The mechanism of action of acitretin is unknown.

Approved for treating severe psoriasis unresponsive to other treatments.

Initial: 25–50 mg per day, with food.

Maintenance: 25–50 mg/day, depending on patient response.

Very Common

• Cheilitis (chapped lips)

• Dry skin, skin peeling, hair loss

• Dry eyes, dry mouth, nosebleeds

Serious Risks

• Liver toxicity (monitor LFTs regularly)

• Hyperlipidemia

• Skeletal abnormalities

• Psychiatric symptoms (e.g., depression, suicidal ideation)

• Vision issues, including night blindness

• Pseudotumor cerebri

• Capillary leak syndrome

• Pancreatitis (especially with triglycerides >800 mg/dL)

Acitretin must not be used by women who are pregnant, plan to become pregnant, or who do not agree to use two forms of contraception.

• Birth defects are a severe risk even after discontinuation — contraception is required for 3 years post-treatment.

• Alcohol intake must be avoided during therapy and for 2 months afterward, as it can convert acitretin to etretinate, a compound with a much longer half-life.