Acitretin

In New Zealand acitretin is available as capsules (10 mg or 25 mg). 

• The dose of acitretin will depend on what it is being used for. Your doctor will tell you which dose is right for you. Depending on your response, your doctor may increase your dose after a few weeks. 
• You may notice your psoriasis getting worse when you first start taking acitretin, but this settles with time.
• Always take your acitretin exactly as your doctor has told you.
• The pharmacy label on your medicine will tell you how much acitretin to take, how often to take it and any special instructions.

• Timing: Acitretin is usually taken once a day, at about the same time each day. Acitretin is best taken with or just after food. 
• Swallow your acitretin capsules whole. Do not split or chew them.
• Avoid alcohol: Avoid alcohol while you are taking acitretin and for 2 months after finishing treatment.
• Missed dose: If you forget to take your dose, take it as soon as you remember that day. But if it is nearly time for your next dose, take the next dose at the right time. Do not take double the dose.
• Keep taking acitretin regularly. Most people notice an improvement in their skin condition in the first week or two, but it may take 2–3 months before you notice the full benefits of acitretin.

Here are some things to know when you're taking acitretin. Other things may be important as well, so ask your healthcare provider what you should know about.

Risk of birth defects

Dry skin, lips, nostrils and eyes

Acitretin reduces oil production in your skin. It can cause dry skin, dry mouth, chapped lips, dry nostrils and dry eyes. These effects can be uncomfortable. Here are some tips to manage these side effects, but if you have any questions, ask your doctor or pharmacist for advice.

• Lips: From the start of treatment, use an emollient lip balm that has a sunscreen in it. It is important to apply the lip balm often during the day, such as in the morning as soon as you wake up, after any food, snack or drink, last thing at night and any other time in between that your lips become dry. 
• Skin: From the start of treatment, use a non-perfumed moisturising cream. Use non-soap cleansers, as these are less likely to irritate your skin compared with a soap cleanser. Avoid beauty treatments such as chemical peels, dermabrasion and waxing during treatment, and for at least 6 months after stopping.
• Eyes: Your eyes may become dry and itchy, especially if you wear contact lenses. Ask your pharmacist to recommend a suitable eye lubricant (also called artificial tears). Read more about eye lubricants. While you are taking acitretin, you may need to wear glasses instead of contact lenses.
• Nostrils: The inside of your nostrils may become dry and crusted and lead to mild nosebleeds. Applying a thin layer of petroleum jelly gently to the inside of the nose may help.

Increased sensitivity to the sun

Acitretin can make you more sensitive to the sun and your skin is more likely to burn. Avoid using sunbeds and unnecessary sun exposure. When outside, protect your skin by using an oil-free sunscreen (SPF50+). Apply the sunscreen to all areas especially your face, neck and ears. Read more about using sunscreen. Wear clothing that protects you from the sun. Wear sunglasses when outdoors.

Your vision may be affected

Your vision may be affected by acitretin, especially your night vision. Make sure you know how you react to acitretin capsules before you drive a car, operate machinery or do anything else that might be dangerous if your vision is affected.

Other precautions

• Breastfeeding: Do not take acitretin if you are breastfeeding.
• Blood donation: Do not donate blood while taking acitretin and for 3 years after stopping it.
• Blood test monitoring: Before you start treatment and during treatment, your doctor will send you for blood tests to check your liver, blood fats and blood count. 

Acitretin interacts with a few medicines such as some antibiotics and vitamin A products. Check with your doctor or pharmacist before taking any other medicines or supplements.