Alitretinoin
Toctino®
Blood count, liver values, kidney values, lipids, SS test, possibly thyroid values
p.o. with meal
30 mg (faster and better response), for NW: 10 mg
85 days
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
Pregnancy/breastfeeding (up to 1 month after stop), liver/kidney insufficiency, uncontrolled hyperlipidemia, uncontrolled hypothyroidism, combination with tetracycline (pseudotumor cerebri), hypervitaminosis A
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
12 weeks, with good response possibility to extend to at least 24 weeks, cycle repetition in case of relapse
Tbl.
systemic