Acitretin

Also Known As: Acitretin, Soriatane, Neotigason

Acitretin (trade name Soriatane or Neotigason) is a second generation retinoid. It is taken orally, and is typically used for psoriasis.

It is a metabolite of etretinate, which was used prior to the introduction of acitretin. Etretinate was discontinued because it had a narrow therapeutic index as well as a long elimination half-life (t1/2=120 days), making dosing difficult. In contrast, acitretin's half-life is approximately 2 days.

Because acitretin can be reverse metabolised into etretinate which has a long half-life, women must avoid becoming pregnant for at least 3 years (http://www.soriatane.com/patient/part.aspx) after discontinuing acitretin. Therefore, acitretin is generally not recommended for women of child bearing age with a risk of becoming pregnant.

Acitretin is the oral retinoid of choice used in the treatment of severe resistant psoriasis. It binds to nuclear receptors that regulates gene transcription. They induce keratinocyte differentiation and reduce epidermal hyperplasia, leading to the slowing of cell reproduction. Acitretin is readily absorbed and widely distributed after oral administration. A therapeutic effect occurs after 2 to 4 weeks or longer.

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