Any generic for Neotigason (Acitretin) for Psoriasis

[giddyup]

My partner was prescribed Neotigason for her persistent psoriasis by Bkk/Pattaya hospital. She was only given 10 tablets at around 60 baht a tablet and it seemed to have some positive results. However the psoriasis has returned and she needs to try the same medication again, but according to our local pharmacist it may only be available from the hospital as she has phoned around and no other pharmacy, including Fascino seems to stock it. Is there something generic or similar that she can try instead?

[oncearugge]

I doubt this medication will be found anywhere other than hospital pharmacies.

Neotigason should be only taken if prescribed by a doctor familiar with its use and side effects.

As far as I know there are no generic versions of this medication nor are there any "alternatives"

I hope your wife was warned to avoid pregnancy for three years after taking Neotigason.

[giddyup]

I doubt this medication will be found anywhere other than hospital pharmacies.

Neotigason should be only taken if prescribed by a doctor familiar with its use and side effects.

As far as I know there are no generic versions of this medication nor are there any "alternatives"

I hope your wife was warned to avoid pregnancy for three years after taking Neotigason.

Pregnancy is not an issue but she wasn't told about drinking while taking the medication. Not that she's a heavy drinker, but she might enjoy one beer or a glass of red once a day, and apparently that's a no-no.

[oncearugge]

I doubt this medication will be found anywhere other than hospital pharmacies.

Neotigason should be only taken if prescribed by a doctor familiar with its use and side effects.

As far as I know there are no generic versions of this medication nor are there any "alternatives"

I hope your wife was warned to avoid pregnancy for three years after taking Neotigason.

Pregnancy is not an issue but she wasn't told about drinking while taking the medication. Not that she's a heavy drinker, but she might enjoy one beer or a glass of red once a day, and apparently that's a no-no.

Full patient information in the link

http://www.drugs.com/uk/neotigason-capsules-10mg-leaflet.html

[simple1]

A number of years ago I was proscribed Sulfasalzine for psoriasis arthritis and since that time, I take it every day, have never had a recurrence of skin based psoriasis. You can obtain in Pattaya, but must check with a specialist if suitable for your partner. I found the best price was from Fascino. In the meantime if your partner also has psoriasis in the scalp coal tar based shampoo is excellent e.g. obtainable in Pattaya Polytar liquid

[Sheryl]

No generic and not available OTC

[oncearugge]

A number of years ago I was proscribed Sulfasalzine for psoriasis arthritis and since that time, I take it every day, have never had a recurrence of skin based psoriasis. You can obtain in Pattaya, but must check with a specialist if suitable for your partner. I found the best price was from Fascino. In the meantime if your partner also has psoriasis in the scalp coal tar based shampoo is excellent e.g. obtainable in Pattaya Polytar liquid

Sulfasalazine is used to treat psoriatic arthritis!

The drug has a number of side effects and should never be self prescribed .

[simple1]

A number of years ago I was proscribed Sulfasalzine for psoriasis arthritis and since that time, I take it every day, have never had a recurrence of skin based psoriasis. You can obtain in Pattaya, but must check with a specialist if suitable for your partner. I found the best price was from Fascino. In the meantime if your partner also has psoriasis in the scalp coal tar based shampoo is excellent e.g. obtainable in Pattaya Polytar liquid

Sulfasalazine is used to treat psoriatic arthritis!

The drug has a number of side effects and should never be self prescribed .

exactly what I posted, but at least for me, completely stopped skin based psoriasis

[oncearugge]

A number of years ago I was proscribed Sulfasalzine for psoriasis arthritis and since that time, I take it every day, have never had a recurrence of skin based psoriasis. You can obtain in Pattaya, but must check with a specialist if suitable for your partner. I found the best price was from Fascino. In the meantime if your partner also has psoriasis in the scalp coal tar based shampoo is excellent e.g. obtainable in Pattaya Polytar liquid

Sulfasalazine is used to treat psoriatic arthritis!

The drug has a number of side effects and should never be self prescribed .

exactly what I posted, but at least for me, completely stopped skin based psoriasis

Not exactly what you posted but I will not quibble about spelling or the non use of the word "psoriatic"

I also believe you made no mention of side effects.

Pleased the treatment improved your skin.

[Sheryl]

While this does have to be obtained at a hospital, BPH in my experience is probably the most expensive hospital in Thailand. So unless she specifically wants a doctor there, another hospital might be better. Especially since people on this medication need periodic tests of liver function.

If she ever gets up to Bangkok, I can recommend Dr. Parichart at St Louis Hospital there.

[giddyup]

Thanks for all the responses.

[BB24]

I have been prescribed Neotigason here in Thailand and been using it for several months - it has worked brilliantly - much better than anything previous prescribed or tried over many years. I also had the same problem with costs (bought at Private Hospital) and we searched everywhere for alternative or cheaper - including internet medical specialist sites (MIMs etc.) and contacts back home. There is no generic and there is no alternative medication that does the same job - and 60baht a tablet was about as good a price as I could find. Because of the nature of the medication (very serious) it can only be supplied through a Hospital in Thailand - I tried every Pharmacy chain/store for miles - several tried to order it for me from the supplier but they were rejected. I now buy it from a local Thai Public Hospital for 58 baht a tablet (I was paying over 90 baht).

