acitretin

What is the most important information I should know about acitretin?

You must use effective birth control to avoid getting pregnant while taking acitretin and for at least 3 years after your last dose. You will need pregnancy tests at regular intervals to make sure you are not pregnant.

What is acitretin?

Acitretin is a retinoid, which is a form of vitamin A.

Acitretin is used to treat severe psoriasis in adults. Acitretin is not a cure for psoriasis, and you may relapse after you stop taking this medication.

Acitretin may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking acitretin?

• you have severe liver disease or severe kidney disease;
• you have high levels of triglycerides (a type of fat) in your blood;
• you are pregnant or breast-feeding;
• you are also using methotrexate; or
• you also use a tetracycline antibiotic (such as demeclocycline, doxycycline, minocycline, tetracycline, and others).

Acitretin is available to women only under an agreement that you will use approved birth control methods and undergo required pregnancy testing while taking this medicine and for at least 3 years after your last dose.

For women taking acitretin who have not had a hysterectomy or have not gone completely through menopause: Before you start taking acitretin you must have 2 negative pregnancy tests (when your doctor first prescribes acitretin, and again during the first 5 days of your menstrual period just before you start taking this medicine). You will also need pregnancy tests every month while you are taking acitretin, and every 3 months for at least 3 years after your last dose.

The first birth control method should include one of the following forms:

• birth control pills (but not the "mini-pill");
• an intrauterine device (IUD);
• birth control shots, inserts, skin patches, or implants;
• a tubal ligation; or
• your male partner's vasectomy.

The second birth control method should include one of the following forms:

• a diaphragm or cervical cap used with a spermicide;
• a latex condom used with or without a spermicide; or
• a vaginal sponge that contains a spermicide.

Start using both forms of birth control at least 1 month before you start taking acitretin. Continue using both forms while you are taking acitretin and for at least 3 years after your last dose. Use both forms of birth control together every time you have sex.

If you are not menstruating, you should have a pregnancy test at least 11 days after you last had sex without using 2 effective forms of birth control.

To make sure acitretin is safe for you, tell your doctor if you have ever had:

• phototherapy;
• kidney or liver disease;
• heart disease;
• high cholesterol or triglycerides (a type of fat in the blood);
• diabetes (you may need to check your blood sugar more often);
• a habit of drinking large amounts of alcohol;
• depression; or
• if you have ever used a medicine called etretinate (Tegison, Tigason).

How should I take acitretin?

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

While using acitretin, you may need frequent blood tests. If you use this medicine long-term, you may need additional medical tests, including x-rays.

What happens if I miss a dose?

Skip the missed dose and take the next regularly scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Overdose may cause headaches or severe dizziness.

What should I avoid while taking acitretin?

Avoid taking more than the minimum recommended daily allowance of vitamin A. Acitretin is a form of vitamin A, and many multivitamin products or dietary supplements contain vitamin A. Taking certain products together can cause you to get too much vitamin A.

What are the possible side effects of acitretin?

• mood changes --depression, aggression, unusual thoughts or behavior, thoughts of hurting yourself;
• heart attack or stroke symptoms --chest pain, dizziness, nausea, feeling short of breath, sudden numbness or weakness (especially on one side of the body), sudden severe headache, problems with speech or balance, swelling or warmth in one or both legs;
• high blood sugar --increased thirst, increased urination, dry mouth, fruity breath odor, headache, blurred vision;
• increased pressure inside the skull --severe headaches, ringing in your ears, dizziness, nausea, vision problems, pain behind your eyes;
• liver problems --nausea, vomiting, loss of appetite, dark urine, or jaundice (yellowing of your skin or eyes);
• problems with your bones or muscles --loss of feeling in your hands or feet, trouble moving, pain in your back, joints, muscles, or bones;
• serious skin problems --itching, redness, pain, swelling or peeling of your skin; or
• signs of a blood vessel problem --sudden swelling, rapid weight gain, fever, muscle pain, feeling light-headed.

Common side effects may include:

• chapped lips, dry mouth;
• itchy or scaly skin;
• weak nails, fragile skin;
• peeling skin on your hands and feet;
• hair loss;
• dry eyes, discomfort while wearing contact lenses;
• dry or runny nose, nosebleeds; or
• joint pain, tight muscles.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect acitretin?

Tell your doctor about all your current medicines and any you start or stop using, especially:

• glyburide;
• phenytoin;
• St. John's wort; or
• hormone replacement therapy or birth control pills (especially "minipills").

This list is not complete. Other drugs may interact with acitretin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

Your doctor or pharmacist can provide more information about acitretin.