Acitretin interactions
Full monograph for AcitretinCheck it against another medicine
Medicines
141 documented
| Medicine | Severity | Mechanism | Effect | Sources |
|---|---|---|---|---|
| Clindamycin + Tretinoin | Major | Synergy | Concomitant use of a retinoid with vitamin A or other retinoids may result in hypervitaminosis A and additive toxicities. Patients may be at increased risk for… | 5 sources — open the full entry |
| Doxycycline Hydrochloride | Major | Synergy | Concomitant use of vitamin A or related compounds (i.e., retinoids) with tetracyclines may increase the risk of pseudotumor cerebri, also known as benign… | 25 sources — open the full entry |
| Ethanol + Isopropyl alcohol | Major | Others | Ethanol consumption with acitretin leads to the formation of etretinate, which has a much longer half-life than acitretin. Major human fetal abnormalities have… | 5 sources — open the full entry |
| Ethinyl Estradiol + Levonorgestrel + Ferrous Fumarate | Major | Antagonism | Acitretin interferes with the contraceptive effect of microdosed progestin preparations. The mechanism of interaction has not been described, and it is not… | 38 sources — open the full entry |
| Fluocinolone Acetonide + Hydroquinone + Tretinoin | Major | Synergy | Concomitant use of a retinoid with vitamin A or other retinoids may result in hypervitaminosis A and additive toxicities. Patients may be at increased risk for… | 5 sources — open the full entry |
| Iron + Folic Acid + Vitamin A + Vitamin C + Zinc | Major | Synergy | Concomitant use of a retinoid with vitamin A or other retinoids may result in hypervitaminosis A and additive toxicities. Patients may be at increased risk for… | 5 sources — open the full entry |
| IsotretinoinOralTopical | Major | Synergy | Concomitant use of a retinoid with vitamin A or other retinoids may result in hypervitaminosis A and additive toxicities. Patients may be at increased risk for… | 5 sources — open the full entry |
| Leflunomide | Major | Synergy | The recent, concomitant, or subsequent use (without the recommended leflunomide washout period or procedure) of other agents known to induce hepatotoxicity may… | 3 sources — open the full entry |
| Levonorgestrel [For emergency contraception] | Major | Antagonism | Acitretin interferes with the contraceptive effect of microdosed progestin preparations. The mechanism of interaction has not been described, and it is not… | 38 sources — open the full entry |
| Medroxyprogesterone AcetateInjectionTablet | Major | Antagonism | Acitretin interferes with the contraceptive effect of microdosed progestin preparations. The mechanism of interaction has not been described, and it is not… | 38 sources — open the full entry |
| Methotrexate | Major | Synergy | The use of etretinate (of which acitretin is the active metabolite) in combination with methotrexate has been associated with an increased risk of hepatitis… | 12 sources — open the full entry |
| Minocycline Hydrochloride | Major | Synergy | Concomitant use of vitamin A or related compounds (i.e., retinoids) with tetracyclines may increase the risk of pseudotumor cerebri, also known as benign… | 25 sources — open the full entry |
| Norethisterone Acetate | Major | Antagonism | Acitretin interferes with the contraceptive effect of microdosed progestin preparations. The mechanism of interaction has not been described, and it is not… | 38 sources — open the full entry |
| Norgestrel + Ethinyl Estradiol + Ferrous Fumarate | Major | Antagonism | Acitretin interferes with the contraceptive effect of microdosed progestin preparations. The mechanism of interaction has not been described, and it is not… | 38 sources — open the full entry |
| Norgestrel [For breastfeeding mother] | Major | Antagonism | Acitretin interferes with the contraceptive effect of microdosed progestin preparations. The mechanism of interaction has not been described, and it is not… | 38 sources — open the full entry |
| Oxytetracycline | Major | Synergy | Concomitant use of vitamin A or related compounds (i.e., retinoids) with tetracyclines may increase the risk of pseudotumor cerebri, also known as benign… | 25 sources — open the full entry |
