Soriatane (Acitretin) - Oral

Warning:

Soriatane (acitretin) can cause severe birth defects, even after you stop taking it. You should not take Soriatane if you plan to become pregnant during therapy or for at least three years after stopping Soriatane. If you can become pregnant, it is advised to use effective forms of contraception (birth control) before, during, and after therapy with Soriatane.

What Is Soriatane?

Soriatane (acitretin) is an oral prescription medication used to treat severe forms of psoriasis in adults.

This medication belongs to a group of drugs called retinoids, which are chemically similar to vitamin A. Acitretin works by suppressing abnormal skin cell growth and reducing inflammation.

Drug Facts

Generic Name: Acitretin

Brand Name(s): Soriatane

Administration Route(s): Oral

Drug Availability: Prescription

Therapeutic Classification: Antipsoriatic

Available Generically: Yes

Controlled Substance: N/A

Active Ingredient: Acitetrin

Dosage Form(s): Capsule

What Is Soriatane Used For?

The Food and Drug Administration (FDA) approved Soriatane to treat severe forms of psoriasis.

Psoriasis is a chronic inflammatory condition that causes skin cells to grow faster than normal and pile up on the skin’s surface. People with the most common form of psoriasis (plaque psoriasis) develop pink, thickened areas (plaques), usually covered with silvery scales. Plaques often occur on the scalp, elbows, knees, and lower back, although any area of the skin can be affected.

Unlike many other psoriasis treatments, Soriatane does not suppress the immune system. For this reason, healthcare providers commonly prescribe Soriatane to treat psoriasis in people with HIV. Soriatane is also effective for less common forms of severe psoriasis, including erythrodermic psoriasis and pustular psoriasis.

Soriatane (Acitretin) Drug Information

Verywell / Zoe Hansen

How to Take Soriatane

Take Soriatane once daily with the largest meal of the day.

People who can become pregnant must avoid alcohol while using Soriatane and for two months after stopping Soriatane. This includes foods, drinks, medicines, and over-the-counter products that contain alcohol. Alcohol changes Soriatane into a long-lasting drug that can cause birth defects during pregnancy. The risk of birth defects may last longer than three years after stopping Soriatane if any form of alcohol is taken with Soriatane or within two months of stopping.

Watch out for dietary supplements containing vitamin A. Since Soriatane is related to vitamin A, using products that also include vitamin A increases the risk of side effects.

Storage

Store Soriatane at room temperature. Protect from light, high temperatures, and humidity. Keep Soriatane and all your medicines in a safe location, up high and out of the reach of children and pets.

Off-Label Uses

Soriatane can be beneficial for treating other skin conditions that are not listed by the FDA.

Your healthcare provider may prescribe Soriatane off-label for other skin conditions, including:

How Long Does Soriatane Take to Work?

Soriatane is a relatively slow-acting medication. Some people notice an improvement in their symptoms within the first eight weeks of treatment, but it can take two to three months to see the full benefit.

What Are the Side Effects of Soriatane?

This is not a complete list of side effects, and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at www.fda.gov/medwatch or 1-800-FDA-1088.

Like other medications, Soriatane may cause side effects. Let your healthcare provider know if you experience any side effects while using this medication.

Common Side Effects

Side effects are common with Soriatane. Let your healthcare provider know if you experience any reactions. They may recommend adjusting your dose to help limit side effects.

Common side effects include:

Psoriasis symptoms, such as redness and itching, may get worse when you first start Soriatane. Talk to your provider if this happens. They may recommend lowering your dose.

