Novatretin (Acitretin generic) - anyone else used it? My experience so far...

[jiml]

I think you have answered your own question that the lower dose has not worked in the past, what makes your dermatologist think it will work now.

As I said above: "In the last couple of years my rash had become a little nasty with spots and patches all over which I was managing with Daivonex and a low dose steroid for the scalp. I didn't have a flare-up but decided to get Acitretin from my derm who thought it was a good idea to try a lower dose regime."

It was my suggestion to my derm that since I wasn't involved in a flare-up that it might be worthwhile to try a lower dose to see if it would be as effective and which would soften the side effects of a higher dose. He thought it a good idea and indicated 20mg as appropriate.

Naturally I expected it to take longer to show results as it's almost half my usual starter dose. What's disconcerting is the renewed activity after the initial settling period and the eruption on my palms and soles. That said, I'm fairly philosophical about it knowing it was somewhat of an experiment. The positive outcome will be a better understanding of how starting on a low dose differs from starting high then going lower (35mg/25mg).

My current supply gives me 38 (from 90) remaining days at 20mg which I doubt is long enough to effect the clearance I was expecting. But if my derm suggests I continue to see what happens I'm open to that since unexpected things can happen. The drug may finally reach a critical point and really kick in. However I will be suggesting stepping up to 30mg for the next month.

The one great benefit of the lower dose is the low level of side effects. But there's no point to that if the outcome is a partial suppression at best. I'd rather experience the normal side effects (which aren't actually too bad) knowing it would be well worth it in the end.

Im reading this as a sufferer who has never used acetretin, but I know with my drug my body reacts badly if I reduce the dose to low
I'm assuming from what I've read from others who are on acetretin who have reduced their dose that the psoriasis comes back and increasing the dose stops the flare see this thread  Flare up on Acitretin it looks to me as if the body needs a certain level of the drug to block the disease, and then reduce the dose, rather than start low
It's just my opinion, your dermatologist will know for sure. I can understand wanting to minimise the side effects,