Acitretin

CLINICAL USE

Severe extensive psoriasis, palmoplantarpustular psoriasis

Severe congenital ichthyosis

Severe Darier’s disease

DOSE IN NORMAL RENAL FUNCTION

Initially: 25–30 mg daily (Darier’s disease10 mg daily) for 2–4 weeks, adjusted
according to response

Ongoing: usually 25–50 mg/day(maximum 75 mg) for further 6–8 weeks.
(In Darier’s disease and ichthyosis not
more than 50 mg daily for up to 6 months)

PHARMACOKINETICS

Molecular weight :
326.4

%Protein binding :
>99 (< 0.1% present
as unbound drug
in pooled human
plasma)

%Excreted unchanged in urine :
Excreted as
metabolites

Volume of distribution (L/kg) :
9

half-life – normal/ESRD (hrs) :
50/–

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : No data available. Assume dose as in
normal renal function

10 to 20 : No data available. Assume dose as in
normal renal function

<10 :
No data available. Assume dose as in
normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :
Unlikely to be dialysed. Dose as in
normal renal function

HD :
Not dialysed. Dose as in normal renal function

HDF/high flux :
Unlikely to be dialysed. Dose as in
normal renal function

CAV/VVHD :
Unknown dialysability. Dose as in
normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Antibacterials: possibly increased risk ofbenign intracranial hypertension with
tetracyclines – avoid concomitant use

Anticoagulants: possible antagonism of theanticoagulant effect of coumarins

Cytotoxics: increased concentrationof methotrexate (also increased risk of
hepatotoxicity) – avoid concomitant use

ADMINISTRATION

Reconstition

–

Route

Oral

Rate of Administration

–

Comments

Take once daily with meals or with milk

OTHER INFORMATION

Manufacturer’s literature contraindicates

the use of acitretin in renal failure

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