Acaril
Generic Name
Acitretin
Manufacturer
Varies by specific brand manufacturer (e.g., Beacon Pharma, Eskayef, Drug International in Bangladesh)
Country
Varies by manufacturer, often Bangladesh for local brands
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| acaril 50 mg tablet | ৳ 15.00 | ৳ 150.00 |
Description
Overview of the medicine
Acaril 50 mg tablet contains Acitretin, a systemic retinoid used for severe forms of psoriasis and other severe disorders of keratinization that are unresponsive to other therapies.
Uses & Indications
Dosage
Adults
Initial dose 25 mg or 30 mg once daily, adjusted according to clinical response and tolerability, usually ranging from 25-50 mg daily. Max 75 mg/day.
Elderly
No specific dosage adjustment required for elderly, but caution due to potential age-related comorbidities and polypharmacy.
Renal_impairment
Use with extreme caution. Acitretin is extensively metabolized by the liver, but active metabolites are excreted renally. Dosage reduction or discontinuation may be necessary in severe renal impairment. Avoid in severe renal impairment.
How to Take
Take orally, preferably once daily with the main meal or milk to enhance absorption.
Mechanism of Action
Acitretin is a synthetic retinoid that modulates keratinocyte differentiation and proliferation. It normalizes abnormal cell growth, which helps in treating conditions like psoriasis by reducing skin cell overgrowth.
Pharmacokinetics
Onset
Therapeutic effects may take several weeks (e.g., 2-4 weeks or more) to become apparent.
Excretion
Excreted almost equally via bile (feces) and kidney (urine). Significant enterohepatic recirculation occurs.
Half life
Acitretin: approx. 50 hours; main metabolite (13-cis-acitretin): approx. 60 hours. Terminal half-life can be longer due to enterohepatic recirculation.
Absorption
Well absorbed from the gastrointestinal tract, absorption is improved when taken with food. Peak plasma concentrations are reached within 2-5 hours.
Metabolism
Extensively metabolized in the liver, primarily to 13-cis-acitretin (an active metabolite) and other polar metabolites. Can be converted to etretinate in the presence of alcohol.
Side Effects
Contraindications
- Pregnancy and women of childbearing potential who are not using effective contraception (highly teratogenic).
- Lactation (breastfeeding).
- Severe hepatic or renal impairment.
- Chronic hyperlipidemia.
- Hypervitaminosis A.
- Concomitant use with tetracyclines (risk of pseudotumor cerebri).
- Concomitant use with methotrexate (increased risk of hepatotoxicity).
Drug Interactions
Alcohol
Increases the formation of etretinate, which has a longer half-life and is also highly teratogenic. Patients must avoid alcohol during and for 2 months after treatment.
Methotrexate
Increased risk of hepatotoxicity. Concomitant use is contraindicated.
Tetracyclines
Increased risk of pseudotumor cerebri (benign intracranial hypertension). Concomitant use is contraindicated.
Vitamin A supplements
Increased risk of hypervitaminosis A. Avoid concomitant use.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe headache, dizziness, nausea, vomiting, drowsiness, and skin peeling. Treatment is supportive, and gastric lavage may be considered if recent. Patients should be monitored for signs of hypervitaminosis A.
Pregnancy & Lactation
Pregnancy Category X: Acitretin is severely teratogenic and is strictly contraindicated in pregnant women and women of childbearing potential unless effective contraception is used for at least one month before, during, and for three years after treatment. Breastfeeding is also contraindicated.
Side Effects
Contraindications
- Pregnancy and women of childbearing potential who are not using effective contraception (highly teratogenic).
- Lactation (breastfeeding).
- Severe hepatic or renal impairment.
- Chronic hyperlipidemia.
- Hypervitaminosis A.
- Concomitant use with tetracyclines (risk of pseudotumor cerebri).
- Concomitant use with methotrexate (increased risk of hepatotoxicity).
Drug Interactions
Alcohol
Increases the formation of etretinate, which has a longer half-life and is also highly teratogenic. Patients must avoid alcohol during and for 2 months after treatment.
Methotrexate
Increased risk of hepatotoxicity. Concomitant use is contraindicated.
Tetracyclines
Increased risk of pseudotumor cerebri (benign intracranial hypertension). Concomitant use is contraindicated.
Vitamin A supplements
Increased risk of hypervitaminosis A. Avoid concomitant use.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe headache, dizziness, nausea, vomiting, drowsiness, and skin peeling. Treatment is supportive, and gastric lavage may be considered if recent. Patients should be monitored for signs of hypervitaminosis A.
Pregnancy & Lactation
Pregnancy Category X: Acitretin is severely teratogenic and is strictly contraindicated in pregnant women and women of childbearing potential unless effective contraception is used for at least one month before, during, and for three years after treatment. Breastfeeding is also contraindicated.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Available in pharmacies by prescription
Approval Status
Approved in many countries (e.g., FDA, EMA, DGDA for specific brands)
Patent Status
Generic available, original patent expired
Clinical Trials
Acitretin has been extensively studied in clinical trials for severe psoriasis and disorders of keratinization, demonstrating efficacy and defining its safety profile, especially its teratogenic risk. Ongoing research may explore new applications or formulations.
Lab Monitoring
- Liver function tests (ALT, AST, ALP, bilirubin) at baseline and monthly during treatment.
- Lipid profile (triglycerides, cholesterol) at baseline and monthly during treatment.
- Blood glucose levels (especially in diabetic patients).
- For women of childbearing potential, pregnancy tests must be performed prior to initiation, monthly during treatment, and every 3 months for 3 years after discontinuation.
Doctor Notes
- Emphasize strict contraception for female patients of childbearing age.
- Inform patients about the teratogenic risk and blood donation restrictions.
- Monitor liver function tests and lipid profiles regularly.
- Advise against concomitant alcohol intake.
- Counsel on potential side effects like dry skin, dry lips, and hair loss.
Patient Guidelines
- Strictly adhere to contraception requirements for women of childbearing potential.
- Avoid alcohol during and for at least 2 months after treatment.
- Do not donate blood during treatment and for 3 years after stopping acitretin.
- Avoid excessive sun exposure and use sunscreen.
- Report any vision changes, severe headache, nausea, vomiting, or abdominal pain immediately.
Missed Dose Advice
If a dose is missed, skip the missed dose and continue with the next scheduled dose. Do not take a double dose to make up for a missed one.
Driving Precautions
Acitretin can cause visual disturbances, especially night vision impairment. Patients should be warned about this and advised to exercise caution when driving or operating machinery, especially in poor light conditions.
Lifestyle Advice
- Maintain good skin hydration using moisturizers.
- Use lip balm regularly for dry lips.
- Avoid contact lenses if dry eyes become severe.
- Discuss dietary fat intake with your doctor if you have hyperlipidemia.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.