Acitretin

Last updated

Acitretin
Acitretin2DACS.svg
Acitretin-from-xtal-3D-bs-17.png
Clinical data
Trade names Soriatane, Neotigason
AHFS/Drugs.com Monograph
MedlinePlus a601010
Pregnancy
category
  • AU:X (High risk)
Routes of
administration
By mouth
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability 60%
Protein binding >99.9%
Metabolism Liver
Elimination half-life 49 hours
Excretion Faeces & urine
Identifiers
  • (2E,4E,6E,8E)-9-(4-methoxy-2,3,6-trimethylphenyl)-3,7-dimethylnona-2,4,6,8-tetraenoic acid
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard 100.054.050 OOjs UI icon edit-ltr-progressive.svg
Chemical and physical data
Formula C21H26O3
Molar mass 326.436 g·mol−1
3D model (JSmol)
  • O=C(O)\C=C(\C=C\C=C(\C=C\c1c(cc(OC)c(c1C)C)C)C)C
  • InChI=1S/C21H26O3/c1-14(8-7-9-15(2)12-21(22)23)10-11-19-16(3)13-20(24-6)18(5)17(19)4/h7-13H,1-6H3,(H,22,23)/b9-7+,11-10+,14-8+,15-12+ Yes check.svgY
  • Key:IHUNBGSDBOWDMA-AQFIFDHZSA-N Yes check.svgY
   (verify)

Acitretin, sold under the brand names Neotigason [1] and Soriatane [5] , is a second-generation retinoid. It is taken orally, and is typically used for psoriasis. [6]

Contents

Acitretin is an oral retinoid used in the treatment of severe resistant psoriasis. Because of the potential for problems and severe side effects it is generally used in only very severe cases of psoriasis that have been unresponsive to other treatments. 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 two to four weeks or longer.

Patients who have received the medication are advised against giving blood for at least three years due to the risk of birth defects. [7]

Adverse effects

Acitretin is highly teratogenic and noted for the possibility of severe birth defects. It should not be used by pregnant women or women planning to get pregnant within 3 years following the use of acitretin. Sexually active women of childbearing age who use acitretin should also use at least two forms of birth control concurrently. Men and women who use it should not donate blood for three years after using it, because of the possibility that the blood might be used in a pregnant patient and cause birth defects. In addition, it may cause nausea, headache, itching, dry, red or flaky skin, dry or red eyes, dry or chapped lips, swollen lips, dry mouth, thirst, cystic acne or hair loss. [8] [5] [9]

Pharmacokinetics

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. However, because acitretin can be reverse metabolised into etretinate which has an extremely long half-life, women must avoid becoming pregnant for at least three years [10] after discontinuing acitretin. Therefore, acitretin is generally not recommended for women of child-bearing age with a risk of becoming pregnant.

Related Research Articles

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Meleda disease (MDM) or "mal de Meleda", also called Mljet disease, keratosis palmoplantaris and transgradiens of Siemens, is an extremely rare autosomal recessive congenital skin disorder in which dry, thick patches of skin develop on the soles of the hands and feet, a condition known as palmoplantar hyperkeratosis. Meleda Disease is a skin condition which usually can be identified not long after birth. This is a genetic condition but it is very rare. The hands and feet usually are the first to show signs of the disease but the disease can advance to other parts of the body. Signs of the disease include thickening of the skin, on hands and soles of feet, which can turn red in color. There currently is no cure and treatment is limited, but Acitretin can be used in severe cases.

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References

  1. 1 2 NEOTIGASON acitretin 10mg capsule blister pack (52455) Australian Department of Health and Aged Care
  2. Anvisa (31 March 2023). "RDC Nº 784 - Listas de Substâncias Entorpecentes, Psicotrópicas, Precursoras e Outras sob Controle Especial" [Collegiate Board Resolution No. 784 - Lists of Narcotic, Psychotropic, Precursor, and Other Substances under Special Control] (in Brazilian Portuguese). Diário Oficial da União (published 4 April 2023). Archived from the original on 3 August 2023. Retrieved 15 August 2023.
  3. "FDA-sourced list of all drugs with black box warnings (Use Download Full Results and View Query links.)". nctr-crs.fda.gov. FDA . Retrieved 22 October 2023.
  4. "Soriatane (acitretin) Capsules". dailymed.nlm.nih.gov. Retrieved 30 December 2023.
  5. 1 2 "Soriatane Side Effects". Drugs.com . Retrieved 15 August 2015.
  6. Zito PM, Mazzoni T (January 2021). "Acitretin". StatPearls. Treasure Island (FL): StatPearls Publishing. PMID   30137855.
  7. AABB Technical Manual, American Association of Blood Banks
  8. "Soriatane". WebMD . Retrieved 15 August 2015.
  9. "Soriatane (Acitretin) Drug Information: Description, User Reviews, Drug Side Effects, Interactions - Prescribing Information at RxList". RxList . Archived from the original on 2 December 2013. Retrieved 15 August 2015.
  10. "Important Safety Information for SORIATANE". soriatane.com. Retrieved 31 October 2015.