| Oxytetracycline + Polymixin B Sulphate | Major | Synergy | Concomitant use of vitamin A or related compounds (i.e., retinoids) with tetracyclines may increase the risk of pseudotumor cerebri, also known as benign… | 25 sources — open the full entry |
| Relugolix + Estradiol + Norethindrone | Major | Antagonism · Unknown | Acitretin interferes with the contraceptive effect of microdosed progestin preparations. The mechanism of interaction has not been described, and it is not…2 documented mechanisms | 38 sources — open the full entry |
| Tetracycline Hydrochloride | Major | Synergy | Concomitant use of vitamin A or related compounds (i.e., retinoids) with tetracyclines may increase the risk of pseudotumor cerebri, also known as benign… | 25 sources — open the full entry |
| Tretinoin (Oral) | Major | Synergy | Concomitant use of a retinoid with vitamin A or other retinoids may result in hypervitaminosis A and additive toxicities. Patients may be at increased risk for… | 5 sources — open the full entry |
| Vitamin A | Major | Synergy | Concomitant use of a retinoid with vitamin A or other retinoids may result in hypervitaminosis A and additive toxicities. Patients may be at increased risk for… | 5 sources — open the full entry |
| Efavirenz | Moderate | Synergy | Coadministration of efavirenz with other agents known to induce hepatotoxicity may potentiate the risk of liver injury. Efavirenz has been associated with… | 7 sources — open the full entry |
| Epirubicin Hydrochloride | Moderate | Synergy | The concomitant or sequential use of epirubicin with agents known to induce hepatotoxicity may potentiate the risk of liver injury. Epirubicin undergoes… | 4 sources — open the full entry |
| Glibenclamide | Moderate | Metabolism | Acitretin in the presence of sulfonylureas may lead to enhanced clearance of blood glucose. The mechanism and the clinical significance of this interaction are… | 15 sources — open the full entry |
| Glimepiride | Moderate | Metabolism | Acitretin in the presence of sulfonylureas may lead to enhanced clearance of blood glucose. The mechanism and the clinical significance of this interaction are… | 15 sources — open the full entry |
| Glimepiride + Metformin | Moderate | Metabolism | Acitretin in the presence of sulfonylureas may lead to enhanced clearance of blood glucose. The mechanism and the clinical significance of this interaction are… | 15 sources — open the full entry |
| Glipizide | Moderate | Metabolism | Acitretin in the presence of sulfonylureas may lead to enhanced clearance of blood glucose. The mechanism and the clinical significance of this interaction are… | 15 sources — open the full entry |
| Glipizide + Metformin Hydrochloride | Moderate | Metabolism | Acitretin in the presence of sulfonylureas may lead to enhanced clearance of blood glucose. The mechanism and the clinical significance of this interaction are… | 15 sources — open the full entry |
| L-Asparginase | Moderate | Synergy | Concomitant use of asparaginase with other hepatotoxic agents may potentiate the risk of liver injury. Hepatomegaly, acute severe hepatotoxicity, and fatal… | 13 sources — open the full entry |
| Methoxsalen | Moderate | Synergy | Concomitant use of methoxsalen with other known photosensitizing agents may increase the risk of photosensitivity reactions. These agents include anthralin… | 7 sources — open the full entry |
| Pioglitazone + Glimepiride | Moderate | Metabolism | Acitretin in the presence of sulfonylureas may lead to enhanced clearance of blood glucose. The mechanism and the clinical significance of this interaction are… | 15 sources — open the full entry |
| Remdesivir | Moderate | Synergy | Concomitant use of remdesivir with other agents that are known to induce hepatotoxicity may theoretically increase the risk of liver injury. Data from… | 5 sources — open the full entry |
Food & lifestyle
alcohol
MajorSynergy
Ethanol consumption with acitretin leads to the formation of etretinate, which has a much longer half-life than acitretin. Major human fetal abnormalities have been associated with the administration of acitretin, etretinate, and other retinoids.
