Acitretin

CLINICAL USE

  • Severe extensive psoriasis, palmoplantar

    pustular psoriasis

  • Severe congenital ichthyosis
  • Severe Darier’s disease

    DOSE IN NORMAL RENAL FUNCTION

  • Initially: 25–30 mg daily (Darier’s disease

    10 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 &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
    326.4
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
    >99 (< 0.1% present
    as unbound drug
    in pooled human
    plasma)
  • %Excreted unchanged in urine &nbsp &nbsp :
    Excreted as
    metabolites

  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp :
    9

  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :
    50/–

    DOSE IN RENAL IMPAIRMENT


    GFR (mL/MIN)


  • 20 to 50 &nbsp &nbsp : No data available. Assume dose as in
    normal renal function
  • 10 to 20 &nbsp &nbsp : No data available. Assume dose as in
    normal renal function
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp :
    No data available. Assume dose as in
    normal renal function

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES


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

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
    Not dialysed. Dose as in normal renal function
  • HDF/high flux &nbsp :
    Unlikely to be dialysed. Dose as in
    normal renal function
  • CAV/VVHD &nbsp &nbsp &nbsp:
    Unknown dialysability. Dose as in
    normal renal function

    IMPORTANT DRUG INTERACTIONS


    Potentially hazardous interactions with other drugs

  • Antibacterials: possibly increased risk of

    benign intracranial hypertension with
    tetracyclines – avoid concomitant use

  • Anticoagulants: possible antagonism of the

    anticoagulant effect of coumarins

  • Cytotoxics: increased concentration

    of 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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