Drug reference

Acitretin

Retinoid · Antipsoriatic

RetinoidAntipsoriatic

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

Extremely teratogenic

FDA category + note

Top interactionssee all 12 →

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Mechanism

Acitretin, a retinoid, exerts its effects by activating nuclear retinoic acid receptors (RARs) and retinoid X receptors (RXRs). These activated receptors form heterodimers (RAR-RXR) that bind to specific DNA sequences called retinoic acid-responsive elements (RAREs). This binding modulates gene transcription, leading to the regulation of cell proliferation and differentiation. This mechanism is therapeutically beneficial for treating psoriasis and disorders of keratinization by normalizing cellular processes.

Indications

Moderate-to-severe plaque psoriasisPsoriasis (recalcitrant, pustular, and other severe forms)Lichen planusSevere ichthyosissevere, widespread psoriatic diseaseespecially when immunosuppression must be avoided

Dosing

Adult: moderate-to-severe plaque psoriasis in adults in need of systemic medicinal therapy, whom other non-biologic systemic treatments (methotrexate, ciclosporin and acitretin) are not appropriate or have failed and who are considered unsuitable for biologic therapy given their current disease state or personal preference.…

Pharmacokinetics

Excretion

Elimination is very slow (taking months) because of accumulation in body fat.

Contraindications

Pregnancy
History of depression (risk of neuropsychiatric reactions)
Pregnancy (highly teratogenic, women must not conceive during therapy and for 3 years after stopping)
Alcohol consumption (during and for 3 months after use)