Acitretin

What is Acitretin for?

It is mainly used to treat severe psoriasis, an inflammatory condition of the skin with increased turnover of skin cells, creating red, scaly patches of skin. The medication works by regulating the normal growth and development of skin cells.

This medication may also be used for other conditions as determined by your doctor.

How should I take or use Acitretin ?

This medication should be taken with or after food for better absorption.  Swallow the capsule whole, do not crush or chew it.

Liquid preparation may be available in some institutions. Please check with your healthcare professionals.

What should I do if I forget to take or use Acitretin ?

If you forget to take a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose. Then take your next dose at the usual time. Do not take two doses to make up for the missed dose.

What precautions should I take when taking or using Acitretin ?

Inform your healthcare professional if:

• You are allergic to this medication or any of the other ingredients of this medication
• You are pregnant, planning to become pregnant, or breastfeeding:
  • This medication can cause serious harm to an unborn child. You are advised to practice strict birth control for at least 1 month before starting on the medication, when taking the medication and at least 3 years after stopping the medication.
  • This medication may pass into breast milk and harm your baby. Do not breastfeed for at least 3 years after stopping the medication
  • If you suspect you are pregnant, do not start acitretin at all.
  • If you are already taking acitretin and discover that you have become pregnant, stop taking it immediately and tell your doctor.
• You have diabetes, high cholesterol or triglycerides (fat in the blood), liver or kidney disease
• You are planning to donate blood. Do not donate blood when taking the medication and for at least 3 years after stopping the medication. This is to prevent passing donated blood to a pregnant woman and causing harm to the baby.
• You are taking any other medications, including supplements, traditional medications and herbal remedies

What food or medication should I avoid when I take or use Acitretin ?

• You should avoid taking alcohol when taking this medication and for 2 months after stopping it. Alcohol causes the medication to stay longer in the body and increases the risk of side-effects.
• Do not take vitamin A supplements or multivitamins that contains vitamin A.
• Do not take isotretinoin as both acitretin and isotretinoin belong to the same group of medications known as retinoids.
• Do not take this medication if you are currently taking any Tetracycline class of antibiotics (such as Doxycycline, Minocycline, and Tetracycline).  This can increase the risk of high pressure in the head leading to headaches, nausea and vomiting.

What are some common side effects of Acitretin ?

• Initial temporary worsening of psoriasis before improvement
  • It may take 2-3 months to see the full benefit of this medication
• Red, cracked and sore lips
  • Apply lip balm frequently
• Irritated and dry eyes
  • Apply lubricating eye-drops or artificial tears to prevent this. Stop the use of contact lenses if irritation persists.
• Dry skin, sometimes with peeling
  • Apply moisturiser regularly to manage skin dryness
• Dry mouth
  • Drink more water or suck on sweets
• Dry nose. Nose bleeding may occur for severe cases
  • Apply white soft paraffin to the lining inside of your nose
• Muscle and joint pain or stiffness
  • Avoid intense physical exercise to prevent it from getting worse
• Increased risk of sunburn
  • Avoid staying directly under sunlight for long durations. Use a broad-spectrum sunscreen product with Sun Protection Factor (SPF) of at least 30 and wear protective clothing when you are exposed to direct sunlight.

Your doctor will also perform blood tests (cholesterol/triglycerides and liver function test) before you start the treatment and during the course of treatment. This is to monitor for any abnormalities as acitretin can cause the level of cholesterol and triglycerides in your blood to increase and may cause raised liver enzymes.

What are some rare but serious side effects that I need to seek medical advice immediately?

The symptoms of a drug allergy include one or more of the following:

• Swollen face/eyes/lips/tongue
• Difficulty in breathing
• Itchy skin rashes over your whole body

Some of these side effects include:

• Liver problem: Signs include dark urine or light coloured stools, nausea, vomiting, loss of appetite, stomach pain, yellowing of your eyes or skin
• Low mood (depression)
• Blurred vision or change in vision
• Severe headache
• Persistent nausea
• Severe backache
• Hair loss

If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

How should I store Acitretin ?

Store in a cool and dry place, away from direct sunlight. Keep this medication away from children.

This medication should be protected from light as it may be degraded upon exposure to light.

How do I throw away Acitretin safely?

Pack this medication into a black trash bag and seal it tightly before throwing into the rubbish chute or bin.