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Acitretin psoriasis

Acitretine ch3o x x Oral 0.25-1.0 mg/kg/d Psoriasis (erythrodermic, pustular, and severe recalcitrant) Palmoplantar keratoderma pustulosis palmoplantaris, icthyosis, Darier s disease, pityriasis rubra pilaris, lichen ruber planus... [Pg.1075]

Systemic therapies are seldom used for mild to moderate psoriasis, and are generally reserved for patients with moderate to severe psoriasis.17 29 Oral agents include sulfasalazine, acitretin, methotrexate, cyclosporine, mycophenolate mofetil, azathioprine, tacrolimus, and hydroxyurea. Parenteral agents include the biologic response modifiers alefacept, efalizumab, etanercept, infliximab, and many others, currently at various stages of research or approval for psoriasis. [Pg.955]

Sequential therapy involves rapid clearing of psoriasis with aggressive therapy (e.g., cyclosporine), followed by a transitional period in which a safer drug such as acitretin is started at maximal dosing. Subsequently, a maintenance period using acitretin in lower doses or in combination with UVB or PUVA can be continued. [Pg.208]

Acitretin is most useful for the treatment of severe psoriasis, particularly the pustular and erythrodermic variants. Psoriatic nail changes and arthritis also may respond. Combining the drug with ultraviolet light therapy (Re-UVB, in the case of ultraviolet B radiation, or Re-PUVA, with psoralen plus ultraviolet A radiation) permits the use of lower doses of both acitretin and ultraviolet radiation. Other conditions for which the drug may be especially useful include congenital and acquired hyperkeratotic disorders, such as the ichthyoses and palmoplantar keratodermas, and severe lichen planus. [Pg.488]

A 35-year-old mother of two has moderate psoriasis. She tells you that her mother had a similar condition 3 years ago and was successfully treated with the agent acitretin. She has come to you because her regular physician refused to write her a prescription for acitretin, and she is very uncomfortable with her skin condition. You tell her that there is a serious risk of teratogenicity if she should become pregnant. She informs you that she is taking oral contraceptives and that the possibility of pregnancy is very low. Do you prescribe the drug she has requested anyway ... [Pg.498]

Acitretin (Soriatane), a metabolite of the aromatic retinoid etretinate, is quite effective in the treatment of psoriasis, especially pustular forms. It is given orally at a dosage of 25-50 mg/d. Adverse effects attributable to acitretin therapy are similar to those seen with isotretinoin and resemble hypervitaminosis A. Elevations in cholesterol and triglycerides may be noted with acitretin, and hepatotoxicity with liver enzyme elevations has been reported. Acitretin is more teratogenic than isotretinoin in the animal species studied to date, which is of special concern in view of the drug s prolonged elimination time (more than 3 months) after chronic administration. In cases where etretinate is formed by concomitant administration of acitretin and ethanol, etretinate may be found in plasma and subcutaneous fat for many years. [Pg.1296]

Medicines related to vitamin D are also effective but an unwanted side effect of the early ones was to cause the body to retain too much calcium, which is detrimental. More than 1500 different compounds have been synthesised to try and find one that would act on the psoriasis without raising the level of calcium in the blood. Calcipotriol cream was the one that performed best and is now widely used. Another chemical, etretinate, was introduced in 1975 and found to be just as effective. It was eventually superseded by acitretin when it was discovered that the body converted etretinate to acitretin and it was the latter which was the active agent. Acitretin is now the prescribed drug and it is very effective with three quarters of those treated reporting noticeable improvement and for about a third of patients their psoriasis cleared up completely. Psoriasis can also be treated with successive oral doses of methoxsalen followed by UV irradiation of the affected area. [Pg.45]

Vitamin A (retinols) plays a role in epithelial function and the retinoic acid derivative, acitretin (Neotigason, orally), inhibits psoriatic hyperkeratosis over 4-6 weeks. Acitretin should be used in courses (6-9 months) with intervals (3-4 months). It is teratogenic, like the other vitamin A derivatives. Rigorous precautions for use in women of childbearing potential are laid down by the manufacturer and must be followed, including contraception for 2 years after cessation, because the drug is stored in the liver and in fat and released over many months. The plasma t) is 3 months. It can cause other serious toxicity (see Vitamin A, p. 739). Tazarotene, a topical retinoid, is of some benefit in mild psoriasis, but is irritant. [Pg.313]

It is plain from this brief outline that treatment of psoriasis requires considerable judgement and choice will depend on the patient s sex, age and the severity of the condition. The combination of UVB and dithranol is probably the safest. When psoriasis is moderate-to-severe a strategy of rotation of treatments, e.g. UVB plus dithranol —> PUVA + acitretin —> UVB plus dithranol and so on may help to reduce the unwanted effects of any one therapy. [Pg.313]

In 1990, etretinate (Tigason) was replaced by acitretin (Neo-Tigason), an aromatic retinoid, a carboxylic acid metabolite of etretinate (15). It is effective in pustular psoriasis and psoriatic palmoplantar keratoderma and in combination with PUVA or topical therapy (calci-potriol or glucocorticoids) in the treatment of other forms of psoriasis. It has also been used to treat disorders of keratinization (ichthyosis, palmoplantar keratoderma, Darier s disease) and severe cutaneous forms of lichen planus. It prevents new skin carcinomas in patients with xeroderma pigmentosum and those who are immunosuppressed. The main advantage of acitretin is its short half-life of 50 hours, compared with over 80 days for etretinate (16). [Pg.3654]

