Acitretin (Soriatane): Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

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Overview: Acitretin is used to treat severe psoriasis. It belongs to a class of medicines called retinoids, which may change how your skin cells grow and shed. Common side effects include dry skin, chapped lips, and hair loss. Acitretin can cause serious harm to an unborn baby. If you can become pregnant, you must use two effective forms of birth control for at least 1 month before starting acitretin, during treatment, and for at least 3 years after stopping acitretin.

Uses

What is acitretin used for?

Acitretin is used to treat severe psoriasis.

Acitretin may also be used for other conditions as determined by your health care provider.

How does acitretin work (mechanism of action)?

Acitretin is in a class of medicines called retinoids. It may work to treat psoriasis symptoms by changing how your skin cells grow and shed.

How is acitretin supplied (dosage forms)?

Brands and other names

Soriatane

Dosage forms and strengths

10 mg, 17.5 mg, 22.5 mg, 25 mg oral capsules

How should I store acitretin?

Acitretin should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. Protect acitretin from light, humidity, and high temperatures.

Side Effects

What are the most common side effects of acitretin?

The most common side effects of acitretin are listed below. Tell your health care provider if you have any of these side effects that bother you.

Runny or dry nose and nosebleeds
Chapped lips
Dry eyes
Dry, itchy, scaly, peeling, or weak skin
Weak finger or toe nails
Dry mouth
Joint pain
Tight muscles
Hair loss

There may be other side effects of acitretin that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.canada.ca/en/health-canada/services/drugs-health-products/medeffect-canadaor by calling 866-234-2345.

What are the serious side effects of acitretin?

While less common, the most serious side effects of acitretin are described below, along with what to do if they happen.

Severe Allergic Reactions. Acitretin may cause allergic reactions, which can be serious. Stop taking acitretin and get help right away if you have any of the following symptoms of a serious allergic reaction.

Breathing problems or wheezing
Racing heart
Fever or general ill feeling
Swollen lymph nodes
Swelling of the face, lips, mouth, tongue, or throat
Trouble swallowing or throat tightness
Itching, skin rash, or pale red bumps on the skin called hives
Nausea or vomiting
Dizziness, feeling lightheaded, or fainting
Stomach cramps
Joint pain

Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking acitretin. Call your health care provider right away if you have any of the following symptoms of liver damage.

Nausea or vomiting
Stomach or belly pain
Fever
Weakness or unusual tiredness
Itching
Loss of appetite
Light-colored poop
Dark-colored urine (pee)
Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

High Cholesterol or Triglycerides. Acitretin may increase the levels of fats (lipids) in your blood. This may increase your risk of having a blood clot, heart attack, or stroke. Keep all appointments for blood work before and while taking acitretin. Stop taking acitretin and get emergency medical help if you have any of the following symptoms of a blood clot, heart attack, or stroke.

Shortness of breath
Dizziness
Nausea
Chest pain
Weakness
Trouble speaking
Swelling in your leg

Vision Changes. Acitretin can cause changes to the eyes, which may affect how well you can see. Acitretin can also make it harder to see at night. Stop taking acitretin and call your health care provider right away if you have eye pain or any vision changes.

Inflammation of the Pancreas (Pancreatitis). Acitretin may cause inflammation of the pancreas, which is called pancreatitis. Stop taking acitretin and call your health care provider right away if you have symptoms of pancreatitis, including vomiting or severe pain in the upper part of your belly that travels to your back.

Increased Pressure Around the Brain. Acitretin can increase the pressure around the brain, a serious condition called pseudotumor cerebri. Stop taking acitretin and call your health care provider right away if you have any of the following symptoms.

Dizziness
Nausea and vomiting
Severe headache
Vision changes

Capillary Leak Syndrome (CLS). Acitretin may cause capillary leak syndrome (CLS), where protein and fluid leak out of your blood vessels into your body tissues. CLS can be serious or life-threatening. Tell your health care provider right away if you have any of the following symptoms of CLS.

Low blood pressure
Dizziness, feeling lightheaded, or fainting upon standing
Fluid retention
Weight gain
Shortness of breath
Muscle aches
Fever

Severe Skin Reactions. Acitretin can cause a rare, severe skin reaction called exfoliative dermatitis or erythroderma. This reaction may start as itchiness, changes in skin color, or flu-like symptoms. You may need treatment in a hospital if this reaction happens. Stop taking acitretin and call your health care provider right away if you have itchy and painful skin or if your skin swells and changes color or peels.

Mental Health Changes. Acitretin can cause changes in mental health, including depression, mood changes, and feelings of aggression. It may also cause suicidal thoughts or actions in a small number of people. If you are about to harm yourself, call 911 or call or text 988, the Suicide & Crisis Lifeline. Stop taking acitretin and call your health care provider right away if you notice any changes in your mental health or have any of the following symptoms.

New or increased thoughts of suicide or death
Suicide attempt
New or increased feelings of anxiety, depression, or other unusual changes in mood or behavior

Bone Problems. Acitretin may rarely cause bone or joint problems if it is taken for a long time. Tell your health care provider right away if you have any trouble moving; stiffness; pain or aching in your bones, muscles, or joints; or any loss of feeling.

Increased Blood Sugar. Acitretin may increase your blood sugar levels, which may lead to or worsen diabetes. If you have diabetes, you may need to check your blood sugar more often. Talk to your health care provider about how to maintain healthy blood sugar levels. Call your health care provider if you have the following symptoms of high blood sugar.

