Acitretin: Formula, Indications, Mechanism of Action, Dosage, Side Effects, Warnings, Contraindications and Interactions

It is a drug that belongs to the category of antipsoriatic and specifically to the group of retinoids, and is normally used for the treatment of psoriasis.

Chemical formula

  • C21H26O3.

Presentation

Acitretin is a product that is available in 10 and 25 mg capsules.

Indications

La acitretin is indicated for:

  • Refractory forms of extensive and severe psoriasis.
  • Psoriasis palmoplantar.
  • Severe vulgar or common ichthyosis.
  • Lichen planus.
  • Other forms of dermatitis.

Mechanism of action

The mechanism of action of acitretin is not yet known.

Acitretin works by inducing keratinocyte differentiation and leading to the slowdown of cell reproduction.

Acitretin reverses the proliferation of the epidermis and reduces the increase in keratinization seen in hyperkeratotic disorders.

Dose

  • Dosage is based on the clinical appearance of the disorder and the tolerability of the product.
  • The doctor must determine the individual dose for each patient.
  • The recommended dose in adults is 25 to 30 mg of acitretin per day.
  • One 25 mg capsule or 3 10 mg capsules for 2 to 4 weeks.
  • At the end of this initial phase, it may be necessary in some cases to increase the dose to a maximum of 75 mg per day of acitretin, i.e. 3 capsules of 25 mg.
  • This maximum dose should not be exceeded.

Side effects

The possible side effects of acitretin occur to a different extent for each patient.

Most side effects are dose related and are generally reversible after tapering.

Side effects of acitretin capsules include cheilitis, rhinitis , dry mouth and chapped lips, runny or dry nose, nosebleeds, arthralgia , spinal hyperostosis, alopecia.

Also peeling of the skin especially on the tips of the fingers, palms of the hands and soles of the feet, dry skin, weak nails, hair loss, dry eyes, itching, itching, erythematous rash, hyperesthesia, paraesthesia, paronychia, atrophy of the skin and increase of fats or lipids in the blood.

Less common, but potentially serious side effects of acitretin include:

  • Severe headaches
  • Sickness.
  • Vomiting
  • Blurry vision.
  • Decreased vision in the dark.
  • Depression .
  • Yellowing of the skin or whites of the eyes.
  • Inappetence.
  • Dark colored urine.
  • Pains in the bones
  • Pain in the joints, muscles or back.
  • Trouble moving
  • Loss of feeling in your hands or feet.
  • Frequent urination
  • However excesiva.
  • Breathlessness .
  • Chest pain.
  • Soft spot.
  • Difficulty speaking or swelling of a leg can be signs of a heart attack, blood clots, or a stroke.

Warnings and Contraindications

Contraception is advised in women.

The patient should avoid becoming pregnant during treatment, and for at least 3 years after stopping treatment.

Acitretin can harm an unborn baby.

Major human fetal abnormalities have been reported in association with acitretin administration including meningomyelocele, meningoencephalocele, multiple synostoses, facial dysmorphia, syndactyly.

Absence of terminal phalanges, malformations of the hip, ankle and forearm, sunken ears, high palate, decreased cranial volume, cardiovascular malformation and alterations of the skull and cervical vertebrae.

Acitretin has a moderate influence on the ability to drive and use machines.

Treatment with acitretin can cause a decrease in night vision.

In some diabetic patients, acitretin can impair oral glucose tolerance.

In geriatric patients, acitretin can cause joint pain.

In children, there is a risk of epiphyseal closure with the use of acitretin.

It is not recommended in cases of kidney or liver disease, heart disease, high cholesterol, and depression.

It is not recommended to donate blood when taking acitretin and for up to three months after completing treatment, because it produces the same side effects in the person who is given the donated blood.

Interactions

Systemic treatment with acitretin can cause an increase in intracranial pressure.

Acitretin should not be given together with other medications such as methotrexate or an antibiotic such as tetracycline.

Progestin-only birth control pills should not be used, they may not work if you take acitretin.

Acitretin should not be given if:

  1. You are receiving phototherapy.
  2. Large amounts of alcohol are consumed.