression or other mental symptoms; shortness of breath; dizziness; chest pain; sudden weakness; trouble speaking; swelling of a leg.
• Advise patient that medication can cause chapped lips, peeling of the fingertips, palms, and soles, itching or scaly skin, runny or dry nose, or nosebleeds and to inform health care provider if any of these occur and are bothersome. Advise patient that health care provider or pharmacist can recommend a lotion or cream to help treat drying or chapping.
• Advise patient that drug may cause decreased night vision and to avoid driving at night if any sudden vision problems occur.
• Advise diabetic patient to monitor blood sugars more frequently when medication is started or after a dose adjustment and to inform health care provider if significant changes in blood sugar are noted.
• Caution patient that medication can increase sensitivity to UV light and to avoid use of sun lamps and unnecessary exposure to sunlight while undergoing treatment.
• Advise patient wearing contact lenses that decreased tolerance to lenses may be experienced during treatment and after therapy has been stopped.
• Instruct patient not to take any prescription or OTC medications or dietary supplements unless advised by health care provider. Caution patient against taking vitamin A supplements in excess of recommended daily allowances.

How to store Acitretin

• Administer prescribed dose qd with the main meal.