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Eicosapentaenoic Acid (EPA)
Omega-3 Fatty Acids
Look Up > Drugs > Etretinate
Etretinate
Pronunciation
U.S. Brand Names
Generic Available
Pharmacological Index
Use
Pregnancy Risk Factor
Contraindications
Warnings/Precautions
Adverse Reactions
Drug Interactions
Mechanism of Action
Pharmacodynamics/Kinetics
Usual Dosage
Dietary Considerations
Mental Health: Effects on Mental Status
Mental Health: Effects on Psychiatric Treatment
Dental Health: Local Anesthetic/Vasoconstrictor Precautions
Dental Health: Effects on Dental Treatment
Patient Information
Dosage Forms

Pronunciation
(e TRET i nate)

U.S. Brand Names
Tegison®

Generic Available

No


Pharmacological Index

Antipsoriatic Agent


Use

Treatment of severe recalcitrant psoriasis in patients intolerant of or unresponsive to standard therapies


Pregnancy Risk Factor

X


Contraindications

Pregnancy, known hypersensitivity to etretinate; because of the high likelihood of long lasting teratogenic effects, do not prescribe etretinate for women who are or who are likely to become pregnant while or after using the drug


Warnings/Precautions

Not to be used in severe obesity or women of childbearing potential unless woman is capable of complying with effective contraceptive measures; therapy is normally begun on the second or third day of next normal menstrual period; effective contraception must be used for at least 1 month before beginning therapy, during therapy, and for 1 month after discontinuation of therapy; pregnancy test must be performed prior to starting therapy


Adverse Reactions

>10%:

Central nervous system: Fatigue, headache, fever

Dermatologic: Chapped lips, alopecia

Endocrine & metabolic: Hypercholesterolemia, hypertriglyceridemia

Gastrointestinal: Nausea, appetite change, xerostomia, sore tongue

Neuromuscular & skeletal: Hyperostosis, bone pain, arthralgia

Ocular: Eye irritation

Respiratory: Epistaxis

1% to 10%:

Cardiovascular: Edema

Central nervous system: Dizziness, lethargy

Hepatic: Hepatitis

Neuromuscular & skeletal: Myalgia

Ocular: Blurred vision

Otic: Otitis externa

Respiratory: Dyspnea

<1%: Syncope, amnesia, confusion, pseudotumor cerebri, depression, urticaria, mouth ulcers, diarrhea, constipation, flatulence, weight loss, gingival bleeding, gout, dysuria, polyuria, phlebitis, hyperkinesia, hypertonia, photophobia, ear infection, kidney stones, rhinorrhea


Drug Interactions

Increased effect: Milk increases absorption of etretinate

Increased toxicity: Additive toxicity with vitamin A


Mechanism of Action

Unknown; related to retinoic acid and retinol (vitamin A)


Pharmacodynamics/Kinetics

Absorption: Oral: Absorbed from small intestine; absorption enhanced when coadministered with whole milk or a high lipid meal (highly lipophilic)

Protein binding: 99%

Metabolism: Undergoes significant first-pass metabolism to form acitretin (active)

Half-life: 4-8 days (with multiple doses)

Elimination: By metabolism and by excretion in feces of unchanged drug and metabolites


Usual Dosage

Adults: Oral: Individualized; Initial: 0.75-1 mg/kg/day in divided doses, increase by 0.25 mg/kg/day at weekly intervals up to 1.5 mg/kg/day; maintenance dose established after 8-10 weeks of therapy 0.5-0.75 mg/kg/day


Dietary Considerations

May be administered with food


Mental Health: Effects on Mental Status

Sedation is common; may cause dizziness; may rarely cause confusion or depression


Mental Health: Effects on Psychiatric Treatment

Concurrent use with psychotropics may produce additive sedation or dry mouth


Dental Health: Local Anesthetic/Vasoconstrictor Precautions

No information available to require special precautions


Dental Health: Effects on Dental Treatment

>10% of patients experience dry mouth


Patient Information

Take with food. Do not take additional vitamin A supplements. You may experience dizziness, blurred vision, or fatigue; use caution when driving or engaging in tasks that require alertness until response to drug is known. Report persistent severe nausea, abdominal pain, visual disturbances, yellowing of skin or eyes, unusual bruising or bleeding, muscle pain or cramping, or unusual nosebleeds. Pregnancy/breast-feeding precautions: Inform prescriber if you are pregnant. Do not get pregnant for 1 month following therapy. Consult prescriber for instruction on appropriate contraceptive measures. This drug cause severe fetal defects. Do not donate blood during therapy or for an indefinite period following therapy. Do not breast-feed.


Dosage Forms

Capsule: 10 mg, 25 mg


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