Soriatane (acitretin) is a medicine used to treat severe forms of psoriasis in adults. It is in a class of medicines called retinoids, a derivative of vitamin A. Soriatane comes in different strengths (10, 17.5, 22.2, and 25mg) and is given once a day with food to increase it’s absorption. The recommended starting dose is 25 to 50mg a day, though some physicians start patients at a dose based on their weight, 0.5 mg/kg/day, and increase the dose as needed. Patience is needed since it may take 2 or 3 months before improvement is seen. Sometimes Soriatane is added to other psoriasis drugs or to phototherapy to increase the effectiveness of these treatments.

The most serious side effect of Soriatane is the high risk of birth defects if a woman becomes pregnant while taking the drug. For women of child bearing potential, two negative pregnancy tests must be done before starting and repeated monthly while taking the drug. In addition, effective birth control is needed while on the medicine and continued for three years after stopping since a small amount of Soriatane remains in the body for a long time.

Sometimes the following common side effects may occur. These usually get better if the Soriatane dose is reduced or stopped:

• Chapped lips; peeling fingertips, palms, and soles; itching; scaly skin all over; weak nails; sticky or fragile skin; runny or dry nose, or nose bleeds. A lotion or cream can help with the drying or chapping
• Dry mouth
• Joint pain
• Tight muscles
• Hair thinning
• Dry eyes. Wearing contact lenses may be uncomfortable during treatment

There are also some uncommon, but serious side effects. The prescriber should be notified if any of these occur:

• Bad headaches, nausea, vomiting, blurred vision
• Decreased vision in the dark (night blindness)
• Depression
• Yellowing of your skin or the whites of your eyes, nausea and vomiting, loss of appetite, or dark urine
• Aches or pains in your bones, joints, muscles, or back; trouble moving; loss of feelings in your hands or feet
• Frequent urination, great thirst or hunger
• Shortness of breath, dizziness, nausea, chest pain, weakness, trouble speaking, or swelling of a leg

Soriatane may have some drug interactions. Vitamin A should be avoided since this is a close relative of Soriatane and additive side effects can occur. Tetracycline type of antibiotics should not be taken with Soriatane since both medicines have a small chance of increasing pressure on the brain. Finally Soriatane can decrease the effectiveness of phenytoin, a drug for epilepsy, if given at the same time.

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