Classifications: antiacne; retinoid; Therapeutic: antiacne
Pregnancy Category: X
10 mg, 25 mg capsules
Acitretin binds to the retinoic acid receptors in the skin, thus modifying gene expression, epithelial cell growth, and
Acitretin is a highly toxic metabolite of retinol (vitamin A).
Treatment of severe, recalcitrant psoriasis in adults.
Sensitivity to parabens, papilledema, severe renal impairment or renal failure, pregnancy (category X) for at least 3 y
after use, lactation.
Patients with impaired hepatic function, hepatitis, diabetes mellitus, obesity, alcoholism, history of pancreatitis, hypertriglyceridemia,
hypercholesterolemia, coronary artery disease, retinal disease, degenerative joint disease.
Route & Dosage
Adult: PO 2550 mg q.d. with main meal
- Administer as single dose with main meal because food enhances absorption.
- Store at 15°25° C (59°77° F) and protect from light. After opening, avoid exposure to high
temperatures and humidity.
Adverse Effects (≥1%)Body as a Whole: Hyperesthesia, paresthesias, arthralgia, progression of existing spinal hyperostosis, rigors,
back pain, hypertonia, myalgia, fatigue
, hot flashes, increased appetite. CNS:
, aggressive feelings and thoughts of self-harm, insomnia
, somnolence. CV:
Flushing, edema. GI: Dry mouth, increased liver function tests, increased triglycerides and cholesterol, hepatitis
, gingival bleeding, gingivitis, increased saliva, stomatitis
, thirst, ulcerative stomatitis
, abdominal pain,
, nausea, tongue disorder. Special Senses:
Blurred vision, blepharitis, conjunctivitis
, decreased night vision/night blindness, eye pain, photophobia; earache, tinnitus;
taste perversion. Respiratory: Sinusitis
. Skin: Alopecia, skin peeling, dry skin, nail disorders, pruritus, rash, cheilitis, skin atrophy, paronychia,
abnormal skin odor and hair texture, cold/clammy skin, increased sweating, purpura, seborrhea, skin ulceration, sunburn. Other: Rhinitis, epistaxis, xerophthalmia.
Combination with ethanol
can create etretinate,
which has a significantly longer half-life
than acitretin; interferes with the contraceptive efficacy
-only oral contraceptives
. Use with methotrexate
increases the risk of heptatitis. Food:
Avoid excess vitamin A.
Rapidly from GI tract, optimal absorption when taken with food. Peak:
25 h. Distribution:
Crosses placenta, distributed into breast milk. Metabolism:
In both urine and feces. Half-Life:
49 h acitretin, 63 h cis
Assessment & Drug Effects
- Monitor for S&S of pancreatitis or loss of glycemic control in diabetics. Report either condition immediately to physician.
- Lab tests: Before initiating therapy and at 1- to 2-wk intervals until response to drug is known, do lipid profile and liver
function tests. Monitor blood glucose and HbA1C periodically.
Patient & Family Education
- Note: Transient worsening of psoriasis may occur during early therapy.
- Review common adverse effects of drug; lag time of 23 mo may be necessary before drug effect is evident.
- Discontinue drug and report immediately to physician if visual problems develop.
- Note: Dry eyes with decreased tolerance for contact lenses may occur.
- Do not drink alcohol while taking this drug; it increases risk of hepatotoxicity and hypertriglyceridemia; females should
avoid alcohol during and for 2 mo following therapy.
- Do not donate blood for 3 y following therapy.
- Avoid excessive exposure to sunlight or UV light.
- Use two forms of effective contraception for 1 mo before and at least 3 y following therapy because of the serious risk of
fetal deformities that could result from exposure to this medication.