Take Acitretin exactly as prescribed by health care provider. For inhalation or direct instillation into bronchial tree. Not for parenteral administration. Acitretin is available in form of Capsules 10 mg, Capsules 25 mg.

Contraindications of Acitretin

Pregnancy; severe liver or kidney function impairment; chronic abnormal elevation in blood lipid values; concurrent use of methotrexate or tetracyclines; hypersensitivity to other retinoids or any component of the product.

Interactions of Acitretin with other drugs

Ethanol: Concurrent use of alcohol and acitretin may lead to the formation of etretinate, which increases the duration of teratogenic potential in women.

Glyburide: The glucose-lowering effect of glyburide may be potentiated.

Methotrexate: Because the risk of hepatitis may be increased, concurrent use is contraindicated.

Phenytoin: Protein binding of phenytoin may be reduced.

Progestin "minipill": Acitretin may interfere with the contraceptive effect.

Tetracyclines: Because acitretin and tetracyclines can cause increased intracranial pressure, concurrent use is contraindicated.

Vitamin A, oral retinoids: Because the risk of hypervitaminosis A is increased, concurrent use is contraindicated.

What are the Side Effects of Acitretin -

Like other medicines, Acitretin can cause side effects. Some of the more common side effects of Acitretin include

* headache, pain, depression, insomnia, somnolence (1% to 10%); myopathy with peripheral neuropathy, aggressive feelings and/or suicidal thoughts,

* Alopecia, skin peeling (60% to 75%); dry skin, nail disorder, pruritus (25% to 50%); erythematous rash, hyperesthesia, paresthesia, paronychia, skin atrophy, sticky skin (10% to 25%); abnormal skin odor, abnormal hair texture, bullous eruption, cold/clammy skin, dermatitis, increased sweating, psoriasiform rash, purpura, pyogenic granuloma, rash, seborrhea, skin fissures, skin ulceration, sunburn, infection (1% to 10%); skin thinning, skin fragility and scaling .

* Increased phosphorus, potassium, sodium, magnesium, decreased magnesium (10% to 25%); increased calcium, chloride, decreased calcium, chloride, phosphorus, potassium, sodium (1% to 10%).

* Arthralgia, spinal hyperostosis (10% to 25%); arthritis, arthrosis, back pain, hypertonia, myalgia, osteodynia, peripheral joint hyperostosis (1% to 10%).

* Increased triglycerides (50% to 75%); increased CPK, fasting blood glucose (25% to 50%); decreased fasting blood sugar, high occult blood (10 to 25%); anorexia, edema, fatigue, hot flashes, increased appetite, gingival bleeding, gingivitis, increased salivation, thirst, infection, decreased and increased iron, flushing (1% to 10%).

Warnings and precautions before taking Acitretin :

* Acitretin must not be used by women who are pregnant or intend to become pregnant during therapy or at any time for at least 3 yr following discontinuation of therapy. Acitretin must not be used by women who may not use reliable contraception while undergoing treatment or for at least 3 yr following discontinuation of treatment. Women must sign a Patient Agreement/Information Consent Form that contains warnings about the risk of potential birth defects. An acitretin medication guide must be given to patients each time acitretin is dispensed, as required by law. If pregnancy occurs during therapy or at any time for at least 3 yr after stopping therapy, the prescriber and patient should discuss the possible effects on the pregnancy.

* The safety and efficay of Acitretin medicine have not been studied in children and adolescents.

* Ensure before using Acitretin that sexually active women who are not clearly postmenopausal or have undergone a hysterectomy are using 2 reliable forms of contraception beginning 1 mo before starting therapy, during therapy, and understand the need to continue effective contraception for 3 yr following cessation of therapy.

* Advise patient before using Acitretin that psoriasis may worsen during the initial treatment period but that gradual improvement should follow and max benefit may not be noted for 2 to 3 mo. Advise patient to notify health care provider if symptoms do not improve as expected or continue to worsen.

* Advise women before using Acitretin of childbearing potential to notify health care provider immediately if pregnant, miss a period, or have sex without using 2 effective forms of birth control either while taking acitretin or for 3 yr following cessation of therapy.

What if Overdose of Acitretin ?

If you think you or anyone else taken overdose of Acitretin , immediately telephone your doctor or contact your local or regional Poisons Information Centre Seek medical attention immediately. You may need urgent medical attention. Identical to acute hypervitaminosis A (headache, vertigo) may be the overdose symptoms of Acitretin.

What if Missed Dose of Acitretin ?

If you miss a dose of Acitretin medicine and you remember within an hour or so, take the dose immediately. If you do not remember until later, skip the dose you missed and go back to your regular schedule. Do not double doses.

Storage Conditions for Acitretin :

Store capsules at controlled room temperature (59° to 77°F). Protect from light. Avoid exposure to high temperatures and humidity after bottle is opened.

By: ashu