Acitretin Alcohol

Concomitant intake of alcohol induces the transformation of acitretin to etretinate, which has a much longer half-hfe (84-168 days) (119). 

Absorption is enhanced when taken with food. Concurrent ingestion of alcohol converts acitretin to etretinate, which has a longer half-life. 

There is evidence that the consumption of alcohol may increase the serum levels of etretinate in patients taking acitretin. A single case report describes a marked reduction in the effects of isotretinoin following the acute intake of alcohol. 

A study in 10 patients with psoriasis taking acitretin found that the concurrent use of alcohol seemed to be associated with an increase in the formation of its metabolite etretinate, which has a much longer half-life than acitretin. The implications of this study are not known, but it is suggested that it may have some bearing on the length of the period after acitretin therapy during which women are advised not to conceive. ... 

An alternative approach to the synthesis of acitretin has been reported from enone 25 (Scheme 9),(42,43) Reduction of 25 followed by addition of acetylene afforded alcohol 29 in 67% yield. Treatment of 29 with 2-methoxy-l-propene in the presence of p-TsOH, followed by reaction with NaOH afforded diene 30. Treatment of 30 with wo-butyl chloroacetate yielded triene 32 via epoxide intermediate 31. Treatment of 32 with PBra and A, iV-dimethylacetamide followed by ester saponification completed a synthesis of acitretin in 6 steps and 25% overall yield. 

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