What is Soriatane (Acitretin)?
Acitretin, also known by its brand name Soriatane, is an antipsoriatic retinol medication. Psoriasis conditions that are effectively treated with Acitretin include – pustular psoriasis, erythrodermic psoriasis, and plaque psoriasis.
This drug is not used for psoriatic arthritis.
How Acitretin Works
Acitretin is a retinol used to treat severe psoriasis that is resistant to other therapies. Retinols are derived from vitamin A, known for their benefits to the skin. Retinol enters the body’s skin cells causing changes that slow down cell production. This slowing of cell production thus prevents the skin’s inflammation responses of reddening, itching, thickening, and scaling. Acitretin is best used in conjunction with Ultraviolet light(UVB) for plaque psoriasis. In pustular psoriasis and erythrodermic psoriasis, Acitretin works well without UVB therapy.
Storage, Dosage & How to Use
Acitretin comes in capsules, which are taken once a day, preferably with meals or milk.
The capsules are color-coded to indicate dosage:
- brown and white capsules – 10 milligrams
- bright yellow capsules –5 milligrams
- brown and yellow capsules – 25 milligrams
Only a month’s supply is given at a time. Store Acitretin at room temperature and away from moisture, heat, or excessive light. Plaque psoriasis is most effective when used in conjunction with Ultraviolet light B therapy. An Acitretin Medication Guide always comes with a 30-capsule bottle.
The most common side effects of Acitretin are:
- chapped lips
- peeling skin
- dry eyes
- runny nose
- joint pain
Other common side effects that might occur include:
- dry mouth
- itchy skin
- fragile skin
- weak nails
- contact lenses become uncomfortable to wear
- tight muscles
The most serious side effects that require immediate medical help are:
- sudden weakness
- loss of appetite
- dark urine
- dry mouth
- rapid weight gain
- muscle pain
Other possible serious side effects that require immediate medical help:
- difficulty breathing
- swelling of the face, tongue and throat
- mood changes and depression
- unusual thoughts or behavior including self-harm thoughts
- chest pain
- shortness of breath
- sudden severe headache
- affected speech
- affected balance
- difficulty moving
- loss of feeling in the hands or feet
- pain in the back, joints, muscles or bones
- sudden swelling including swelling in the hands
- peeling of skin
- swelling or warmth in one or both legs
- increased urination
- blurred vision
- pain behind the eyes
- ringing in the ears
If you experience any of these serious symptoms, discontinue use of the medication and contact your healthcare provider immediately.
Warnings & Precautions
USING ACITRETIN WHEN PREGNANT IS CONTRAINDICATED.
If you are planning to get pregnant, or could be pregnant from unprotected sex, this medication should NOT be taken. Beginning a month prior to using Acitretin, women need to use two forms of reliable birth control. These birth control methods need to be continued for an additional three years, at least, after taking the medication. Pregnancy tests should also be performed prior to and routinely throughout the use of acitretin.
Severe human fetal abnormalities have been reported in association with taking acitretin.
Liver function should be checked prior to initiating treatment. Clinical trials have documented liver function disorders associated with using Acitretin. Most cases returned to normal liver function after discontinuing Acitretin therapy.
If hepatotoxicity is suspected, acitretin should be immediately discontinued and the cause of the symptoms investigated.
Fasting levels of serum cholesterol and triglycerides should also be checked prior to initiating acitretin therapy. Discontinue Acitretin if dyslipidemia or symptoms of pancreatitis occur.
Ossification abnormalities, degenerative spurs, bridging of vertebrae, ligament calcification, and narrowing or destruction of cervical disc space have been documented. In 15% of adversely affected cases, the patient had pre-existing skeletal conditions.
Adults receiving long-term Acitretin treatment should be periodically examined for adverse musculoskeletal and bone effects.
DECREASED NIGHT VISION
Practice caution when driving at night or when operating any type of vehicle or machinery in dim visual conditions. Report new visual disturbances and changes to the provider.
Rare reports of severe, sudden, and new headaches, nausea and vomiting, as well as visual disturbances have been documented. Discontinue Acitretin immediately and contact the provider to be referred for neurologic evaluation.
Acitretin cannot be taken with certain health conditions. Let your prescribing Provider know if you have any of the following conditions so that they can choose another medication for you:
- liver disease
- kidney dysfunctions
- intracranial hypertension
- eye conditions
- psychiatric disorders
A number of medications given for these conditions can also interfere with the safe and effective use of acitretin. Be certain to review your medications with the healthcare provider. Also tell your doctor if you are taking activated charcoal, CoQ10, fish oil, Flonase, iodine, L-arginine, B-12, C, or D3 supplements. And finally, alcohol or any foods containing alcohol cannot be used when taking acitretin.
Medications that cannot be used while receiving Acitretin treatment:
- medications that have ethanol as an ingredient
- microdosed progestin mini-pill
- oral retinoids and vitamin A
Acitretin is associated with an increased risk of severe birth defects. Do not use acitretin if you may be pregnant or might become pregnant during the time of using acitretin and for the three years after stopping the use of acitretin. Your body takes three years to eliminate any trace of Acitretin.
If you decide to use acitretin, you must be using two forms of birth control every time you have sex.
The first method of birth control must be:
- birth control pills
- an insert
- tubal ligation
- intrauterine device(IUD)
- your sexual partner can have a vasectomy
The second method of birth control must also be used with every sexual encounter.
The second method of birth control can be:
- diaphragm or cervical cap with a spermicide
- latex condom with or without spermicide
- vaginal sponge that contains spermicide