alitretinoin at a glance
Medicine class
Oral retinoid related to vitamin A
Licensed use
Severe chronic hand eczema in adults when potent topical corticosteroids have not worked
Administration
Take the capsule with a main meal and swallow it whole
Pregnancy safety
Highly teratogenic; strict pregnancy-prevention requirements apply
What is alitretinoin used for?
The selected product is licensed for:
Adults with severe chronic hand eczema that is unresponsive to potent topical corticosteroids.
Response may be more likely when eczema is predominantly hyperkeratotic rather than predominantly pompholyx.
How does alitretinoin work?
Alitretinoin binds retinoic acid receptors and retinoid X receptors. It alters gene activity involved in skin-cell behaviour and reduces inflammatory and immune signalling; its precise mechanism in chronic hand eczema is not fully understood.
alitretinoin preparations and strengths
Capsule
Route: Oral
Strengths: 10 mg, 30 mg
How to take alitretinoin
Follow the prescribing label and specialist's instructions.
Take the capsule with a main meal because food substantially improves absorption.
Swallow the capsule whole; do not chew it.
Do not share alitretinoin with anyone. Return unused capsules to a pharmacist.
alitretinoin side effects
Common or expected effects
- Headache
- Raised triglycerides or cholesterol on blood tests
- Dry skin or dry or inflamed lips
- Nausea, vomiting or dry mouth
- Dry or irritated eyes
- Dizziness or tiredness
- Muscle or joint pain
- Changes in thyroid or liver blood tests
Get urgent medical advice
- Severe allergic reaction, including facial or throat swelling or breathing difficulty
- Severe headache with nausea, vomiting or visual disturbance, suggesting raised pressure around the brain
- Severe abdominal pain, which may indicate pancreatitis
- Severe or bloody diarrhoea
- Depression, aggression, psychosis, suicidal thoughts or other major mood changes
- New or worsening visual difficulty, including reduced night vision
alitretinoin in pregnancy
Alitretinoin must not be used during pregnancy because it can cause severe birth defects and miscarriage. Anyone who could become pregnant must meet Pregnancy Prevention Programme requirements, including effective contraception before, throughout and for one month after treatment, with pregnancy testing as directed. Suspected pregnancy requires immediate discontinuation and urgent contact with the prescriber.
alitretinoin while breastfeeding
Alitretinoin is contraindicated while breastfeeding. It is likely to pass into breast milk and may harm the child; discuss an alternative treatment or feeding plan with the specialist.
alitretinoin interactions
Check all prescribed, over-the-counter and complementary products with the specialist or pharmacist.
Tetracycline antibiotics
The combination is contraindicated because it can increase the risk of raised pressure around the brain.
Vitamin A supplements or other retinoids
Avoid concurrent use because additive effects can cause vitamin A toxicity.
Ketoconazole and other strong CYP3A4 inhibitors
They may increase alitretinoin exposure and require specialist review.
Common questions about alitretinoin
Answers are fully visible for fast scanning and source review.
What is alitretinoin used for?
It is licensed for adults with severe chronic hand eczema that has not responded to potent topical corticosteroids.
Is alitretinoin a steroid?
No. It is an oral retinoid related to vitamin A.
Why must alitretinoin be taken with food?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.