For the Patient: Acitretin Other names: SORIATANE
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1 For the Patient: Acitretin Other names: SORIATANE Acitretin (A-si-TRE-tin) is a drug that is used to treat some types of cancer. It is a capsule that you take by mouth. Tell your doctor if you have ever had an unusual or allergic reaction to tretinoin (Alltrans retinoic acid, ATRA, VESANOID ) or isotretinoin (ACCUTANE, ISOTREX ), or vitamin A preparations before taking acitretin. Blood tests may be taken regularly during treatment. The dose of your chemotherapy may be changed based on the test results and/or other side effects. If you are a woman and are able to bear children, a blood test to determine whether you are pregnant will be taken before starting acitretin treatment, and then repeated every four weeks. Acitretin may harm the baby if used during pregnancy. Severe birth defects or death to the unborn baby may occur. Discuss birth control with your doctor before starting treatment. Two forms of reliable birth control must be used at the same time during treatment and for 2-3 years after your last dose of acitretin. Tell your doctor right away if you become pregnant. Do not breast feed during treatment. Men who are taking acitretin must use a condom every time they have sex with a female partner who is able to bear children. This is because it is not known if the drug is present in semen. Tell your doctor right away if your partner becomes pregnant. It is important to take acitretin exactly as directed by your doctor. Make sure you understand the directions. You may be given capsules of more than one strength to make the right dose. Take acitretin with food. If you miss a dose of acitretin, take it as soon as you can if it is within 12 hours of the missed dose. If it is more than 12 hours since your missed dose, skip the missed dose and go back to your usual dosing times. BC Cancer Agency Cancer Drug Manual Page 1 of 5 Acitretin
2 Other drugs such as methotrexate, phenytoin (DILANTIN ), tretinoin (All-trans retinoic acid, ATRA, VESANOID ), isotretinoin (ACCUTANE, ISOTREX ), tetracycline-like antibiotics, some birth control pills, and vitamin A preparations may interact with acitretin. Tell your doctor if you are taking these or any other drugs as you may need extra blood tests or your dose may need to be changed. Check with your doctor or pharmacist before you start or stop taking any other drugs. For women of childbearing potential: Do not drink of alcohol while you are taking acitretin and for 2 months after your last dose of acitretin. For men: Avoid or limit alcohol consumption while you are taking acitretin and for 2 months after your last dose of acitretin. Discuss the safety of drinking alcohol while taking acitretin with your doctor. Do not donate blood while you are taking acitretin and for 2-3 years after your last dose of acitretin. Store acitretin capsules out of the reach of children, at room temperature, away from heat, light, and moisture. Tell doctors, dentists, and other health professionals that you are being treated with acitretin before you receive any treatment from them. Side effects are listed in the following table in the order in which they may occur. Tips to help manage the side effects are included. Nausea does not usually occur with acitretin. Dry skin and skin rashes may commonly occur. The palms of your hands and soles of your feet may peel, become dry, or itch. Dry lips, eyes, and mouth may commonly occur. If you wear contact lenses you may find them uncomfortable. Sugar control may sometimes be affected in diabetics. Apply a moisturiser to dry skin several times a day. If dryness, peeling, or itching is very irritating, call your doctor. Otherwise, be sure to mention it at your next visit. Use lip balm for dry lips several times a day. Try lemon drops, sugarless gum, ice chips, or artificial saliva for dry mouth. Use moisturizing eye drops for dry eyes. If you are diabetic, check your blood sugar regularly BC Cancer Agency Cancer Drug Manual Page 2 of 5 Acitretin
3 Your skin may sunburn more easily than usual. Minor bleeding, such as nosebleeds, may sometimes occur. Headache and/or muscle or joint pain may sometimes occur. Hair loss is common and may begin within a few days or weeks of treatment. Your hair may thin or you may lose it completely. Your scalp may feel tender. Hair loss may occur on your face and body. Hair will grow back once you stop treatment with acitretin. Colour and texture may change. Refer to Your Medication Sun Sensitivity and Sunscreens* or the BC Health Guide for more information. After sun exposure, if you have a severe sunburn or skin reaction such as itching, rash, or swelling, contact your doctor. Sit up straight and tip your head slightly forward. Tilting your head back may cause blood to run down your throat. Pinch your nostrils shut between your thumb and forefinger or apply firm pressure against the bleeding nostril for 10 full minutes. After 10 minutes, check to see if your nose is still bleeding. If it is, hold it for 10 more minutes. Stay quiet for a few hours and do not blow your nose for at least 12 hours after the bleeding has stopped. Get emergency help if a nosebleed lasts longer than 20 minutes. Take acetaminophen (e.g., TYLENOL ) every 4-6 hours if needed, to a maximum of 4 g (4000 mg) per day. Severe headache that is not controlled with acetaminophen or headache, which occurs together with nausea and vomiting or changes in eyesight, should be reported to your doctor immediately. Refer to For the Patient: Hair loss due to chemotherapy.* You may also want to: Apply mineral oil to your scalp to reduce itching. If you lose your eyelashes and eyebrows, protect your eyes from dust and grit with a broad-rimmed hat and glasses. BC Cancer Agency Cancer Drug Manual Page 3 of 5 Acitretin
4 Increase in cholesterol may sometimes Discuss this with your doctor if you have: occur. A history of heart disease. High blood pressure. High cholesterol. You may need to have your cholesterol level checked a few months after starting acitretin. *Please ask your chemotherapy nurse or pharmacist for a copy. STOP TAKING ACITRETIN AND SEE YOUR DOCTOR OR GET EMERGENCY HELP IMMEDIATELY IF YOU HAVE: Severe headache that is not controlled with acetaminophen or headache which occurs together with nausea and vomiting or changes in eyesight. Nosebleeds lasting more than 20 minutes. SEE YOUR DOCTOR AS SOON AS POSSIBLE (DURING OFFICE HOURS) IF YOU HAVE: Unprotected sex or forget to use birth control during treatment and for 2-3 years after your last dose of acitretin. Painful redness, peeling, tingling, numbness, swelling or blistering of the palms of your hands, the bottoms of your feet, and/or other parts of your body. Signs of liver problems such as yellow eyes or skin, white or clay-coloured stools. Signs of kidney problems such as lower back or side pain, swelling of feet or lower legs. Changes in eyesight that are not occurring with a headache. Signs of gout such as joint pain. Ringing in your ears or hearing problems. Signs of bladder problems such as changes in urination, painful burning sensation, presence of blood, or abdominal pain. For diabetics: uncontrolled blood sugars. CHECK WITH YOUR DOCTOR IF ANY OF THE FOLLOWING CONTINUE OR BOTHER YOU: Uncontrolled nausea, vomiting, chills, fatigue, or weight gain, or loss. Headache or pain not controlled with acetaminophen (e.g., TYLENOL ). Painless redness, peeling, tingling, numbness, swelling or blistering of the palms of your hands, bottoms of your feet and/or other parts of the body. Skin rash or itching. Dry skin, mouth, lips, eyes, or nose. Trouble sleeping. BC Cancer Agency Cancer Drug Manual Page 4 of 5 Acitretin
5 Taste alterations. Swelling of feet or lower legs. Easy bruising or minor bleeding. Sensitivity to touch or pain. Stuffy or runny nose. Brittle nails. Tiredness and lack of energy. Nervousness or mood changes that are not usual for you. For men: impotence (loss of sexual ability). REPORT ADDITIONAL PROBLEMS TO YOUR DOCTOR BC Cancer Agency Cancer Drug Manual Page 5 of 5 Acitretin
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