Not sure the dosage your wife tried or the symptons etc. and I am certainly not going to recommend anything on a forum (and hope you would never accept anything on a forum without checking with an expert), but as others have said, this stuff is VERY serious. She must have a blood test after 4-6 weeks (read liver cancer), and she must avoid expsoure to the sun (read skin cancer), and there will be complications and downsides - there is a list of them and it varies from person to person. This website is very informative - https://www.medicines.org.uk/emc/medicine/21212.

I am not aware of this medication being prescribed just for a week or so (10 tablets) - but if it worked then she should go back and talk to a Dermatologist. If she did not before, then she really should see a Dermatologist specialist and discuss everything - and be made aware of the complications she may experience. As someone said on this forum - for 2-3 years after stopping taking them she MUST not become pregnant - AND she should not donate blood for at least 2 years too. AND several types of antibiotics commonly prescribed can be extremely toxic when taking Neotigason. And there are other contradictions and complications - I suggest she read the information on the website in detail and talk to a skin specialist before taking it again - but if it is recomended than I can say that it worked for me.

[giddyup]

BB24 Thanks for all the info, but how long must you continue to take this medication once symptoms disappear? Considering all the rather nasty side effects on would wonder if the cure is worse than the disease.

[oncearugge]

BB24 Thanks for all the info, but how long must you continue to take this medication once symptoms disappear? Considering all the rather nasty side effects on would wonder if the cure is worse than the disease.

The manufacturer recommends that this medication is not used continuously for longer than six months.

A specialist may, in some circumstances, advise the treatment continued for a longer period.

It is important that periodic Specialist review is undertaken regularly whilst taking the medication.

[BB24]

BB24 Thanks for all the info, but how long must you continue to take this medication once symptoms disappear? Considering all the rather nasty side effects on would wonder if the cure is worse than the disease.

Hi giddyup - as oncearugge says it is normal for 4-6 months - after that it is only given after blood tests are done and the person has 'passed' (and needs more treatment). However, it is not uncommon for people to take Retinoid medications for a year or two - especially those requireing treatment for severe acne. Neotigason is a 2nd generation Retinoid and with these types of medications it is all about the person's body/systems response (positives and negatives) and the dosage being prescribed. https://en.wikipedia.org/wiki/Retinoid https://en.wikipedia.org/wiki/Acitretin I started on a single 20mg dosage and found the side affects a problem (eyesight and headaches) so after about 3-4 weeks I was switched to 10mg twice a day. The normal dosage is 20-30mg a day - up to a maximum of 75mg. After about 4-6 months treatment the normal thing (after blood tests) is to reduce the dosage and monitor the outcomes - symptoms and skin problem. If the conditioon re-emerges, then it can be a lot of things from another 3-6 months of treatment, to another treatment/medication, including UV Therapy. The number one most important main thing is to find a skin specialist that is experienced in diagnosing skin problems and treating patients with Retinoids - this is NOT a drug anyone should take without constant ongoing monitoring by a specialist (and regular blood tests).

Check these sites out for info: https://www.psoriasis-association.org.uk/pages/view/about-psoriasis/treatments/systemic-medication https://www.psoriasis-association.org.uk/pages/view/about-psoriasis/treatments/ultraviolet-light-therapy http://www.australianprescriber.com/magazine/32/1/14/8

By the way, Neotigason is not a medication that you should ever stop taking suddenly as this can cause severe reactions - it worries me you were given 10 and sent away. If she ever takes the medication again you must not just stop it - Retinoids are a systemic drug - they affect everything and all organs/systmes in the body have to adjust to it (and some people's cannot). As you can probably tell, I have had skin problems for many years - previously I avoided using such strong medications as Retinoids as I knew the potential downsides (and liked to drink). But as I am now retired, and staying in a hot climate which made previous management techniques fail, I decided 'why not' - very glad I did (after 2 months taking). But I sure miss the beers and wine - and yes she must not drink alcohol when taking it as it can create a toxic reaction (take it from me who just had to try a few beers once).

Perhaps best to take this 'off line' - if you want further advice/info (got lots) - send me a message.

[giddyup]

BB24 Appreciate all your helpful advice and have passed it on to my partner, who feels at this stage she'd rather discontinue the medication because of the potential dangerous side effects. Her rash comes and goes, the most irritating (and itchy) is on her hands where cracking can occur at the fingertips. Unless her condition gets much worse she would rather tolerate the discomfort than risk liver damage etc. The doctor at Bkk/Pattaya hospital wanted to see her after the 10 days days of using the drug to monitor her condition, but I just think she's had a bit of a gutful of all the different treatment and medication she's been prescribed.