Contents

Search

acitretin (Soriatane)

Tradename: Soriatane. Indications: - treatment of recalcitrant psoriasis - cutaneous T-cell lymphoma [4] - lichen planus [4] - lamellar ichthyosis - erythroderma - Darier-White disease [4] Contraindications: 1) pregnancy 2) females must be tested for pregnancy prior to use 3) females must be placed on effective contraceptive 1 month prior to & 3 years after therapy 4) lactation [4] 5) alchoholism 6) increased intracranial pressure 7) severe hepatic failure 8) severe renal failure 9) acute pancreatitis [4] Dosage: 25-50 mg PO QD-weekly. Give with food. Tabs: 10, 25 mg. Monitor: 1) serum AST, serum ALT & serum LDH a) prior to initiation of therapy b) every 1-2 weeks for 1st 1-2 months of therapy c) as necessary > 2 months of therapy d) stop if evidence of hepatotoxicity 2) lipid panel a) prior to initiation of therapy b) every 1-2 weeks until response to therapy is established, usually 4-8 weeks c) continue close monitoring in patients with diabetes, obesity, alcohol use, or personal or famility history of lipid disorder d) serum glucose: a) monitor carefully in patients with diabetes b) may increase or decrease serum glucose Adverse effects: 1) mucous membranes a) chelitis (75%) b) rhinitis 25-50% c) xerostomia (10-25%) d) epistaxis (10-25%) 2) skin & skin appendages a) alopecia, skin peeling (50-75%) b) dry skin, nail disorder, pruritus (25-50%) c) erythematous rash, hyperesthesia, paresthesia, paronychia, skin atrophy, sticky skin (10-25%) 3) eye - xerophthalmia (10-25%) 4) musculoskeletal - arthralgia, spinal hyperostosis (10-25%) 5) central nervous system - rigors (10-25%) 6) increased triglycerides (25-50%) 7) pseudotumor cerebri (uncommon) 8) hepatotoxicity 9) headache Drug interactions: 1) may increase hepatotoxicity of methotrexate 2) increased toxicity in combination with alcohol 3) may increase hypoglycemic effect of glyburide 4) may decrease effectiveness of 'minipill' 5) increased toxicity of vitamin A 6) risk of pseudotumor cerebri increased by coadministration of doxycycline Mechanism of action: 1) unknown 2) related to vitamin A activity 3) possible reduction in cell proliferation 4) anti-keratizing effects 5) anti-inflammatory effects Active metabolite of etretinate (Tegison).

Related

etretinate (Tegison)

General

oral dermatologic agent retinoid

Properties

MISC-INFO: elimination route LIVER

Database Correlations

PUBCHEM correlations

References

  1. The 1998 Physician's Desk Reference (PDR), Medical Economics
  2. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998 - not on National VA formulary
  3. Prescriber's Letter 17(7): 2010 Recommended Lab Monitoring for Common Medications Detail-Document#: 260704 (subscription needed) http://www.prescribersletter.com
  4. Deprecated Reference

Substructures

isoprene