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DERMATOLOGICALS › ANTIPSORIATICS › ANTIPSORIATICS FOR SYSTEMIC USE › Retinoids for treatment of psoriasis
etretinate
D05BB01
Forms & Strengths
- Oral capsules: 10 mg
- Oral capsules: 25 mg
Adult Dosing
- Initial dose: 0.75 to 1 mg/kg/day in divided doses
- Maintenance dose: 0.5 to 0.75 mg/kg/day based on efficacy and tolerance
- Maximum daily dose: 1.5 mg/kg/day
Pediatric Dosing
- Safety and efficacy in pediatric patients have not been established
- Use is generally avoided due to severe long-term risks such as premature epiphyseal closure
Indications
- Severe recalcitrant psoriasis including pustular and erythrodermic variants
- Other severe keratinizing dermatoses unresponsive to standard therapy
Mechanism of Action
- Synthetic aromatic analog of retinoic acid
- Modulates cellular differentiation and proliferation
- Exerts anti-inflammatory and anti-keratinizing effects in psoriatic epidermis
Contraindications
- Pregnancy (category X) or planned pregnancy within 3 years of therapy cessation due to extreme teratogenicity and long half-life
- Severe hepatic or renal impairment
- Hyperlipidemia
- Hypersensitivity to retinoids
Adverse Reactions
- Cheilitis, xerosis, alopecia, nail disorders, skin thinning and fragility
- Elevated liver function tests and hyperlipidemia (hypertriglyceridemia, hypercholesterolemia)
- Pseudotumor cerebri (benign intracranial hypertension)
- Skeletal abnormalities including hyperostosis and premature epiphyseal closure
Drug Interactions
- Alcohol: promotes conversion of etretinate to acitretin, prolonging elimination
- Methotrexate: increased risk of hepatotoxicity
- Tetracyclines: increased risk of pseudotumor cerebri
- Vitamin A and other retinoids: additive toxicities
- Phenytoin: protein-binding displacement
Curated Content: Needs Vetting Before Put to Clinical Use