Women of childbearing potential must not drink alcohol during therapy and for two months after therapy is stopped. If alcohol is consumed, acitretin can change inside the patient's body to a form of the drug that can remain in the body for an extended period of time. This conversion increases the risk of birth defects if a woman was to become pregnant after stopping acitretin. Women of childbearing potential should not use acitretin unless they are willing to use reliable birth control while taking the medication and for at least two years after treatment is stopped.
Before starting acitretin treatment it is also important to consult your doctor if you are taking any medication or supplement, especially vitamin A, tetracyclines, methotrexate, or supplements such as St. John's Wort. These could increase your risk of side effects.
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| Acitretin Side Effects |
Do not have surgical cosmetic procedures on your skin while taking acitretin because retinoids can increase your chance of scarring or inflammation. Avoid such procedures or avoid oral retinoids for up to six months before having such procedures.
As well, you should protect yourself from the sun and avoid using tanning beds. Some patients can expose themselves to ultraviolet radiation (UVB/PUVA) if under a doctor's supervision. Retinoids are known to increase your skin's sensitivity to ultraviolet light in both natural and artificial sunlight.
Sun Safety Tips
- Avoid peak sun exposure when the sun's rays are strongest (between 10 a.m. and 3 p.m.).
- Seek the shade.
- Use a broad-spectrum sunscreen with an SPF of at least 15 that protects against both UVA and UVB.
- Wear protective clothing, particularly a broad-brimmed hat and long sleeves.
- pregnant or planning to become pregnant
- nursing women
- unwilling to use birth control
- experience an abnormal decrease in the number of white blood cells (leukopenia)
- experiencing moderate to severe elevation of cholesterol or triglycerides
- experiencing major liver abnormality
- experiencing major kidney abnormality
- vitamin A or any other supplement containing vitamin A that exceeds the minimum recommended allowance
- certain antibiotics (minocycline (Minocin), doxycycline (Vibra-Tabs), tetracycline)
- cyclosporine
- alcohol
- methotrexate
- St. John's wort
Side Effects
While there are many potential side effects with acitretin, most are mild and short-lived. Acitretin has a better safety profile than most other available systemic agents, and is a useful medication for appropriate psoriasis patients.
Some side effects occur after a few weeks of starting treatment, but will often improve. These include chapped lips, dry skin, nosebleeds, dry mouth, dry or irritated eyes, and peeling of the skin of the fingertips, palms, and soles. Hair loss is not common, but can be very distressing for those affected; however, hair will gradually regrow after treatment ceases. If you experience joint and muscle pain, it is wise to avoid excessive exercising, particularly weight lifting and contact sports. Other adverse effects are less frequent, but can be more serious.
Increased pressure behind the eye is relatively uncommon, but can occur with acitretin use. The risk of developing this condition (pseudotumor cerebri) is increased in young, over-weight women. Common symptoms include severe headache, nausea, vomiting, and blurred vision. If these symptoms occur, immediately contact your doctor, who might discontinue the treatment.
Although rare, depression and suicide have been reported, mostly in association with isotretinoin; however, there is insufficient information to indicate that retinoids such as isotretinoin or acitretin cause depression. Several studies based on drug-use registries in Saskatchewan and the United Kingdom showed no increase in suicide or depression with acitretin, compared to people who were not taking this medication. Still, it is important to be aware of this association, and to pay close attention to any changes in mood and any symptoms of depression. If you happen to experience feelings of sadness, irritability, fatigue, difficulty concentrating, or loss of appetite, you should immediately contact your doctor. Other rare side effects include injury to the liver, increase in blood lipids, and inflammation of the pancreas (pancreatitis).
Once acitretin therapy is started, regular follow-up visits are necessary to monitor your response to the medication, and to determine if you have any side effects from the medication. Your doctor will be able to increase your dosage if the results need to be improved, decrease it to reduce any side effects, or discontinue it altogether.
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| Acitretin Side Effects |
What Tests or Follow-ups Are Required While on Acitretin?
Regular blood tests will be completed while patients are on acitretin to monitor the blood cell count, liver and kidney function, and to ensure that female patients of childbearing age do not get pregnant. Also, the triglyceride and cholesterol levels will be tested, so fasting will be required for 12 hours prior to testing.
Stop taking acitretin and contact your doctor immediately if you become pregnant while on this medication or within two years after stopping this medication. To find out more, you can check out Acitretin Side Effects.