How does this medication work? What will it do for me?

Acitretin is a derivative of vitamin A. It is used to treat severe psoriasis and other skin disorders. Acitretin reduces the speed at which the cells involved in psoriasis are formed. It may take 2 to 3 months before the full benefit of acitretin is seen.

Psoriasis is a skin condition that involves chronically occurring bright red patches covered with silvery scales. It cannot be passed from one person to another.

Your doctor may have suggested this medication for conditions other than the ones listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

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What form(s) does this medication come in?

10 mg
Each brown and white, hard gelatin capsule (No. 4) with "ACTAVIS" in black lettering contains acitretin 10 mg. Nonmedicinal ingredients: gelatin, glucose (liquid, spray-dried), microcrystalline cellulose, and sodium ascorbate; gelatin capsule shell: iron oxide (yellow, black, and red) and titanium dioxide.

25 mg
Each brown and yellow, hard gelatin capsule (No. 1) with "ACTAVIS" in black lettering contains acitretin 25 mg. Nonmedicinal ingredients: gelatin, glucose (liquid, spray-dried), microcrystalline cellulose, and sodium ascorbate; gelatin capsule shell: iron oxide (yellow, black, and red) and titanium dioxide.

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How should I use this medication?

The recommended starting dose of acitretin is 25 mg once daily. If the desired effect has not been seen after 4 weeks and side effects have been tolerated, your doctor may increase the dose to 50 mg once daily. The maximum dose is 75 mg once a day.

Acitretin should be taken once daily with food or just after a meal.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

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Who should NOT take this medication?

Acitretin should not be taken by anyone who:

  • is allergic to acitretin, vitamin A, or to any of the ingredients of the medication
  • has certain types of abnormal cholesterol levels
  • has excess vitamin A in the body
  • has severely reduced kidney or liver function

A woman capable of becoming pregnant must not take acitretin unless ALL of the following criteria are met:

  • She is able to use effective birth control methods.
  • She is reliable in understanding and carrying out instructions.
  • She has had a pregnancy test within 2 weeks before the start of treatment.
  • She has received and understands information regarding the risks of having babies with deformities associated with acitretin exposure.
  • She has severe psoriasis or other severe skin disease, as judged by the doctor.

Acitretin must not be taken by pregnant women. As well, women must not become pregnant while taking acitretin and should use effective birth control for at least 2 years after stopping this medication. Women should not breast-feed while taking acitretin or for 2 years after stopping the medication.

Alcohol must not be consumed while taking acitretin and for 2 months after stopping the treatment.

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What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

When acitretin is first started, you may experience more redness, itching, skin scaling, peeling, and dry skin for the first month as your body adjusts to the medication. This will normally fade as treatment continues. It is important that you see your doctor regularly (preferably once a month) and report any side effects that become bothersome.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • abdominal pain
  • abnormal hair texture
  • back pain
  • cold or clammy skin
  • dry eyes
  • dry mouth, chapped lips (especially in the first few weeks)
  • dry skin
  • earache
  • fatigue
  • fluid retention
  • gum swelling or bleeding
  • hair loss (especially in the first few weeks)
  • headache
  • impotence
  • increased appetite
  • increased saliva
  • increased sweating
  • infection
  • inflammation around the fingernails
  • insomnia (difficulty sleeping)
  • itchiness (especially in the first few weeks)
  • loss of appetite
  • mouth sores
  • muscle pain
  • nail disorders
  • nausea
  • nervousness
  • nosebleeds
  • numbness
  • rash
  • rhinitis (runny nose)
  • ringing in the ears
  • sensitivity of skin or eyes to light
  • skin peeling or scaling (especially in the first few weeks)
  • skin ulcers
  • sore joints
  • sticky skin
  • taste disturbances
  • thirst

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • abnormal vision
  • aches or pains in bones or joints
  • arthritis
  • blurred vision
  • changes in mood
  • dark urine
  • decrease in night vision
  • difficulty in moving
  • eye irritation
  • eye pain
  • eye sensitivity to light
  • flu-like symptoms
  • headaches
  • nausea (severe)
  • other visual problems
  • persistent feeling of dry eyes
  • vomiting
  • yellowing of the skin or eyes

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take this medication.

Alcohol: Alcohol must not be consumed while taking acitretin and for 2 months after stopping the treatment.

Benign intracranial hypertension: Acitretin has been known to cause a condition called benign intracranial hypertension. Contact your doctor if you experience any of these symptoms: headache, nausea and vomiting, and changes in vision.

Blood donation: Do not donate blood while taking acitretin and for at least 2 years after your last dose of acitretin, as your blood should not be given to pregnant women.

Cholesterol: Acitretin has caused an increase in cholesterol levels. You doctor will probably ask you to have regular cholesterol blood tests while taking this medication.

Contact lenses: If you wear contact lenses, you may find them uncomfortable during and after treatment with acitretin due to dry eyes.

Diabetes: Acitretin can cause changes in glucose tolerance for people with diabetes. People with diabetes should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Excessive bone growth: Long-term use of acitretin may lead to excessive bone growth or unusual bone formation. Your doctor may request that you have yearly X-rays to monitor for bone changes.

Liver: Acitretin can cause changes in how well the liver functions. You will probably need to have regular liver tests while you are taking this medication.

Sunburn: Protect yourself from exposure to the sun, as acitretin may increase the sensitivity of your skin to the sun.

Women capable of becoming pregnant: See "Who should not take this medication?"

Pregnancy: Acitretin can cause birth defects. This medication must not be taken during pregnancy. If you become pregnant while taking acitretin, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking acitretin, it may affect your baby. Breast-feeding mothers must not take this medication.

Children: The safety and efficacy of using this medication have not been established for children.

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What other drugs could interact with this medication?

There may be an interaction between acitretin and any of the following:

  • alcohol
  • any medications or products containing vitamin A
  • any medications or products related to vitamin A
  • methotrexate
  • phenytoin
  • progestin-only birth control
  • tetracyclines (e.g., tetracycline, doxycycline)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.