Acitretin: Risks of Drug Residue and Sexual Activity - Pharmacology

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Psoriasis Acitretin Issues


Hello, I would like to ask if taking the psoriasis medication Acitretin can leave teratogenic drug residues in the body.
If there is intimate behavior such as oral sex, could the contact with prostatic fluid lead to my girlfriend indirectly ingesting the medication? Can blood tests detect any remaining residues?

yu, 20~29 year old female. Ask Date: 2019/08/07

Dr. Hong Kunyi reply Pharmacology


Hello, sir: The pregnancy category for this medication (Acitretin) is classified as Category X (both animal and human studies have shown that this drug has adverse effects on the embryo, and the benefits of this drug for pregnant women are very low; therefore, it is contraindicated for use in pregnant women or women who may become pregnant).
This medication is highly teratogenic, and its use is absolutely prohibited in pregnant women and women who may become pregnant unless effective contraception has been practiced for at least four weeks prior to treatment, and adequate contraceptive measures are taken during treatment and for two years after discontinuation.
Women who may become pregnant should not accept blood from patients currently taking this medication; therefore, patients undergoing treatment with this drug are prohibited from donating blood until one year after completing treatment.
As for intimate activities such as oral sex, there is no clinical evidence regarding the exposure to bodily fluids.
However, due to the drug's high lipophilicity, the manufacturer's insert suggests that a significant amount may be secreted into breast milk.
Thus, in a more conservative approach, if there is a possibility of pregnancy, it is advisable to avoid contact with related bodily fluids, even in trace amounts, and caution is recommended.
I hope this answers your question, and I wish you good health and well-being.

Reply Date: 2019/08/07

More Info


Acitretin is a systemic retinoid primarily used for the treatment of severe psoriasis and other skin disorders. It is known for its effectiveness in managing these conditions; however, it also carries significant risks, particularly regarding its teratogenic effects. This means that Acitretin can cause birth defects if a woman becomes pregnant while taking the medication or shortly after discontinuation.

One of the critical aspects of Acitretin is its long half-life and the potential for drug residue to remain in the body. Acitretin can persist in the body for an extended period, and it is recommended that women of childbearing age avoid becoming pregnant for at least three years after stopping the medication. This is due to the risk of teratogenic effects, which can occur even after the drug has been discontinued.

Regarding your question about intimate behavior, such as oral sex, it is important to note that while Acitretin is primarily excreted through urine and feces, there is limited data on its presence in seminal fluid or prostate secretions. However, the theoretical risk of transferring drug residues through sexual contact, such as through prostate fluid, is considered low. The amount of drug that might be present in such fluids is unlikely to be sufficient to cause any significant effects in a partner. Nonetheless, it is always prudent to discuss any concerns with a healthcare provider.

As for blood tests, while they can be used to monitor the levels of certain medications in the bloodstream, routine testing for Acitretin specifically is not commonly performed unless there is a clinical indication. If you are concerned about drug residues, discussing this with your healthcare provider may provide more personalized guidance. They can assess your situation and determine if any specific tests are warranted based on your medical history and current treatment plan.

In summary, while Acitretin does have a risk of teratogenic effects and can leave residues in the body, the likelihood of significant transfer through sexual activity is low. It is essential to adhere to the guidelines regarding pregnancy prevention while on this medication and for a period after discontinuation. If you have further concerns about the implications of Acitretin on your sexual health or potential drug interactions, consulting with a healthcare professional is advisable. They can provide tailored advice based on your specific circumstances and health needs.

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