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Acitretin is an oral medication a doctor may recommend for a patient with severe psoriasis or certain other skin conditions. It is among a class of drugs known as retinoids and is available by prescription only. Before patients can receive this drug, the doctor will review the risks; it cannot be taken during pregnancy because it can cause severe birth defects. Women may not be able to access the drug until they can demonstrate compliance with a birth control regimen, or show evidence that pregnancy is not a concern, as in the case of patients who are already in menopause.
This drug acts to slow skin growth. Slower skin growth will reduce the plaques and scaling seen with many skin conditions, and keep the patient more comfortable. Patients need to take acitretin with food, preferably foods with fats, as fat is necessary to transport the medication through the intestinal wall. Patients on this drug should be aware that they can be at increased risk of hyperlipidemia, where fat levels in the blood rise.
Patients on acitretin can experience dry, peeling skin and may need to use moisturizers, lubricating eye drops, and lip balm to keep their skin and eyes comfortable. In addition, the drug causes sun sensitivity. It is important to wear sun protection while outdoors. Patients who use phototherapy for their skin or other reasons should talk to their doctors about acitretin risks.
This drug can react with alcohol in the bloodstream to create a lingering teratogenic compound that may last for three years or even more. Patients should not drink alcohol while on acitretin, even if they do not plan to become pregnant. They also shouldn't donate blood, as there is a risk that the blood could go to a pregnant woman who needs a transfusion, and she could experience pregnancy complications as a result. Patients who have not taken the drug in at least three years are safe to donate blood again.
Pregnant and breastfeeding women cannot use acitretin because of the risks, and should not take the drug for at least three years before starting a pregnancy. Before a doctor can prescribe the drug, he may request two pregnancy tests to confirm that the patient is not pregnant, and will likely discuss birth control options. The drug can interact with some birth control methods and make them less effective, so it is important to take a drug that will work safely with acitretin. Patients who think they might pursue pregnancies in the next three years should request a different treatment option.