What to do: Female patients should be warned that ethanol is contraindicated during active treatment with acitretin and for two months after cessation of therapy.
1 source
- "Product Information. Soriatane (acitretin)." Roche Laboratories (2001):
Conditions
Conditions in which Acitretin needs care, as documented in this source.
Hyperlipidemias
MajorAcitretin is contraindicated in patients with chronic abnormally elevated blood lipid values. It is recommended to evaluate lipid status in patients before initiation of therapy and periodically until the lipid response to the drug is established. Care should be taken in subjects with an increased tendency to develop hypertriglyceridemia included those with disturbances of lipid metabolism, obesity, or a familial history of these conditions. Serum lipids must be more closely monitored in high-risk patients and during long-term treatment with acitretin. Dietary modifications, reduction in dose of acitretin, or drug therapy should be employed to control significant elevations of triglycerides, and if hypertriglyceridemia and low HDL levels persist, discontinuation of acitretin should be considered.
1 source
- "Product Information. Soriatane (acitretin)." Roche Laboratories (2001):
Intracranial Hypertension
MajorThe use of retinoids has been associated with cases of pseudotumor cerebri (benign intracranial hypertension). Early signs and symptoms include papilledema, headache, nausea and vomiting, and visual disturbances. Patients who experience symptoms of this disorder while on retinoid therapy should be referred to a neurologist. If the diagnosis is confirmed, the retinoid should be discontinued permanently.
2 sources
- "Product Information. Accutane (isotretinoin)." Roche Laboratories (2001):
- "Product Information. Soriatane (acitretin)." Roche Laboratories (2001):
Kidney Diseases
MajorThe use of acitretin has been associated with significant lower plasma concentrations in patients with end-stage renal failure. Therapy with acitretin is contraindicated in patients with severely impaired kidney function. It is recommended to monitor renal function as per clinical guidelines. Acitretin is not removed by hemodialysis.
1 source
- "Product Information. Soriatane (acitretin)." Roche Laboratories (2001):
Liver Diseases
MajorThe use of retinoids has been associated with elevations in liver enzymes and toxic hepatitis. Therapy with acitretin is contraindicated in patients with severely impaired liver function.
1 source
- "Product Information. Soriatane (acitretin)." Roche Laboratories (2001):
Mental Disorders
MajorThe use of retinoids, primarily isotretinoin, has been associated with causing depression, psychosis and rarely, suicidal ideation. Therapy with retinoids should be administered cautiously in patients with preexisting psychiatric conditions or depression. In addition to withdrawal of therapy, evaluation and follow-up may be necessary in affected patients.
2 sources
- "Product Information. Accutane (isotretinoin)." Roche Laboratories (2001):
- "Product Information. Soriatane (acitretin)." Roche Laboratories (2001):
Alcoholism
ModerateLike other retinoids, acitretin is a teratogen. The concurrent use of alcohol and acitretin has been associated with the formation of etretinate, a related retinoid drug with a considerably longer half-life (mean: 120 days vs. 49 hours). Alcohol should be avoided during acitretin therapy and for two months after completion of therapy in female patients of child-bearing age, since it may prolong the duration of teratogenic potential of the drug.
1 source
- "Product Information. Soriatane (acitretin)." Roche Laboratories (2001):
Diabetes Mellitus
ModerateThe use of acitretin may adversely affect blood sugar levels and result in problems with blood sugar control. In addition, new cases of diabetes have been diagnosed during retinoid therapy, including diabetic ketoacidosis. It is recommended to monitor blood sugar levels very closely in diabetic patients.
1 source
- "Product Information. Soriatane (acitretin)." Roche Laboratories (2001):
Toxic Optic Neuropathy
ModerateOphthalmologic manifestations have been reported with the use of acitretin. It is recommended that any patient treated with acitretin who is experiencing visual difficulties should discontinue the drug and undergo ophthalmologic evaluation.
1 source
- "Product Information. Soriatane (acitretin)." Roche Laboratories (2001):