Drug information of acitretin

Mechanism of effect

The mechanism of action of acitretin is unknown, however it is believed to work by targeting specific receptors (retinoid receptors such as RXR and RAR) in the skin which help normalize the growth cycle of skin cells.

Pharmacodynamic

Acitretin is a retinoid. Retinoids have a structure similar to vitamin A and are involved in the normal growth of skin cells

Pharmacokinetics

Oral absorption of acitretin is optimal when given with food. Acitretin is more than 99.9% bound to plasma proteins, primarily albumin.. Following oral absorption, acitretin undergoes extensive metabolism The chain-shortened metabolites and conjugates of acitretin and cis-acitretin are ultimately excreted in the feces (34% to 54%) and urine (16% to 53%). Half life: 49 hours (range 33 to 96 hours).

Drug indications

psoriasis treatment , congenital ichthyosis

Dosage

Usual Adult Dose for Psoriasis Initial dose: 25 to 50 mg orally once a day, administered as a single dose with main meal Maintenance dose: 25 to 50 mg orally once a day, administered upon an individual patient's response to initial treatment.

Drug contraindications

Pregnancy , Renal dysfunction , hypersensitivity to drug or its components. , severe hepatic impairment , combination of methotrexate , coadministration with tetracyclines

Side effects

nausea , Headache , insomnia , Dermatit , abdominal pain , fatigue , Blurred vision , Angioedema , Increased risk of suicidal thinking , Depression , Diarrhea , urticaria , neuropathy , edema , sinusitis , Infections , anorexia , somnolence , conjunctivitis , Pain , Hypersensitivity , taste perversion , MI , sweating , dysuria , Tinnitus

Interactions

Medroxyprogesterone , Tetracycline , Doxycycline , Cimetidine , Phenytoin , Warfarin , Vitamin A , Contraceptive , Contraceptive DE , Contraceptive HD , Contraceptive LD , Demeclocycline , aminolevulinic acid oral , Aminolevulinic acid topical , Remdesivir , Sarecycline , Omadacycline

Alerts

1-Acitretin must not be used by females who are pregnant, or who intend to become pregnant during therapy or at any time for at least 3 years following discontinuation of therapy. 2-Hepatotoxicity: There have been reports of hepatitis-related deaths worldwide 3-Acitretin has not been studied in and is not indicated for treatment of acne. 4-Significantly lower doses of phototherapy are required when acitretin is used because effects on the stratum corneum induced by acitretin can increase the risk of erythema.

Points of recommendation

1-Some patients receiving retinoids have experienced problems with blood sugar control. In diabetics, blood-sugar levels should be monitored very carefully. 2-In clinical trials, the incidence of hypertriglyceridemia was 66%, hypercholesterolemia was 33%, and that of decreased HDL was 40%. Pretreatment and follow-up measurements should be obtained under fasting conditions. 3-It is recommended that Liver Function Tests be performed prior to initiation of therapy with acitretin, at 1 to 2 week intervals until stable 4-This drug should be administered with meals. 5-Protect from light. Exposure to high temperatures and humidity should be avoided after the bottle is opened.

Pregnancy level

X