Acitrin
Generic Name
Acitretin
Manufacturer
Example: Beximco Pharmaceuticals
Country
Bangladesh (for example)
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| acitrin 10 mg tablet | ৳ 3.01 | ৳ 30.10 |
Description
Overview of the medicine
Acitretin is a retinoid, a derivative of vitamin A, used to treat severe forms of psoriasis and other keratinization disorders. It works by normalizing cell growth and differentiation in the skin.
Uses & Indications
Dosage
Adults
Initial dose 25-30 mg once daily for 2-4 weeks. Maintenance dose usually 25-50 mg daily, adjusted based on response and tolerability.
Elderly
No specific dosage adjustment usually required, but caution due to potential comorbidities.
Renal_impairment
Use with caution. Dosage reduction may be necessary.
How to Take
Take orally, preferably with food or milk, once daily. Swallow the tablet whole.
Mechanism of Action
Acitretin is a retinoid that modulates keratinocyte proliferation and differentiation. It binds to nuclear retinoic acid receptors (RARs), leading to changes in gene expression that normalize epidermal cell growth, reduce inflammation, and decrease hyperkeratinization characteristic of psoriatic lesions.
Pharmacokinetics
Onset
Therapeutic effects typically observed after 2-4 weeks, maximum effect by 3-6 months.
Excretion
Primarily via bile and feces (approx. 34-54%) and urine (approx. 16-53%).
Half life
Parent drug: approx. 50 hours. Active metabolite (13-cis-acitretin): approx. 2-4 days. Terminal half-life can be very long, especially if ethanol is consumed.
Absorption
Well absorbed orally, bioavailability is increased with food. Peak plasma concentrations reached within 2-5 hours.
Metabolism
Extensively metabolized in the liver, primarily to 13-cis-acitretin (an active metabolite) and other polar metabolites. Ethanol ingestion can lead to formation of etretinate, which has a very long half-life.
Side Effects
Contraindications
- Pregnancy and women of childbearing potential unless effective contraception is used for at least 1 month before, during, and for 3 years after treatment due to high teratogenicity.
- Severe hepatic or renal impairment.
- Chronic excessive alcohol consumption.
- Hypersensitivity to acitretin or other retinoids.
- Concurrent use with tetracyclines (risk of pseudotumor cerebri) or methotrexate (risk of hepatotoxicity).
Drug Interactions
Alcohol
May lead to formation of etretinate, a highly teratogenic metabolite with a very long half-life. Alcohol consumption should be avoided.
Methotrexate
Increased risk of hepatotoxicity. Avoid concomitant use.
Tetracyclines
Increased risk of pseudotumor cerebri. Avoid concomitant use.
Vitamin A and other retinoids
Increased risk of hypervitaminosis A. Avoid concomitant use.
Progestin-only oral contraceptives
May reduce efficacy of these contraceptives. Advise use of two forms of contraception.
Storage
Store below 25°C (77°F) in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include headache, nausea, vomiting, drowsiness, irritability, and dry skin/mucous membranes. Management involves discontinuation of the drug and supportive care. No specific antidote.
Pregnancy & Lactation
Acitretin is highly teratogenic (Category X) and contraindicated in pregnancy. Women of childbearing potential must use effective contraception for 3 years after treatment. Breastfeeding is contraindicated.
Side Effects
Contraindications
- Pregnancy and women of childbearing potential unless effective contraception is used for at least 1 month before, during, and for 3 years after treatment due to high teratogenicity.
- Severe hepatic or renal impairment.
- Chronic excessive alcohol consumption.
- Hypersensitivity to acitretin or other retinoids.
- Concurrent use with tetracyclines (risk of pseudotumor cerebri) or methotrexate (risk of hepatotoxicity).
Drug Interactions
Alcohol
May lead to formation of etretinate, a highly teratogenic metabolite with a very long half-life. Alcohol consumption should be avoided.
Methotrexate
Increased risk of hepatotoxicity. Avoid concomitant use.
Tetracyclines
Increased risk of pseudotumor cerebri. Avoid concomitant use.
Vitamin A and other retinoids
Increased risk of hypervitaminosis A. Avoid concomitant use.
Progestin-only oral contraceptives
May reduce efficacy of these contraceptives. Advise use of two forms of contraception.
Storage
Store below 25°C (77°F) in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include headache, nausea, vomiting, drowsiness, irritability, and dry skin/mucous membranes. Management involves discontinuation of the drug and supportive care. No specific antidote.
Pregnancy & Lactation
Acitretin is highly teratogenic (Category X) and contraindicated in pregnancy. Women of childbearing potential must use effective contraception for 3 years after treatment. Breastfeeding is contraindicated.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Varies by manufacturer, typically 2-3 years
Availability
Pharmacies, Hospitals
Approval Status
Approved by major regulatory bodies (e.g., FDA, EMA)
Patent Status
Generic available
Clinical Trials
Extensive clinical trials have confirmed efficacy in severe psoriasis, but due to its teratogenicity and side effects, its use is carefully monitored.
Lab Monitoring
- Liver function tests (baseline, then monthly or as advised).
- Lipid profile (triglycerides and cholesterol) (baseline, then monthly or as advised).
- Pregnancy tests for women of childbearing potential (before, monthly during, and for 3 years after treatment).
Doctor Notes
- Emphasize strict contraception and alcohol avoidance.
- Regular monitoring of liver function, lipids, and pregnancy status is crucial.
- Counsel patients on potential side effects, especially mucocutaneous dryness.
Patient Guidelines
- Strict adherence to contraception is paramount.
- Avoid alcohol consumption during and for 2 months after treatment.
- Do not donate blood during and for 3 years after treatment.
- Avoid excessive sun exposure; use sunscreen.
- Report any vision changes, severe headache, severe abdominal pain, or mood changes immediately.
- Use moisturizers and lip balms frequently for dry skin.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it's almost time for the next dose. Do not double the dose.
Driving Precautions
May cause reduced night vision, blurred vision, or visual disturbances. Patients should be warned not to drive or operate machinery at night if affected.
Lifestyle Advice
- Maintain good hydration.
- Avoid activities that require good night vision until visual effects are determined.
- Consider non-hormonal contraception or ensure dual contraception methods.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
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