Acitretin (By mouth)

Introduction:

Acitretin (a-si-TRE-tin)

Treats severe psoriasis (a skin problem) in adults. This medicine is a retinoid and is related to vitamin A.

Brand Name(s):

Soriatane

There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

You should not use this medicine if you have had an allergic reaction to acitretin, etretinate (Tegison®), or similar medicines such as isotretinoin (Accutane®). Do not use this medicine if you are pregnant or breast feeding, or if you may become pregnant during your treatment or for 3 years after you stop using this medicine. You should not use this medicine if you have severe kidney disease, severe liver disease, or high blood cholesterol or triglycerides that cannot be controlled. Do not use this medicine if you are also using methotrexate (Rheumatrex®, Trexall®) or any tetracycline antibiotic (such as doxycycline, minocycline, tetracycline, Vibramycin®). You should not use this medicine if you cannot follow all of the instructions in the Medication Guide.

How to Use This Medicine:

Capsule

  • Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
  • It is best to take this medicine with food, at your main meal of the day.
  • This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions. Ask your pharmacist for the Medication Guide if you do not have one. Your doctor might ask you to sign some forms to show that you understand this information.

If a dose is missed:

  • If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine:

  • Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
  • Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
  • Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Make sure your doctor knows if you are also using phenytoin (Dilantin®), multivitamins or vitamin A supplements, or any other retinoid medicine (such as isotretinoin, Accutane®). Make sure your doctor knows if you are also using oral medicine for diabetes, such as glipizide, glyburide, metformin, rosiglitazone, Actos®, Avandia®, Glucophage®, Glucotrol®, Glucovance®, Metaglip®.
  • Do not drink alcohol while you are using this medicine and for at least 2 months after your last dose of acitretin. Make sure your doctor knows if you currently drink alcohol.
  • If you are using birth control pills, ask your doctor if your pills are the right kind to use. Some kinds of birth control pills ("minipills") will not work as well. Be very careful with any other medicine or supplement you use. Some medicines, such as St. John's wort or medicine for seizures, can make birth control pills not work as well.

Warnings While Using This Medicine:

  • For women: Using this medicine while you are pregnant can cause very serious birth defects. You must use two forms of birth control for the entire time that you are being treated with this medicine, for 1 month before starting this medicine, and for 3 years after you take your last dose of this medicine. You will need to have two negative pregnancy tests to be sure that you are not pregnant before you start using this medicine. You also might need to have pregnancy tests during treatment, depending on your situation. If you think you have become pregnant while using this medicine, tell your doctor right away.
  • Some people who have used this medicine have become very depressed or angry. Tell your doctor right away if you think this medicine is causing mental or emotional changes for you. Some signs of this may be feeling very sad or nervous, getting upset easily, or thinking about hurting yourself or someone else. Other signs may include eating more, eating less, gaining weight, losing weight, or having trouble thinking.
  • Make sure your doctor knows if you have liver disease, kidney disease, or diabetes. Tell your doctor if you have any problems with your bones, such as having bone spurs. Your doctor needs to know if you have high cholesterol or triglycerides in your blood, or if you have a family history of these problems.
  • Do not donate blood during the time you are being treated with this medicine and for at least 3 years after you take your last dose.
  • Your doctor will need to check your blood at regular visits while you are using this medicine. Be sure to keep all appointments.
  • Your psoriasis may get worse for a short time before it starts to improve. You may have more itching or redness. Tell your doctor if this happens. This medicine works gradually. Your skin will probably start to look and feel better after using this medicine for 8 weeks. Your skin may keep improving for up to 3 months.
  • Make sure your doctor knows if you are also receiving light therapy (phototherapy). This medicine may make your skin more sensitive to sunlight. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

  • Chest pain, weakness, trouble breathing.
  • Increased hunger or thirst, increase in how much or how often you urinate.
  • Muscle or joint pain or stiffness, numbness in your hands or feet.
  • Nausea, vomiting.
  • Severe headache, dizziness, or light-headedness.
  • Skin or eyes turn yellow, loss of appetite, pain in your upper stomach, dark-colored urine or pale stools.
  • Sudden and severe stomach pain, fever.
  • Trouble seeing (especially at night), blurred vision, pain in your eye.

If you notice these less serious side effects, talk with your doctor:

  • Stuffy or runny nose.
  • Dry eyes or mouth, chapped lips.
  • Mild skin dryness, peeling, scales, redness, or itching.
  • Trouble wearing contact lenses.
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