Acitretin is indicated for the treatment of severe psoriasis. The initial dose is 25 to SO mg in a single dase with food. Because of.significant variation in pharmacokinetics and efficacy. however, the maintenance dose should be individualized. Initial response may occur in 2 weeks, but maximal response requires 2 to 5 months. Because of significant adverse effects a.ssociaied with its use. acitretin should be reserved for patients who do nut respond to other therapies or whose clinical condition contraindicates the use of other treatments. [Pg.874]

Drug Based on the Retinoid Structure Used to Treat Psoriasis (Fig. 8.8). Etrinate is the ethyl ester of acitretin and is active after hydrolysis to the acidic drug. The terminal" half-life after 6 months of etrinate therapy is 120 days. In contrast, the terminal" half-life of acitretin is only 33-96 h. Both drugs are... [Pg.373]

Topical treatments of first choice for mild to moderate psoriasis include keratolytics, corticosteroids, vitamin D analogues (calcipotriene, calcitriol, and tacalcitol), and tazarotene. The systemic treatment of first choice for moderate to severe psoriasis is acitretin. See Tables 96-2 and 96-3 for topical and systemic psoriasis treatment guidelines. [Pg.1772]

Acitretin, an oral retinoid, is the active metabolite of etretinate and has demonstrated clinical effects similar to etretinate, but with fewer adverse effects. Acitretin is indicated for the treatment of severe psoriasis, including erythrodermic and generalized pustular types, but is more useful as an adjunct in the treatment of plaque psoriasis. In contrast to the fast-acting cyclosporine and methotrexate, acitretin resolves psoriatic lesions more slowly. [Pg.1777]

An initial recommended dose of acitretin is 25 to 50 mg once daily, with therapy continued until lesions have resolved. A dosage of 50 mg/day is typically required for plaque psoriasis, and even at this relatively high dose, acitretin is only moderately effective. It is better tolerated when taken in conjunction with a meal. [Pg.1777]

Sulfasalazine, commonly used in the treatment of inflammatory bowel disease and rheumatoid arthritis, is selectively used as an alternative treatment, particularly in patients with concurrent psoriatic arthritis. Sulfasalazine is an anti-inflammatory agent that inhibits 5-lipoxygenase. When used as a single agent in the treatment of psoriasis, it is not as effective as is therapy with methotrexate, PUVA, or acitretin. One possible advantage of sulfasalazine therapy compared with other systemic treatments is its relatively high margin of safety. The usual dose of oral sulfasalazine is 3 to 4 g/day for 8 weeks. ... [Pg.1778]

Katz HI, Waalen J, Leach EE. Acitretin in psoriasis an overview of adverse effects. J Am Acad Dermatol 1999 41 S7-S12. [Pg.1782]

Kuijpers, A.L., Van Pelt, J.P., Bergers, M., Boegheim, P.J., Den Bakker, J.E., Siegenthaler, G., Vande Kerkhof, P.C. and Schalkwijk, J. (1998) The effects of oral liarozole on epidermal proliferation and differentiation in severe plaque psoriasis are comparable with those of acitretin. The British Journal of Dermatology, 139, 380-389. [Pg.406]

Acitretin is currently the only retinoid licensed in the United Kingdom for the treatment of psoriasis and is only available for treatment of patients in hospitals. It is given orally and has anti-inflammatory and cytostatic actions. This is useful in inflammatory psoriasis. The half-life of acitretin is about two days. However, there is a high risk of teratogenesis and women must use adequate contraception and stop treatment for two years before conception. [Pg.144]

Abacavir - antiviral Acarbose - oral hypoglycaemic Acipimox - lipid lowering drug Acitretin - oral retinoid psoriasis Acrivastine - antihistamine Acyclovir - antiviral... [Pg.323]

Adtretin is a second-generation retinoid. Acitretin (Soriatane) is the major metabolite of etretinate, an aromatic retinoid that formerly was approved for psoriasis but withdrawn from the market because of its undesirable pharmacokinetics. Acitretin has an elimination half-Ufe of 2 to 3 days. [Pg.43]


See other pages where Acitretin psoriasis is mentioned: [Pg.450]    [Pg.1296]    [Pg.231]    [Pg.450]    [Pg.1296]    [Pg.231]    [Pg.955]    [Pg.955]    [Pg.206]    [Pg.62]    [Pg.482]    [Pg.498]    [Pg.466]    [Pg.383]    [Pg.317]    [Pg.193]    [Pg.195]    [Pg.736]    [Pg.2822]    [Pg.7]    [Pg.4]    [Pg.117]    [Pg.291]    [Pg.320]    [Pg.1769]    [Pg.395]    [Pg.403]    [Pg.151]   
See also in sourсe #XX -- [ Pg.955 ]

See also in sourсe #XX -- [ Pg.1773 , Pg.1777 ]

See also in sourсe #XX -- [ Pg.203 ]




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