Soriatane (Acitretin)

How Soriatane Works

Soriatane 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

Soriatane comes in capsule form, taken once per 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 Soriatane 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 Soriatane Medication Guide always comes with a 30-capsule bottle.

Side Effects

The most common side effects of Soriatane 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
• nosebleeds
• tight muscles

The most serious side effects that require immediate medical help are:

• aggression
• sudden weakness
• vomiting
• loss of appetite
• dark urine
• jaundice
• thirst
• dry mouth
• rapid weight gain
• muscle pain
• light-headedness

Other possible serious side effects that require immediate medical help:

• hives
• difficulty breathing
• swelling of the face, tongue and throat
• mood changes and depression
• unusual thoughts or behavior including self-harm thoughts
• chest pain
• dizziness
• nausea
• 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
• fever

If you experience any of these serious symptoms, discontinue use of the medication and contact your healthcare provider immediately.

Warnings & Precautions

USING SORIATANE 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 Soriatane, 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 this medication.

Severe human fetal abnormalities have been reported in association with Soriatane.

HEPATOTOXICITY

Liver function should be checked prior to initiating treatment. Clinical trials have documented liver function disorders associated with use. Most cases returned to normal liver function after discontinuing therapy.

If hepatotoxicity is suspected, Soriatane 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 therapy. Discontinue Soriatane if dyslipidemia or symptoms of pancreatitis occur.

SKELETAL ABNORMALITIES

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.

INTRACRANIAL HYPERTENSION

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.

Interactions

Soriatane 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
• hyperlipidemia
• diabetes
• kidney dysfunctions
• intracranial hypertension
• eye conditions
• alcoholism
• psychiatric disorders

A number of medications given for these conditions can also interfere with the safe and effective use of Soriatane. 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 taken.

Medications that cannot be used while receiving Soriatane treatment:

• medications that have ethanol as an ingredient
• glyburide
• microdosed progestin mini-pill
• methotrexate
• phenytoin
• tetracyclines
• oral retinoids and vitamin A

Contraindications

Pregnancy

Soriatane is associated with an increased risk of severe birth defects. Do not use if you may be pregnant or might become pregnant during the time of using Soriatane and for the three years after stopping the use of this medication. Your body takes three years to eliminate any trace of Acitretin.

If you decide to use Soriatane, 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
• injection
• implant
• 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