Acitretin’s anti-proliferative effects have prompted research into its role for certain skin cancers, but robust clinical evidence is lacking. Its use for cancer prevention remains off-label and should only be considered within a specialist-led protocol.
Because acitretin’s metabolite etretinate remains in the body for up to 120 days, effective contraception is required for at least 3 years after the last dose.
UK-marketed Soriatane 10 mg tablets typically bear the imprint “S 10” on one side, with the other side plain or displaying the manufacturer’s logo.
Alcohol can increase the risk of liver enzyme elevations and lipid abnormalities while on acitretin. Limiting alcohol intake is advised to protect hepatic health.
A low-carbohydrate diet may help control acitretin-induced hypertriglyceridaemia, but any dietary changes should be discussed with a clinician to ensure overall nutritional adequacy.
Yes. Acitretin can heighten skin sensitivity to ultraviolet light. Patients should use broad-spectrum sunscreen (SPF 30 or higher) and wear protective clothing when outdoors.
Initial liver tests are performed before starting therapy, followed by repeat testing at 4-6 weeks, then every three months, or more frequently if abnormalities arise.
Acitretin can reduce the effectiveness of oral contraceptives by inducing hepatic enzymes. An additional non-hormonal barrier method (e.g., condoms) is recommended throughout treatment.
Co-administration is not routinely recommended due to limited safety data and an increased risk of hepatotoxicity. Combination therapy should only be pursued under specialist supervision.
Take the missed dose as soon as you remember, unless it is close to the time of your next scheduled dose-then skip the missed one and continue with your regular schedule. Do not double-dose.
Soriatane is a prescription-only oral medication marketed in the United Kingdom under the brand name Soriatane. The active ingredient is acitretin, a synthetic retinoid derived from vitamin A. Soriatane is supplied as a 10 mg pill and is regulated by the Medicines and Healthcare products Regulatory Agency (MHRA).
Acitretin belongs to the retinoid family, a group of compounds that influence cell growth and differentiation. Although its primary approved use is in severe psoriasis, it is sometimes considered in the supportive care of certain dermatologic cancers because of its anti-proliferative properties.
Acitretin binds to nuclear retinoic acid receptors (RAR) and retinoid X receptors (RXR). This interaction:
After oral ingestion, acitretin is well-absorbed (≈70 % bioavailability). It undergoes hepatic metabolism to its active metabolite, etretinate, which has a long half-life (up to 120 days). Because of this prolonged elimination, the drug remains detectable in the body for months after the last dose.
Approved indication (UK, MHRA):
Typical patient profile:
Note: Acitretin is not approved for oncology indications by the MHRA. Any use outside the approved psoriasis indication should be considered off-label and guided by a specialist.
Small observational studies and case series have reported clinical improvement in early-stage CTCL when acitretin is combined with phototherapy. Evidence is limited to low-level data (case reports, small cohorts).
Regulatory status: Not approved for CTCL. Disclaimer: Off-label use requires supervision by a dermatologist or oncologist, with careful monitoring for toxicity.
Absolute contraindications
Known hypersensitivity to acitretin or any excipients.
Pregnancy or planning to become pregnant (acitretin is highly teratogenic).
Severe uncontrolled hyperlipidaemia or hepatic impairment.
Existing severe renal disease requiring dialysis.
Relative contraindications
Mild to moderate liver enzyme elevation.
Uncontrolled diabetes mellitus.
Concurrent use of tetracycline antibiotics (increased risk of intracranial hypertension).
Patients over 65 years may need dose adjustment due to altered metabolism.
Special populations
Pregnancy/Lactation: Acitretin is contraindicated throughout pregnancy and for at least 3 years after the last dose because of its long-lasting metabolite. Effective contraception must be maintained.
Elderly: Start at the lower end of the dosing range and monitor renal and hepatic function closely.
Pediatric: Not recommended; safety and efficacy have not been established in children.
Management: Use moisturisers, hydrate lips frequently, and follow lipid-lowering strategies if labs rise.
Patients should provide a complete medication, supplement, and herbal product list to their healthcare provider before initiating Soriatane.
This article provides educational information about Soriatane and is not a substitute for professional medical advice. Treatment decisions, including use for unapproved indications, must be made under the guidance of a qualified healthcare provider. The content is intended for informational purposes and does not constitute medical recommendations. Always consult a physician before starting, stopping, or changing any medication regimen.
