This medication is used by adults to treat severe hand eczema that has not improved with other treatments (such as corticosteroids applied to the skin). Alitretinoin belongs to a class of drugs known as retinoids, which are related to vitamin A. It works by decreasing the production of certain substances that cause skin inflammation.

Read the Patient Information Leaflet if available from your pharmacist before you start taking alitretinoin and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth as directed by your doctor, usually once daily with a meal.

The dosage is based on your medical condition and response to treatment.

Take this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time each day.

Since this drug can be absorbed through the skin and lungs and may harm an unborn baby, women who are pregnant or who may become pregnant should not handle this medication or breathe the dust from the capsules.

Tell your doctor if your condition lasts or gets worse. It may take up to 2 months to notice improvement.

Headache, flushing, dry eyes, or dry lips/skin may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

To relieve dry eyes, you may use a lubricating eye ointment or tear replacement eye drops. Ask your pharmacist for details. If you wear contact lenses and get dry eyes, you may need to wear glasses while using this medication.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including:

• mental/mood changes (such as depression, anxiety, thoughts of suicide)
• back/joint/muscle pain

Stop taking alitretinoin and tell your doctor right away if you have any very serious side effects, including:

• headache that is severe or doesn't go away
• nausea/vomiting that doesn't stop
• abdominal pain
• bloody/severe diarrhea
• bleeding from the rectum
• vision changes (such as blurred/double vision, decreased vision)

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

• rash
• itching/swelling (especially of the face/tongue/throat)
• dizziness
• trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before taking alitretinoin, tell your doctor or pharmacist if you are allergic to it; or to vitamin A-related drugs (other retinoids such as isotretinoin); or if you have any other allergies. This product may contain inactive ingredients (such as soy), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of:

• diabetes
• high cholesterol/triglycerides
• high levels of vitamin A
• kidney disease
• liver disease
• mental/mood problems (such as depression)
• thyroid disease

Do not donate blood while taking this drug and for at least 1 month after stopping treatment. This will lessen the chance of your blood being given to a pregnant woman.

This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.

Alitretinoin may cause vision changes, including decreased night vision. Do not drive, use machinery, or do anything that needs clear vision (especially at night) until you are sure you can perform such activities safely.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

This drug must not be used during pregnancy. It may harm an unborn baby. Females must use two reliable forms of birth control for 1 month before starting alitretinoin, during use, and for at least 1 month after treatment has stopped. If you become pregnant or think you may be pregnant, tell your doctor right away. See also Warning section.

Since this drug can be absorbed through the skin and lungs and may harm an unborn baby, women who are pregnant or who may become pregnant should not handle this medication or breathe the dust from the capsules.

It is unknown if this medication passes into breast milk. However, similar drugs pass into breast milk. Breastfeeding is not recommended while using this medication. Consult your doctor before breastfeeding.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug include:

• tetracycline antibiotics
• vitamin A

Do not use "minipills" (non-estrogen-containing pills) for birth control because they may not work as well with this drug. Also, some drugs may cause hormonal birth control to work less well by decreasing the amount of birth control hormones in your body. Examples include griseofulvin, modafinil, rifamycins (such as rifampin, rifabutin), St. John's wort, among others. See also Warning section.

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call 1-800-222-1222. Canada residents can call 1-844-764-7669. Symptoms of overdose may include: severe headache, diarrhea, facial flushing.

Do not share this medication with others.

Lab and/or medical tests (such as pregnancy tests, cholesterol/triglyceride levels, liver function) must be done before you start taking this medication and while you are taking it. Keep all medical and lab appointments. Consult your doctor for more details.

If you miss a dose, take it as soon as you remember. If it is near the time of your next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.