acitretin at a glance
Medicine class
Systemic retinoid related to vitamin A
Main role
Specialist treatment of severe psoriasis and keratinisation disorders
Administration
Swallow capsules whole with a meal or milk
Monitoring
Blood tests assess liver function and blood lipids
Blood donation
Do not donate during treatment or for three years after stopping
What is acitretin used for?
Licensed uses for the selected product are severe or treatment-resistant disorders involving abnormal skin-cell growth and keratinisation.
Extensive, severe refractory psoriasis
Pustular psoriasis affecting the hands and feet
Severe congenital ichthyosis and ichthyosiform dermatitis
Lichen planus affecting the skin or mucous membranes
Other severe, refractory dermatitis characterised by dyskeratosis or hyperkeratosis
How does acitretin work?
Acitretin helps normalise skin-cell proliferation, differentiation and keratinisation. It reduces abnormal thickening and scaling, but is symptomatic rather than curative.
acitretin preparations and strengths
Capsule
Route: Oral
Strengths: 10 mg, 25 mg
How to take acitretin
Follow the specialist’s instructions and do not change or stop treatment without discussing it with them.
Swallow hard capsules whole with a meal or milk; food improves absorption.
Discuss additional creams, ointments or other skin treatments with the prescriber.
Avoid excessive sunlight and unsupervised sun-lamp use because sensitivity to ultraviolet light may increase.
Never share capsules; return unused capsules to a pharmacy.
acitretin side effects
Common or expected effects
- Dry or inflamed lips
- Dry mouth and nose, sometimes with nosebleeds
- Dry, peeling, itchy or more sensitive skin
- Hair thinning or hair loss and fragile nails
- Dry or inflamed eyes, blurred vision or reduced night vision
- Thirst or feeling cold
- Raised cholesterol, triglycerides or liver-test results
Get urgent medical advice
- Severe headache with nausea, vomiting or visual disturbance, which may indicate raised pressure around the brain
- Yellow skin or eyes, which may indicate hepatitis
- Serious allergic reaction
- Severe widespread peeling or inflammation of the skin
- Marked mood or behavioural change, psychosis or suicidal thoughts
acitretin in pregnancy
Acitretin causes a very high risk of severe congenital malformations and must not be used during pregnancy. Anyone who can become pregnant must meet the Pregnancy Prevention Programme conditions, including effective contraception before and throughout treatment and for three years after stopping, with medically supervised pregnancy testing. Suspected pregnancy requires immediate contact with the prescriber and specialist assessment.
acitretin while breastfeeding
Breastfeeding is contraindicated because acitretin is fat-soluble and passes into breast milk. Discuss an alternative treatment or feeding plan with the specialist.
acitretin interactions
Check prescription, over-the-counter and complementary products before treatment. Important interactions include:
Tetracycline antibiotics
Concurrent use is contraindicated because both can increase pressure around the brain.
Methotrexate
Concurrent use is contraindicated because of the risk of liver inflammation.
Vitamin A supplements or other retinoids
Avoid concurrent use because vitamin A toxicity may be increased.
Low-dose progestogen-only contraceptive pills
Acitretin may reduce their contraceptive effect, so they must not be relied upon during treatment.
Common questions about acitretin
Answers are fully visible for fast scanning and source review.
What skin conditions is acitretin licensed to treat?
The selected product is licensed for severe refractory psoriasis, pustular psoriasis of the hands and feet, severe congenital ichthyosis and ichthyosiform dermatitis, lichen planus, and certain other severe refractory keratinisation disorders.
Is acitretin an immunosuppressant?
No. It is a systemic retinoid related to vitamin A that alters skin-cell growth, differentiation and keratinisation.
Should capsules be taken with food?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.