Severe Side Effects

Soriatane can cause serious side effects. Contact your healthcare provider right away if you have a severe reaction. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms include:

  • Severe birth defects: Soriatane can cause severe birth defects during treatment and for three years after stopping treatment. People who can become pregnant must ensure they are not pregnant before starting Soriatane and avoid becoming pregnant for at least three years after stopping.
  • Liver problems: Soriatane can cause liver problems, including inflammation of your liver (hepatitis). Your healthcare provider will monitor your liver function with a blood test before and during treatment with Soriatane. Let your provider know if you develop any signs of liver problems, including yellowing of the skin or the whites of your eyes, nausea, vomiting, loss of appetite, or dark urine. 
  • Increased brain pressure (pseudotumor cerebri): This condition can lead to blindness and death. Contact your provider right away if you have a bad headache, nausea, vomiting, or blurred vision while taking Soriatane. 
  • Vision problems, especially in the dark (night blindness): Decreased vision at night can happen at any time, so it’s important to be very careful when driving in the dark. Stop taking Soriatane and let your provider know if you develop vision problems or eye pain. 
  • Depression: Some people may experience a depressed mood, aggressive behavior, or suicidal thoughts. Let your provider know if you have a history of mental illness. 
  • Bone or muscle changes: Soriatane can affect your bones and muscles. Watch out for any pain in your bones, muscles, joints, or back; trouble moving; or loss of feeling in your hands or feet.
  • High blood sugar: Soriatane can increase blood sugar, even if you don’t have diabetes. Signs of high blood sugar include intense thirst, hunger, and frequent urination.
  • Heart attack, blood clots, or stroke: Soriatane can affect your blood fat and cholesterol levels. It’s possible these changes could cause a heart attack, blood clot, or stroke. Signs include shortness of breath, dizziness, nausea, chest pain, weakness, trouble speaking, or swelling in one leg. 
  • Leaky blood vessels: Soriatane can cause fluid to leak out of your blood vessels and into different body areas (capillary leak syndrome). Call your medical provider right away if you develop swelling, weight gain, fever, lightheadedness, or muscle aches. 
  • Serious skin problems: Watch for red, swollen, peeling, itchy, or painful skin. Symptoms may begin in a small area but then spread over a large part of the body. 
  • Serious allergic reactions: Some people may develop a severe allergic reaction to Soriatane. Symptoms include hives; itching; swelling of your face, mouth, or tongue; or problems breathing. Seek medical care right away if this happens. 
  • Photosensitivity: Limit sun or UV exposure, and use plenty of sunscreen. Phototherapy can also increase the risk of burning while on acitretin.

Long-Term Side Effects

Soriatane can cause birth defects, even after you stop taking it. Try not to become pregnant during treatment and for at least three years after stopping Soriatane. Consuming any form of alcohol (in foods, drinks, medicines, or other products) with Soriatane can cause the risk of birth defects to last longer than three years. Do not consume alcohol while taking Soriatane or for two months after stopping treatment.

Report Side Effects

Soriatane may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Soriatane Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (capsules):
    • For severe psoriasis:
      • Adults—At first, 25 to 50 milligrams (mg) once a day as a single dose. Your doctor may adjust your dose as needed.
      • Children—Use and dose must be determined by your doctor.

Modifications

You must not take Soriatane if you are pregnant since it can cause severe birth defects. Do not breastfeed while using Soriatane, as Soriatane can pass into your breastmilk and harm your baby.

Missed Dose

If you forget to take your dose of Soriatane, skip the missed dose. Do not double up doses or take extra.

Overdose: What Happens If I Take Too Much Soriatane?

Overdosing on Soriatane may cause a headache or symptoms of vertigo. Vertigo describes a spinning, tilting, or swaying sensation that can make you feel dizzy or off balance.

What Happens If I Overdose on Soriatane?

If you think you or someone else may have overdosed on Soriatane, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Depakote, call 911 immediately.

Precautions

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It is important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can cause very serious birth defects. You must use 2 forms of birth control together for 1 month before starting this medicine, for the entire time that you are being treated with this medicine, and for 3 years after you take your last dose of this medicine. You will need to have 2 negative pregnancy tests to be sure that you are not pregnant before you start using this medicine. You will also need to have pregnancy tests every month during treatment, and every 3 months for 3 years after you stop taking the medicine. If you think you have become pregnant while using this medicine, call your doctor right away.

