Uses of Soritec: - Psoriasis Oral Darier's disease Adult: Initially, 10 mg daily for 2-4 wk. Max: 50 mg/day. Congenital icthyosis Adult: Initially, 25-30 mg daily for 2-4 wk before dose adjustments are done. Usual range: 25-50 mg daily for further 6-8 wk. Max: 75 mg daily for short periods. Severe psoriasis Adult: Initially, 25-30 mg daily for 2-4 wk before dose adjustments are done. Usual range: 25-50 mg daily for further 6-8 wk. Max: 75 mg daily for short periods. Severe lichen planus Adult: Initially, 25-30 mg daily for 2-4 wk before dose adjustments are done. Usual range: 25-50 mg daily for further 6-8 wk. Max: 75 mg daily for short periods.

Oral Retinoid preparations

Acitretin is a retinoid, an aromatic analogue of vitamin A. The mechanism of action of acitretin is unknown, however, evidence exists for a wide range of actions at various cellular and subcellular levels. These include regulation of RNA/DNA synthesis, modulation of factors which influence epidermal proliferation, modification of glycoprotein synthesis and modulation of the immune response. Whatever the exact mechanism of action, the most prominent effect of acitretin is a modulation of cellular differentiation in the epidermis which re-establishes a more normal pattern of cell growth.

How to use Acitretin: Take this medicine in the dose and duration as advised by your doctor. Do not chew, crush or break it. Acitretin is to be taken with food. Administration: Concomitant use with keratolytics or high dose vitamin A. Reduces anticoagulant effect of coumarins e.g. warfarin. Concomitant use of microdised progestin oral contraceptives. Concomitant use of methotrexate can potentiate hepatotoxicty. Concomitant use with tetracycline. Adult Dose: Female patients to avoid alcohol during and 2 mth after treatment. Avoid blood donation during therapy or at least 1-3 yr after stopping therapy. Children. Radiographic treatment for prolonged therapy. Therapy should not last >6 mth. Monitor plasma lipid and glucose levels (especially diabetics) regularly. Monitor LFTs. Lactation: enters breast milk/not recommended. Renal Dose: Acitretin is an active metabolite of etretinate but its mechanism of action is unknown.

Pregnancy (before the start, during and at least 2-3 yr after cessation of therapy), lactation. Hepatic and renal impairment. Hyperlipidaemia.

Acitretin is highly teratogenic and must not be used by women who are pregnant. The same applies to women of childbearing potential unless strict contraception is practiced 4 weeks before, during and for 2 years after treatment. The use of Acitretin is contra-indicated in women who are breast feeding.Acitretin is contraindicated in patients with severe hepatic or renal impairment and in patients with chronic abnormally elevated blood lipid values. Concomitant administration of Acitretin with other retinoids or Vitamin A is contra-indicated due to the risk of hypervitaminosis A. Acitretin is contra-indicated in cases of hypersensitivity to the preparation (acitretin or excipients) or to other retinoids. Patients with rare glucose-galactosemalabsorption should not take this medicine.

Common - Dry lips - Dryness in mouth - Skin peeling - Joint pain - Muscle tightness - Cracked lips - Itching - Change in finger nails - Runny nose - Nosebleeds - Hair loss - Increased levels of blood fat

Acitretin is contraindicated in pregnant women or nursing mother. It is highly teratogenic. Its use is contraindicated in women who might become pregnant during or within 2 years of the cessation of treatment.

Precaution: Lichen planus, Psoriasis, Congenital icthyosis, Darier's disease

Manifestations of acute Vitamin A toxicity include severe headache, vertigo, nausea or vomiting, drowsiness, irritability and pruritus. Signs and symptoms of accidental or deliberate overdosage with Acitretin would probably be similar. Specific treatment is unnecessary because of the low acute toxicity of the preparation.

Store in a cool & dry place, protected from light. Do not store above 25°C.

Oral Retinoid preparations

Should be taken with food. Take w/ main meals or w/ a glass of milk.

Cheilitis (>75%),Alopecia (50-75%),Hypertriglyceridemia (50-75%),Skin peeling (50-75%),Dry skin (25-50%),Dysglycemia (25-50%),Increased LFT (25-50%),Nail disorder (25-50%),Pruritus (25-50%),Rhinitis (25-50%),Arthralgia (10-25%),Changes in phosphorus, potassium, sodium, & magnesium levels (10-25%),Dry mouth (10-25%),Epistaxis (10-25%),Erythematous rash (10-25%),Hepatotoxicity (10-25%),Hyperesthesia (10-25%),Paresthesia (10-25%),Paronychia (10-25%),Rigors (10-25%),Skin atrophy (10-25%),Spinal hyperostosis (10-25%),Sticky skin (10-25%),Xerophthalmia (10-25%) 1-10% Edema,Flushing,Depression,Fatigue,Headache,Insomnia,Somnolence,Abdominal pain,Anorexia,Diarrhea,Gingivitis,Increased appetite,Nausea,Stomatitis,Vomiting,Hot flashes,Vision changes,Corneal epithelial abnormality,Sinusitis Potentially Fatal: Phototoxicity, jaundice, hepatitis and hepatotoxity.