Cornification disorders

Active Ingredient: Acitretin

Indication for Acitretin

Population group: only adults (18 years old or older)

Acitretin is indicated for:

  • Severe extensive psoriasis which is resistant to other forms of therapy.
  • Palmo-plantar pustular psoriasis.
  • Severe congenital ichthyosis.
  • Severe Darier’s disease (keratosis follicularis).

For this indication, competent medicine agencies globally authorize below treatments:

25mg or 30mg for 2 to 4 weeks

Route of admnistration

Oral

Defined daily dose

25 - 75 mg

Dosage regimen

From 25 To 75 mg once every day

Loading dose

25 mg

Maintenance dose

50 mg

Detailed description

Initial daily dose should be 25mg or 30mg for 2 to 4 weeks. After this initial treatment period the involved areas of the skin should show a marked response and/or side-effects should be apparent. Following assessment of the initial treatment period, titration of the dose upwards or downwards may be necessary to achieve the desired therapeutic response with the minimum of side-effects. In general, a daily dosage of 25-50mg taken for a further 6 to 8 weeks achieves optimal therapeutic results. However, it may be necessary in some cases to increase the dose up to a maximum of 75mg/day.

In patients with Darier’s disease a starting dose of 10mg may be appropriate. The dose should be increased cautiously as isomorphic reactions may occur.

Therapy can be discontinued in patients with psoriasis whose lesions have improved sufficiently. Relapses should be treated as described above.

Patients with severe congenital ichthyosis and severe Darier’s disease may require therapy beyond 3 months. The lowest effective dosage, not exceeding 50mg/day, should be given.

Continuous use beyond 6 months is contra-indicated as only limited clinical data are available on patients treated beyond this length of time.

Dosage considerations

Should be taken once daily with meals or with milk.

Active ingredient

Acitretin

Acitretin, a synthetic aromatic derivative of retinoic acid, has a favourable therapeutic ratio, with a greater and more specific inhibitory effect on psoriasis and disorders of epithelial keratinisation. The usual therapeutic response to acitretin consists of desquamation (with or without erythema) followed by more normal re-epithelialisation. Acitretin is the main active metabolite of etretinate.

Read more about Acitretin

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