Etretinate (trade name Tegison), acitretin (Soriatane), and isotretinoin (Accutane) are retinoids. Etretinate and acitretin are similar to isotretinoin, except that etretinate and acitretin are approved by the FDA only for use in the treatment of psoriasis, while isotretinoin is also approved by the FDA for use in treating acne. How oral retinoids work in the treatment of psoriasis is not completely understood, although they are thought to block the overproduction of skin cells. The substantial amount of data on the clinical effectiveness of these treatments, either alone or in combination with other therapies such as sunlight or etanarcept, makes them great options. (Sources: Seminars in Cutaneous Medicine and Surgery, September 2008, pages 197-206; British Journal of Dermatology, June 2008, pages 1345-1249; and European Journal of Dermatology, November-October 2000, pages 517-521.)
While none of these retinoids are to be used when a woman is pregnant, the risks associated with usage are considered serious and extremely problematic even for women who are not pregnant. All systemic retinoids have the strong potential to cause major fetal abnormalities, including neurological and skeletal deformities. For the patient, its use may potentially cause liver and cholesterol problems, which are just a few of the side effects. It is essential that effective contraception be used for at least one month before and throughout treatment. However, because etretinate can remain in the blood for up to three years after treatment, birth control must be continued for an indefinite period of time following therapy. It has not yet been determined how long it is necessary to wait before becoming pregnant after you stop taking etretinate to ensure that none of the drug remains in your system (Source: www. fda. gov/cber/bldmem/072893.txt). As a result of the risks associated with etretinate, particularly the length of time it can stay in the system, acitretin and isotretinoin are considered safer choices, and are just as effective for severe psoriasis (Source: Journal of the American Academy of Dermatology, November 2001, pages S150-S157).
Severe fetal abnormalities do occur if a woman is or becomes pregnant while taking either acitretin or isotretinoin (Accutane), but because these drugs don’t remain in the system for long after you are finished with treatment, no long waiting period is required before becoming pregnant. Specifics regarding how long to wait after treatment before considering having a baby should be discussed with your physician.