Etretinate (trade name Tegison) is a

medication A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy ( pharmacotherapy) is an important part of the medical field an ...

developed by

Hoffmann–La Roche F. Hoffmann-La Roche AG, commonly known as Roche, is a Swiss multinational healthcare company that operates worldwide under two divisions: Pharmaceuticals and Diagnostics. Its holding company, Roche Holding AG, has shares listed on the SIX ...

that was approved by the FDA in 1986 to treat severe psoriasis. It is a second-generation retinoid. It was subsequently removed from the

Canadian Canadians (french: Canadiens) are people identified with the country of Canada. This connection may be residential, legal, historical or cultural. For most Canadians, many (or all) of these connections exist and are collectively the source of ...

market in 1996 and the

United States The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 U.S. state, states, a Washington, D.C., federal district, five ma ...

market in 1998 due to the high risk of birth defects. It remains on the market in Japan as Tigason.

Pharmacology

Etretinate is a highly lipophilic,

aromatic In chemistry, aromaticity is a chemical property of cyclic (ring-shaped), ''typically'' planar (flat) molecular structures with pi bonds in resonance (those containing delocalized electrons) that gives increased stability compared to sat ...

retinoid. It is stored and released from

adipose tissue Adipose tissue, body fat, or simply fat is a loose connective tissue composed mostly of adipocytes. In addition to adipocytes, adipose tissue contains the stromal vascular fraction (SVF) of cells including preadipocytes, fibroblasts, vascular ...

, so its effects can continue long after dosage stops. It is detectable in the plasma for up to three years following therapy. Etretinate has a low therapeutic index and a long elimination half-life (''t''_1/2) of 120 days, which make dosing difficult. Etretinate has been replaced by

acitretin Acitretin (trade names Soriatane and Neotigason) is a second-generation retinoid. It is taken orally, and is typically used for psoriasis. Acitretin is an oral retinoid used in the treatment of severe resistant psoriasis. Because of the potenti ...

, the free acid (without the ethyl ester). While acitretin is less lipophilic and has a half-life of only 50 hours, it is partly metabolized to etretinate in the body, so that it is still a long-acting teratogen and pregnancy is prohibited for two years after therapy.

Precautions

*Etretinate is a teratogen, and may cause

birth defect A birth defect, also known as a congenital disorder, is an abnormal condition that is present at birth regardless of its cause. Birth defects may result in disabilities that may be physical, intellectual, or developmental. The disabilities c ...

s long after use. Therefore, birth control is advised during therapy, and for at least three years after therapy has stopped. *Etretinate should be avoided in children, as it may interfere with bone growth. *If a patient has ever taken etretinate, he or she is not eligible to donate blood in the United States, the United Kingdom, or Québec, due to the risk of birth defects. In Japan, people may not donate blood for two years after ceasing to use the medication.

Side effects

Side effects are those typical of hypervitaminosis A, most commonly * bone or joint pain, stiffness; in long-term treatment diffuse idiopathic skeletal hyperostosis * muscular or abdominal cramps * dry, burning, itching eyelids * unusual bruising

History

The drug was approved by the FDA in 1986 to treat severe psoriasis. It was subsequently removed from the

market in 1996 and the

market in 1998 due to the high risk of birth defects. for etretinate In Japan, the drug remains on market branded ''Tigason''.

References

{{Retinoid receptor modulators Retinoids Withdrawn drugs Ethyl esters Phenol ethers Polyenes

Pharmacology

Precautions

Side effects

History

See also

References