Some of the views expressed in the following
notes on newly approved products should be
regarded as preliminary, as there may have been
limited published data at the time of
publication, and little experience in Australia
of their safety or efficacy. However, the
Editorial Executive Committee believes that
comments made in good faith at an early stage
may still be of value. Before new drugs are
prescribed, the Committee believes it is
important that more detailed information is
obtained from the manufacturer's approved
product information, a drug information centre
or some other appropriate source.
Neotigason (Roche Products)
10 mg and 25
mg capsules
Indication: severe
psoriasis and keratinisation disorders
Acitretin is a metabolite of etretinate, an aromatic
retinoid used in the treatment of severe psoriasis
and keratinisation disorders. Vitamin A derivatives
such as etretinate are teratogenic and pregnancy
must be avoided. As the half life of etretinate is
approximately 120 days, women treated with the drug
are advised to avoid pregnancy for at least two
years after discontinuing therapy.
Acitretin, which has been approved for the same
indications as etretinate, has a life of only 54
hours. Therefore, theoretically, the risk period for
teratogenesis is reduced. However, studies have
discovered that the body can convert acitretin back
into etretinate. Although the concentrations of
etretinate generated during acitretin therapy are
likely to be less than those found inpatients taking
etretinate itself, the risk of teratogenesis
remains. Therefore, women prescribed acitretin must
also be advised to avoid pregnancy for two years
after stopping treatment.
It is not known if acitretin has any clinical
advantages over its parent compound. All the
precautions associated with etretinate, e.g.
monitoring of lipids and liver function, apply to
acitretin.
