Acitretin (Systemic)

Brand Names : Soriatane, 13-cis acitretin, etretin, isoetretin

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For acitretin, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual reaction to acitretin, etretinate, isotretinoin, tretinoin, or vitamin A-like preparations, including vitamin A supplements. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Diet - Make certain your health care provider knows if you are on any special diet, such as a low-sodium, low-cholesterol, or low-sugar diet. Discuss with your doctor how often you drink alcohol, even if it is only an occasional drink.

Pregnancy - Acitretin must not be taken during pregnancy. It has been shown to cause serious birth defects and other problems in humans .

Before taking this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant. Beginning at least 1 month before you start to take acitretin, you should plan on using two effective forms of birth control to prevent pregnancy . In addition, since it is not known how long pregnancy should be avoided after treatment stops, you should plan not to become pregnant for at least 2 or 3 years after you stop taking acitretin or as directed by your doctor. If you become pregnant, stop taking the medicine and tell your doctor .

Breast-feeding - It is not known whether acitretin passes into the breast milk. However, use of acitretin is not recommended during breast-feeding because it may cause unwanted effects in nursing babies. You also should plan not to breast-feed for at least 2 or 3 years after you stop taking acitretin.

Children - This medicine has been tested in some children and has been shown not to cause different side effects or problems in children than it does in adults. However, children may be more sensitive to some of the medicine's effect on bones, which may prevent normal bone growth during puberty. This can cause them to grow up to be shorter adults than expected. Therefore, it is especially important that you discuss with the child's doctor the good that this medicine may do as well as the risks of using it.

Older adults - This medicine has been tested and has not been shown to cause different side effects or problems in older people than it does in younger adults. However, some older patients may have higher levels of the medicine in the blood stream as compared to younger adults, and they may be more sensitive to its effects. This may increase their chance of developing side effects during treatment.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together, even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking acitretin, it is especially important that your health care professional know if you are taking any of the following:

• Alcoholic beverages - Drinking alcohol may convert acitretin to a much longer-acting product that can stay in the body 60 times longer than acitretin does. This may result in a greater chance of developing side effects for months or years, depending on how much and how often one drinks. This unusual effect can occur even after you stop taking acitretin, especially for the first 2 months after you stop taking this medicine

• Cyclosporine (e.g., Sandimmune or Neoral) or
• Hydantoins, such as phenytoin (e.g., Dilantin) - Acitretin may increase the effects of these medicines

• Etretinate (e.g., Tegison) or
• Isotretinoin (e.g., Accutane) or
• Tretinoin (oral) (e.g., Vesanoid) or
• Tretinoin (topical) (e.g., Avita, Renova, or Retin A) or
• Vitamin A, including vitamin supplements - Etretinate, isotretinoin, and tretinoin are not used together with acitretin; problems in skin, vision, and bone may be more likely to occur when they are used at the same time. If vitamin A is taken with acitretin, the dose of vitamin A should not exceed the minimum recommended daily allowance (RDA)

• Methotrexate - Acitretin may increase the chance of causing liver problems if used with methotrexate

• Oral contraceptives, progestin-only (e.g., Micronor) - Acitretin may prevent progestin-only oral contraceptives from working properly and may result in an unplanned pregnancy. This does not occur with oral contraceptives containing both estrogens and progestins

• Tetracyclines - Using acitretin at the same time that tetracyclines are used may increase the chance of severe pressure occurring in the brain

Other medical problems - The presence of other medical problems may affect the use of acitretin. Make sure you tell your doctor if you have any other medical problems, especially:

• Diabetes mellitus (sugar diabetes) or
• High cholesterol or triglycerides, uncontrollable (or history of) or
• Inflammation of pancreas (or history of) - Acitretin may make these conditions worse or increase cholesterol or triglyceride problems

• Hypervitaminosis A (or history of) - If you have past or current problems with toxic symptoms from vitamin A, acitretin may increase the chance that they will occur again

• Kidney disease, severe or
• Liver disease, severe - May cause acitretin to stay in the body for a longer period of time and increase the chance of side effects