Adult Dosing
Treatment of severe psoriasis
- Initial dose: 25-50 mg PO qd, taken with the main meal
- Maintenance dose: 25-50 mg PO qd, based on the patient’s response to initial treatment
Notes:- Relapses may be treated as outlined for initial therapy
- When used with phototherapy, reduce the phototherapy dose based on the individual patient’s response
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
See Supplemental Patient Information
- Periodically perform appropriate examinations in view of possible ossification abnormalities. Because the frequency and severity of iatrogenic bony abnormality in adults is low, periodic radiographic examination is warranted only in cases of long term use or those with clinical symptoms. If such disorders arise, discuss about continuation of therapy with the patient on the basis of a careful risk/benefit analysis
- Elevated liver function test results have been reported in patients receiving acitretin; if hepatotoxicity is suspected during treatment, discontinue therapy and investigate the etiology further
- Patients with preexisting abnormalities of the spine showed new changes or progression of preexisting findings such as degenerative spurs, anterior bridging of spinal vertebrae, diffuse idiopathic skeletal hyperostosis, ligament calcification and narrowing and destruction of cervical disc space
- Few patients treated with acitretin showed abnormalities in the knees and ankles before treatment that progressed during treatment
- Blood lipid analysis should be performed before initiating therapy and again at intervals of 1 to 2 weeks until the lipid response to the drug is established. Elevations in triglycerides and cholesterol and reduction in HDL have been reported with therapy. Most of these effects were reversible upon discontinuation of the drug
- Monitor serum lipids in high-risk patients and during long-term treatment
- Discontinue therapy in any patient experiencing visual difficulties and subject him to an ophthalmologic evaluation
- Significant increase in triglyceride levels (>800 mg/dL) has been associated with fatal fulminant pancreatitis
- Pseudotumor cerebri (benign intracranial hypertension) has been associated with acitretin and other retinoids. Patients should be examined for papilledema if they experience headache, nausea and vomiting and visual disturbances. Therapy should be discontinued if papilledema is present and the patient should be referred for neurological evaluation and care
- The main goal of Pregnancy Prevention Actively Required During and After Treatment (P.A.R.T) is to explain the program requirements, to reinforce the educational messages, and to assess program effectiveness
- Not to be used by female patients who intend to become pregnant during therapy or who may not be able to use reliable contraception during therapy or for at least 3 yrs following cessation of therapy [US Black Box Warning]
- Ethanol should not be ingested by female patients either during therapy or for 2 months after cessation of therapy [US Black Box Warning]
- Depression and other psychiatric symptoms including aggressive feelings or thoughts of self-harm have been reported in patients receiving acitretin
Cautions: Use cautiously in
Supplemental Patient Information
- Advise female patients not to get pregnant while taking acitretin and for at least 3 yrs after stopping therapy
- Instruct female patients of reproductive potential not to ingest beverages or products containing ethanol during therapy and for 2 months after therapy discontinuation
- Inform female patients that any method of birth control may fail including tubal ligation, and that microdosed progestin "minipill" preparations should not be used with acitretin
- Advise patients that a transient worsening of psoriasis may sometimes occur during the initial treatment period
- Inform patients that they may experience decreased night vision during therapy and warn them to be cautious when driving or operating machinery at night; also advise that they may have decreased tolerance to contact lenses during therapy and sometimes after treatment cessation
- Instruct patients not to donate blood during and for 3 yrs following therapy; advise women of childbearing potential not to receive blood from patients being treated with acitretin
- Advise patients not to take vitamin A supplements in excess of minimum recommended daily allowances to avoid possible additive toxic effects
- Inform patients to avoid the use of sun lamps and excessive exposure to sunlight as the effects of UV light are enhanced by retinoids
- Advise patients not to give their acitretin capsules to any other individuals
Pregnancy Category:X
Breastfeeding: Limited information indicates that acitretin is excreted in human breast milk. Other topical agents that are less likely to be absorbed by the mother are recommended during breastfeeding, especially while nursing a newborn or preterm infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 27 January 2011). As per manufacturer's data, nursing mothers should not receive acitretin prior to or during nursing because of the potential for serious adverse reactions in nursing infants.
Pricing data from www.DrugStore.com in U.S.A.
- Soriatane 10 MG CAPS [Bottle] (GLAXO SMITH KLINE)
30 mg = $800
90 mg = $2300.05 - Soriatane 25 MG CAPS [Bottle] (GLAXO SMITH KLINE)
30 mg = $953.02
60 mg = $1870.07
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
