Neotigason Dosage/Direction for Use

Because there are differences in the absorption and rate of metabolism of acitretin, the dosage must be individually adjusted. The capsules should preferably be taken once daily with a meal, or with milk. The following will serve as guidelines.
Adults: The initial daily dosage, 25mg (i.e. 1 capsule 25mg) or 30mg (i.e. 3 capsules 10mg) for about 2-4 weeks may give satisfactory therapeutic results.
The maintenance dose must be based on clinical efficacy and tolerability. In general, a daily dosage of 25-50mg taken for a further 6-8 weeks achieves optimal therapeutic results.
It may be necessary in some cases to increase the dose up to a maximum of 75mg/day (i.e. 3 capsules 25mg).
In patients with Darier's disease starting dose of 10mg may be appropriate. The dose should be increased cautiously as isomorphic reactions may occur.
Therapy can be terminated in patients with psoriasis whose lesions have resolved sufficiently. Relapses should be treated as described previously.
Patients with severe congenital ichthyosis and severe Darier's disease may require therapy beyond 3 months. The lowest effective dosage, not exceeding 50mg/day should be given.
Continuous use beyond 6 months is contraindicated as only limited clinical data are available on patients treated beyond this length of time.
Elderly: Dosage recommendations are the same as for other adults.
Children: In view of possible severe side effects associated with long-term treatment, the risk should be carefully weighed against the therapeutic benefit. Acitretin should be used only when all alternative therapies have proved inadequate.
The dosage should be established according to bodyweight. The daily dosage is about 0.5mg/kg.
Higher doses (up to 1mg/kg daily) may be necessary in some cases for limited periods, but only up to a maximum of 35mg/day. The maintenance dose should be kept as low as possible in view of possible long-term side effects.
Combination treatment: Other dermatological therapy, particularly with keratolytics, should normally be stopped before administration of Neotigason. However, the use of topical corticosteroids or bland emollient ointment may be continued if indicated.
When Neotigason is used in combination with other types of therapy, it may be possible depending on the individual patient's response, to reduce the dosage of Neotigason.