Alitretinoin
Alitretinoin (known as Toctino) is an oral treatment for adults with severe hand eczema who have not responded to potent topical steroids. This treatment is a retinoid drug. This drug is not known to be helpful for treating other types of eczema.
How does Alitretinoin work
The active ingredient in alitretinoin, a type of chemical that is naturally found in the body and is known as a retinoid (as it is related to vitamin A). Alitretinoin works by helping to regulate the growth and activity of skin cells, and reducing inflammation., by dampening dowm response of immune system. This makes it useful for treating certain skin conditions, such as chronic hand eczema, by calming overactive immune responses in the skin and helping damaged skin heal more effectively. It is taken as a capsule that is taken by mouth once a day with a meal for 12-24 weeks, depending on how the condition responds to the treatment.
Who prescribes Alitretinoin?
Alitretinoin can only be prescribed by dermatologists or doctors with experience in managing severe hand eczema and retinoids. The specialist will determine whether your hand eczema is severe by examining your hands and asking questions about how the eczema affects your life. You will need to be carefully monitored.
What are the side effects?
The most common side effects are headaches, dry lips and skin, and flushing. Other side effects include raised blood fats such as cholesterol, and decreased levels of thyroid hormone. Due to potential side effects, a lower dose will be prescribed if you are diabetic.
FAQ's
Alitretinoin does not affect female fertility, but pregnancy must be avoided on the treatment.
Alitretinoin can is related to vitamin A and can cause serious harm to an unborn baby. People taking it are advised not to get pregnant (or get someone pregnant) during treatment and for a period after stopping the medicine, because it can cause birth defects. This means that anyone with childbearing potential must avoid becoming pregnant during treatment and for one month after stopping treatment – for example, by using two effective methods of contraception. The drug can only be prescribed if a pregnancy test is negative. Regular pregnancy tests will be taken during treatment.
There is no strong evidence that alitretinoin permanently affects male fertility, but men are usually advised to use contraception during treatment to avoid any risk to a baby.
You should not breastfeed while taking alitretinoin and for a month after completing treatment.
You should avoid alcohol while taking alitretinoin because it can harm your liver and raise blood fats.
Yes, Alitretinoin can be used with emollients and along side topical treatments ( topical steroids and topical calcineurin inhibitors). Some drugs can interact with alitretinoin, for example other retinoid drugs and medications that raise blood fats and liver levels.
Do not have live vaccines when taking alitretinoin, these include MMR, chickenpox, yellow fever, Oral polio vaccine, BCG (tuberculosis), some influenza vaccines in nasal form. Inactivated (killed) vaccines like the flu shot, COVID-19 vaccines, and tetanus vaccines are generally safe to take while on alitretinoin. Vaccination timing should be discussed with your healthcare professional - usually, live vaccines are avoided during treatment and for a short period after stopping alitretinoin.