Do not use methotrexate (Rheumatrex®, Trexall®) or a tetracycline medicine to treat an infection (eg, doxycycline, minocycline, tetracycline, Minocin®, or Vibramycin®) while you are using this medicine. Using these medicines together may cause unwanted side effects.

Do not take vitamin A or any supplement containing vitamin A while you are using this medicine, unless otherwise directed by your doctor. To do so may increase the chance of side effects.

Your skin condition may improve or get worse during the first few weeks of treatment and you also may notice some skin irritation from the medicine. With continued use, the expected skin irritation will lessen after a few weeks. Check with your doctor if the skin irritation becomes worse or if your skin condition does not improve within 8 to 12 weeks.

Women who are able to bear children must avoid all forms of alcohol while they are taking this medicine and for 2 months after they stop. Do not eat foods, drink beverages, or take medicines that contain alcohol. Drinking alcohol will make the medicine remain in the body for an extended period of time and will increase the chance for side effects. If a woman consumes alcohol during acitretin treatment, she should consider delaying a pregnancy for longer than 2 to 3 years. Talk to your doctor if you have any questions about this.

Do not donate blood during treatment with acitretin, for 3 years following treatment, or as directed by your doctor. Women who are able to bear children must not receive blood containing the medicine.

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.

Acitretin may cause bone or muscle problems, including joint pain, muscle pain or stiffness, or difficulty moving. You may get hurt more easily during rough sports. You may also heal more slowly.

Acitretin may cause blurred vision or a decrease in night vision (night blindness). The night blindness may occur suddenly. Do not drive or do anything else that could be dangerous if you are not able to see well. Check with your doctor right away if you have vision changes.

Acitretin may cause dry eyes. Wearing contact lenses may become uncomfortable while using this medicine. To help relieve dry eyes, check with your doctor about using a lubricating solution, such as artificial tears. If severe eye irritation or inflammation occurs, check with your doctor.

Acitretin may cause dryness of the mouth, nose, and throat. For temporary relief of mouth dryness, use sugarless candy or gum, melt bits of ice in your mouth, or use a saliva substitute. However, if dry mouth continues for more than 2 weeks, check with your medical doctor or dentist. Continuing dryness of the mouth may increase the chance of developing dental disease, including tooth decay, gum disease, and fungus infections.

Avoid exposing your skin to wind, cold weather, and sunlight, even on cloudy days. Your skin will be more prone to sunburn, dryness, or irritation, especially during the first 2 or 3 weeks. You should not stop taking this medicine, unless the skin irritation becomes too severe. Do not use a sunlamp or tanning bed. Use sunscreen or sunblock lotions with a sun protection factor (SPF) of at least 15 on a regular basis. Wear protective clothing and hats and stay out of direct sunlight, especially between the hours of 10 a.m. and 3 p.m.

Unless your doctor tells you otherwise, you should avoid skin products that can irritate the skin. Some examples are:

  • Any topical acne product or skin product containing a peeling agent (eg, benzoyl peroxide, resorcinol, salicylic acid, or sulfur).
  • Hair products that are irritating, such as permanents or hair removal products.
  • Skin products that cause sensitivity to the sun, such as those containing spices or limes.
  • Skin products containing a large amount of alcohol, such as astringents, shaving creams, or after-shave lotions.
  • Skin products that are too drying or abrasive, such as some cosmetics, soaps, or skin cleansers.

For diabetic patients:

  • This medicine may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests or if you have any questions, check with your doctor.

Pancreatitis may occur while you are using this medicine. Tell your doctor right away if you have sudden and severe stomach pain, chills, constipation, nausea, vomiting, fever, or lightheadedness.

Acitretin may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you or your caregiver notice any of these side effects, check with you doctor right away.

Call your doctor right away if you have a fever, cloudy urine, decrease or increase in the amount of urine, fainting or lightheadedness, nausea, stomach pain, or swelling of the hands, ankles, feet, or lower legs. These may be symptoms of a rare but serious condition called capillary leak syndrome.

