Classifications: skin and mucous membrane agent; antiacne; retinoid
Prototype: Isotretinoin
Pregnancy Category: X


10 mg, 25 mg capsules


The mechanism of action of acitretin is unknown.

Therapeutic Effects

Acitretin is a highly toxic metabolite of retinol (vitamin A).


Treatment of severe psoriasis in adults.


Pregnancy (category X), sensitivity to parabens, lactation.

Cautious Use

Patients with impaired hepatic function, hepatitis, diabetes mellitus, obesity, alcoholism, history of pancreatitis, hypertriglyceridemia, hypercholesterolemia, coronary artery disease, retinal disease, degenerative joint disease.

Route & Dosage

Adult: PO 25–50 mg q.d. with main meal



Adverse Effects (1%)

Body as a Whole: Hyperesthesia, paresthesias, arthralgia, progression of existing spinal hyperostosis, rigors, back pain, hypertonia, myalgia, fatigue, hot flashes, increased appetite. CNS: Headache, depression, aggressive feelings and thoughts of self-harm, insomnia, somnolence. CV: Flushing, edema. GI: Dry mouth, increased liver function tests, increased triglycerides and cholesterol, hepatitis, gingival bleeding, gingivitis, increased saliva, stomatitis, thirst, ulcerative stomatitis, abdominal pain, diarrhea, nausea, tongue disorder. Special Senses: Blurred vision, blepharitis, conjunctivitis, decreased night vision/night blindness, eye pain, photophobia; earache, tinnitus; taste perversion. Respiratory: Sinusitis. Skin: Alopecia, skin peeling, dry skin, nail disorders, pruritus, rash, cheilitis, skin atrophy, paronychia, abnormal skin odor and hair texture, cold/clammy skin, increased sweating, purpura, seborrhea, skin ulceration, sunburn. Other: Rhinitis, epistaxis, xerophthalmia.


Drug: Combination with ethanol can create etretinate, which has a significantly longer half-life than acitretin; interferes with the contraceptive efficacy of progestin-only oral contraceptives. Food: Avoid excess vitamin A.


Absorption: Rapidly absorbed from GI tract, optimal absorption when taken with food. Peak: 2–5 h. Distribution: Crosses placenta, distributed into breast milk. Metabolism: Metabolized active metabolite, cis-acitretin. Elimination: Excreted in both urine and feces. Half-Life: 49 h acitretin, 63 h cis-acitretin.

Nursing Implications

Assessment & Drug Effects

Patient & Family Education

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug