Alitretinoin

Commercial name

Toctino®

Before therapy

Blood count, liver values, kidney values, lipids, SS test, possibly thyroid values

Administration

p.o. with meal

Dosage

30 mg (faster and better response), for NW: 10 mg

Median effect of action

85 days

Be careful

Hypothyroidism, hyperlipidemia, combination with MTX (increased hepatoxicity), combination with St. John's wort (interaction with hormonal contraceptives), combination with vitamin A or other retinoids (hypervitaminosis), possibly UV protection SPF 15, depression/suicidality, possibly worsening by alitretinoin. Avoid tetracyclines due to pseudotumor cerebri

Contraindications

Pregnancy/breastfeeding (up to 1 month after stop), liver/kidney insufficiency, uncontrolled hyperlipidemia, uncontrolled hypothyroidism, combination with tetracycline (pseudotumor cerebri), hypervitaminosis A

Anamnesis points, selected side effects and measures

dose-dependent NW -> dose reduction to 10 mg, headsz (21 %) -> analgesics, facial flushing, increased lipid levels -> lipid reducers, central hypothyroidism (T4 and TSH decreased), chelilitis/conjunctivitis -> refatting, artificial tears, no contact lenses

Duration of theraphy

12 weeks, with good response possibility to extend to at least 24 weeks, cycle repetition in case of relapse

Format

Tbl.

Application

systemic