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 : 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 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

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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

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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