What Is Soriatane (Acitretin)?
Reviewed by: HU Medical Review Board | Last reviewed: March 2023 | Last updated: March 2023
Soriatane® is the brand name for 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.
The active ingredient in Soriatane is 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. Currently, Soriatane is the only type of oral retinoid approved by the US Food and Drug Administration for the treatment of psoriasis1.
Soriatane is approved for use in treating plaque psoriasis as well as other types of psoriasis including2:
Soriatane 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 Soriatane at a lower dose for a longer period of time if they do not experience side effects.
How does Soriatane (acitretin) work to treat psoriasis?
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 Soriatane 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 2-4 months for treatment with Soriatane to have an effect on psoriasis symptoms, and up to 6 months for the medicine to have its full effect. During treatment with Soriatane, 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 Soriatane, more than 75% of patients with severe plaque psoriasis had a reduction in symptoms of at least 50%4. Soriatane also tends to be more effective when it is used in combination with other types of treatments for psoriasis, such as phototherapy. Soriatane seems to be particularly effective in treating pustular psoriasis, with one study reporting that it was effective in 84% of patients4.
Who should not take Soriatane (acitretin)?
If a person has Soriatane in their system while pregnant, it can cause very severe birth defects. People who are pregnant or breastfeeding can never take Soriatane. People who can possibly become pregnant are required to have 2 negative pregnancy tests before they can start treatment with the drug. They are also required to use 2 forms of birth control before, during, and after treatment2. Soriatane can stay in the body for a very long time, so a person who wishes to become pregnant must stop taking the medicine for 3 full years before trying to conceive.
Soriatane also cannot be taken by people who have:
- severe liver disease
- severe kidney disease
- high levels of cholesterol (fat) in the blood that can’t be controlled with medication
- an allergy to retinoid medicines
What are the possible side effects and risks of taking Soriatane (acitretin)?
Treatment with Soriatane 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
Other more serious side effects include:
- liver problems
- mood changes, including depression, aggression, irritability, or thoughts of self-harm
- vision problems (night blindness)
- skin infections
- blood vessel problems
Soriatane 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 Soriatane 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.
Let your healthcare provider know if you have any side effects that are severe or will not go away. They will be able to advise you about how to deal with them, and can lower your dosage or stop treatment altogether if needed.
Can Soriatane (acitretin) be used with other treatments or drugs?
Soriatane can 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
Soriatane 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 Soriatane 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.