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Etretinate
Etretinate (TegisonŽ) is an oral retinoid used in the treatment of recalcitrant psoriasis vulgaris, pustular psoriasis, and keratinizing disorders.
Contraindications:
- Pregnancy - etretinate is a potent teratogen. It must only be used after a negative pregnancy test, and is started immediately after the next menses. Females must be on birth control, preferably 2 types, unless there is certainty of abstinence from sexual intercourse.
- Etretinate persists in the body for a very long time, possibly years. It should therefore be used with great circumspection in females not past the childbearing years. For some capacity for childbearing is an absolute contraindication.
- Etretinate is being replaced by acitretin, which has a much shorter elimination period.
Precaution:
- Lactation - safety for the infant has not been established.
- Long term use is associated with the development of hyperostosis.
- Avoid if pre-existing liver damage.
Adverse effects:
- Xerosis, cheilitis, dry eyes
- Myalgia
- Elevated triglyceride and/or cholesterol. Levels early in treatment should be monitored at least monthly.
- Other side effects - please consult your compendium.
Dosage:
- 50 to 75 mg/day (0.75 - 1.0 mg/kg/day) is the usual dose.
- Careful monitoring for systemic side effects is required.
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