Do not take other medicines without checking first with your doctor. This includes vitamins, herbal products, prescription or nonprescription (over-the-counter [OTC]) medicines. Some of these medicines or nutritional supplements (eg, St. John's wort) may make your birth control pills not work.

What Are Reasons I Shouldn’t Take Soriatane?

Certain conditions increase your risk of developing complications from Soriatane. Do not take Soriatane if you:

  • Are pregnant or might become pregnant while on Soriatane or within three years after stopping Soriatane
  • Are breastfeeding 
  • Have severe liver or kidney problems
  • Take methotrexate 
  • Take tetracycline medications, including minocycline, doxycycline, or tetracycline 
  • Have had repeated high blood fat levels (triglycerides or cholesterol)
  • Have an allergy to Soriatane or another retinoid medication

What Other Medications Interact With Soriatane?

Soriatane may interact with other medications you take. Keep an up-to-date list of all your medicines—including over-the-counter products—and share this information with your healthcare provider any time there are changes.

Never take Soriatane with:

  • Alcohol (if you can become pregnant) 
  • Methotrexate
  • Other oral retinoids, such as isotretinoin 
  • Products that contain vitamin A 
  • Tetracycline antibiotics, including doxycycline, minocycline, and tetracycline


Soriatane can also interact with:

This is not a complete list of all the medications Soriatane may interact with. Always ask your healthcare provider before starting anything new.

Frequently Asked Questions

  • What is Soriatane used for?

    Soriatane is used to treat severe forms of psoriasis in adults.

  • How does Soriatane work?

    Soriatane is a retinoid medication. It works by slowing the abnormal growth of skin cells and reducing inflammation.

  • How can Soriatane affect pregnancies?

    Soriatane can cause severe birth defects. People who can become pregnant must ensure they are not pregnant before starting Soriatane. Avoid pregnancy during treatment and for at least three years after stopping Soriatane. If you do become pregnant during this time, you should report it to the manufacturer at 1-888-784-3335 or to the FDA at 1-800-FDA-1088. Use two forms of birth control every time you have sex.

  • What drugs should not be taken with Soriatane?

    Never take Soriatane with methotrexate, tetracycline antibiotics (like minocycline and doxycycline), other oral retinoids like isotretinoin, or products that contain vitamin A. People who can become pregnant must not consume any form of alcohol.

  • How long does it take for Soriatane to work?

    Some people may notice an improvement in their psoriasis symptoms within the first eight weeks of treatment. However, it can take two to three months to see the full benefit. Sometimes psoriasis symptoms get worse when you first start Soriatane. This usually improves with time, but let your healthcare provider know if this happens. They may adjust your dose of Soriatane.

  • What are the side effects of Soriatane?

    Soriatane can cause several side effects. Your healthcare provider may adjust your dose to limit some of these. Common side effects include chapped lips; dry eyes; dry mouth; hair loss; increased levels of blood fats; itching; joint pain; peeling fingertips, palms, or soles; runny or dry nose; nosebleeds; weak or scaly skin; tight muscles; and weak nails.

How Can I Stay Healthy While Taking Soriatane?

Severe psoriasis doesn’t just affect the way you look. It can be itchy, painful, and impact your self-esteem. Fortunately, Soriatane is one effective option your healthcare provider may recommend.

To avoid severe birth defects, people who can become pregnant must participate in the “Do Your P.A.R.T.” program—a program designed to prevent pregnancy during and for three years after treatment with Soriatane. Your healthcare provider will discuss this program with you.

Soriatane is associated with several other severe complications. It is important to review the warnings each time you pick up your prescription. Let your provider know right away if you develop symptoms of a serious reaction. Knowing the warning signs of a reaction can help keep you healthy while effectively treating your psoriasis.

Medical Disclaimer

Verywell Health's drug information is meant for education purposes only and not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare professional. Consult your doctor before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

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