Thirsty more than usual
Peeing more than usual
Increase in hunger
Tiredness
Feeling sick to your stomach
Confusion
Your breath smelling fruity

Warnings & Precautions

Who should not take acitretin?

Allergies to Ingredients. People who are allergic to any of the following should not take acitretin.

Acitretin
Soriatane
Any other medicine known as a retinoid
Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific acitretin products they stock.

Pregnancy. Do not take acitretin if you are pregnant or might become pregnant while taking acitretin or within at least 3 years of stopping it. If you become pregnant, stop taking acitretin and contact your health care provider right away. See the Pregnancy section for more details.

Kidney Problems. Acitretin should not be taken if your kidneys are not working as well as they should be. If there is a concern about the health of your kidneys, your health care provider may do tests to see if they are working well enough to take this medicine.

Liver Problems. Acitretin should not be taken if your liver is not working as well as it should be. If there is a concern about the health of your liver, your health care provider may do tests to see if it is working well enough to take this medicine.

High Cholesterol or Triglycerides. Acitretin should not be taken if you have high levels of fat in your blood. If there is a concern about your cholesterol or triglyceride levels, your health care provider may do tests to see if it is safe for you to take this medicine.

Drug Interactions. Acitretin should not be taken while you are using certain other medicines. Before taking acitretin, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

What should I know about acitretin before using it?

Do not take acitretin unless it has been prescribed to you by a health care provider. Take it as prescribed.

Do not share acitretin with other people, even if they have the same condition as you. It may harm them.

Keep acitretin out of the reach of children.

Sometimes, psoriasis symptoms may get worse when you first start taking acitretin. It may take a couple of months for you to see the full benefit of the medicine.

Acitretin can make it harder for you to see at night. Do not drive at night until you know how acitretin affects you.

Acitretin may cause dry eyes, which can make it harder for you to wear contact lenses. Talk with your health care provider if this is a concern.

You should not donate blood while taking acitretin or for at least 3 years after stopping it.

Acitretin can make your skin more sensitive to light from the sun, sunlamps, and tanning beds. This is called photosensitivity. Exposure to this light can cause severe sunburns, blisters, and swelling. Try to avoid being in the sun. If you need to be in sunlight, wear sunscreen, a hat, and clothing that covers your skin.

Acitretin can cause serious harm to an unborn baby. The drugmakers for acitretin have programs to help reduce the risk of this happening. As part of these programs, people who can become pregnant must have two negative pregnancy tests before starting acitretin. In order to keep taking acitretin, people who can become pregnant must commit to using two forms of birth control and also take a pregnancy test each month. See the Pregnancy section for more details.

It is important to keep all appointments with your health care provider, including for blood work or other tests, before starting and while you are taking acitretin.

What should I tell my health care provider before using acitretin?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if acitretin is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

High blood sugar or diabetes
Heart problems
High cholesterol or triglycerides
Liver problems
Kidney problems
Depression
Alcohol use disorder

Current and Past Treatments. Tell your health care provider if you are receiving phototherapy. Your phototherapy may need to be adjusted if you are taking acitretin. Also tell your health care provider if you have ever taken etretinate (Tegison, Tigason), which is a medicine for psoriasis that is no longer available.

Pregnancy. Acitretin may cause serious harm to an unborn baby. Tell your health care provider if you are pregnant or plan to become pregnant. If you can become pregnant, you will need to have two negative pregnancy tests before starting acitretin, and the second test must be done within 7 days of starting acitretin. Pregnancy tests must be repeated every month while you are taking acitretin, and every 3 months for at least 3 years after you stop taking acitretin.

If you can become pregnant, you must use two methods of effective birth control at the same time for at least 1 month before starting acitretin, while you are taking it, and for at least 3 years after stopping it. Talk to your health care provider about your birth control options. If you do become pregnant while taking acitretin or within 3 years of stopping it, stop taking acitretin right away and contact your health care provider. You should report your pregnancy to the drugmaker or to the FDA MedWatch program at 800-FDA-1088 (800-332-1088).

Breastfeeding. Do not take acitretin while you are breastfeeding. Acitretin passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should stop breastfeeding or stop acitretin.

Interactions

Does acitretin interact with foods or drinks?

There are no known interactions between acitretin and foods or drinks. Acitretin should be taken with food.

If you can become pregnant, you must avoid alcohol while taking acitretin and for 2 months after stopping it. This includes any drink, food, or medicine (including over-the-counter medicines) that contains alcohol. This is very important because alcohol can change acitretin into a substance that may increase the risk of birth defects and that can take more than 3 years to be cleared from your body.

Does acitretin interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking acitretin.

Methotrexate (Trexall and others), which is a medicine commonly used for rheumatoid arthritis or certain types of cancer
A tetracycline, such as doxycycline, minocycline, omadacycline (Nuzyra), sarecycline (Seysara), or tetracycline, which is a medicine used to treat infections or other conditions
Glyburide, which is a medicine used to treat diabetes
Phenytoin (Dilantin, Phenytek, and others), which is a medicine to control seizures
A vitamin A supplement
A progestin-only birth control pill, also called a minipill, such as drospirenone (Slynd) or norethindrone (Camila, Nor-QD, and others)
St. John’s wort, which is a supplement that may be used for depression

This may not be a complete list of medicines that can interact with acitretin. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker