Reviewed by: HU Medical Review Board | Last reviewed: September 2023
Acitretin is an oral treatment option for adults with severe psoriasis. It is a systemic treatment for psoriasis, which means that it has an effect on the entire body and not just the psoriasis symptoms.
Acitretin, which is a type of medicine called an oral retinoid. Oral retinoids contain a form of synthetic vitamin A that is made in a laboratory.1
Acitretin is taken by mouth in a capsule, which comes in several different dosages for different types of psoriasis. It is usually taken once a day with food. Healthcare providers may advise lowering the dose or stopping treatment when the patient’s symptoms improve and then re-starting the medication if needed3. Other patients may be advised to take Acitretin at a lower dose for a longer period of time if they do not experience side effects.
How does acitretin work?
Plaque psoriasis is an autoimmune condition, in which inflammation in a person’s body triggers the production of an excessive number of new skin cells before the older skin cells can be shed naturally. The new skin cells push the older skin cells up to the surface of the skin, where they build up and cause plaques to form.
Researchers are still working to understand exactly how acitretin works to reduce psoriasis symptoms. However, they do know that the medicine is able to affect the rate at which new skin cells are produced and old skin cells are shed2.
It may take up to 2 to 4 months for treatment with acitretin to have an effect on psoriasis symptoms, and up to 6 months for the medicine to have its full effect. During treatment with acitretin, some people find that their psoriasis symptoms get worse before they start to get better2.
Studies suggest that after 6-12 months of treatment with acitretin, more than 75% of patients with severe plaque psoriasis had a reduction in symptoms of at least 50%4. Acitretin also tends to be more effective when it is used in combination with other types of treatments for psoriasis, such as phototherapy. Acitretin seems to be particularly effective in treating pustular psoriasis, with one study reporting that it was effective in 84% of patients4.
What are the possible side effects?
Treatment with acitretin can also cause less serious side effects that can often be resolved by lowering the dosage or stopping the medication1. These include:
- dry skin, lips, nostrils, and eyes
- peeling skin on the hands, feet, and fingertips
- nail changes
- hair shedding or thinning
- increased sensitivity to light
- gum bleeding and nose bleeding
- “sticky”-feeling skin
- changes in blood cholesterol
- muscle, bone, or joint pain
Acitretin has a boxed warning, the strictest warning from the US Food and Drug Administration (FDA). It has this warning because of the problems it can cause with birth defects and because it can have bad effects if you drink alcohol while taking it. Also, because of the length of time that acitretin can stay in your body, you should not give blood during treatment or for 3 years after treatment.
These are not all the possible side effects of Soriatane. Talk to your doctor about what to expect when taking Soriatane. You also should call your doctor if you have any changes that concern you when taking Soriatane.
Other things to know
Acitretincan interact badly with certain other types of medications if they are taken at the same time, such as1:
- progestin-only birth control pills, which may not work while taking Soriatane
- vitamin A or any other type of retinoid, such as isotretinoin
- phenytoin, a medicine used to treat epilepsy
Acitretin tends to work more effectively to reduce psoriasis symptoms when it combined with other treatments2, such as:
- topical medicines
- biologic therapies, such as Enbrel (Etanercept) and Remicade (infliximab)
Some patients find it effective to rotate acitretin with other types of systemic medicines, such as methotrexate or cyclosporine3.
It is very important to let your healthcare provider know about any and all prescription medicines, over-the-counter medicines, vitamins or supplements that you are taking to monitor for any drug interactions.