Health Boards
Wed-04-11-2015, 08:07 AM
Chronic Plaque Psoriasis sufferer for 45 years who's having an interesting experience with Novatretin, the Canadian-sourced generic form of Acitretin. I'm in New Zealand.
Acitretin (as NeoTigason) has been my go-to miracle drug for flare-ups. I've taken it 8 times previously (over 30 years) at a dosage of 35mg/6 weeks then 25mg/6 weeks then discontinued. Results have always been fantastic: significant thinning and fading all over by end of week four or five, then complete fading by weeks 8-10. Often I've stopped taking it with a couple of weeks to go since clearance has been so good. Rash slowly returns over next year but is usually well-behaved only requiring topicals for the next few years until the next flare-up.
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.
Neotigason is no longer funded so Novatretin was substituted. I began 20mg/day on Aug 12. I anticipated a slower improvement and indeed it took about 2-3 weeks before I noticed any fading which was only on some areas of my body. But by week 6 I noticed some new spotting and some increased activity in the patches that had started to fade. I particularly noticed heat and activity on my palms and especially soles which had been wonderfully clear for the last 2 years.
So now at week 7 the rash is about the same as it was when I started, perhaps worse if I add in my soles. It's disturbing to me that after a mild initial improvement things have returned to their original state.
I've got a couple of theories:
- the lower dose is enough to provide some initial improvement but also just enough to be antagonistic resulting in an overall unsatisfactory result and worsening in some areas
- the generic is simply not as good as NeoTigason
I've just had my second round of blood tests so I intend contacting my derm with my experience and concerns. I will suggest increasing the dosage to 30mg and see what he thinks.
Other side effects are hardly noticeable with a little dryness and increased sun sensitivity. But this is very mild compared to what happens at my normal dose of 35mg.
I'm wondering if anyone else has had experience with generics when they've previously had excellent and consistent results with the regular brand.
Now I understand that some folks experience flare ups or worsening before improvement but since my long term experience has been quite different it seems very strange to me that this time my reaction is so distressingly different. By now, every time without fail, my rash has been radically reduced and almost cleared, and that's after a major flare-up.
Any thoughts welcome.
Acitretin (as NeoTigason) has been my go-to miracle drug for flare-ups. I've taken it 8 times previously (over 30 years) at a dosage of 35mg/6 weeks then 25mg/6 weeks then discontinued. Results have always been fantastic: significant thinning and fading all over by end of week four or five, then complete fading by weeks 8-10. Often I've stopped taking it with a couple of weeks to go since clearance has been so good. Rash slowly returns over next year but is usually well-behaved only requiring topicals for the next few years until the next flare-up.
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.
Neotigason is no longer funded so Novatretin was substituted. I began 20mg/day on Aug 12. I anticipated a slower improvement and indeed it took about 2-3 weeks before I noticed any fading which was only on some areas of my body. But by week 6 I noticed some new spotting and some increased activity in the patches that had started to fade. I particularly noticed heat and activity on my palms and especially soles which had been wonderfully clear for the last 2 years.
So now at week 7 the rash is about the same as it was when I started, perhaps worse if I add in my soles. It's disturbing to me that after a mild initial improvement things have returned to their original state.
I've got a couple of theories:
- the lower dose is enough to provide some initial improvement but also just enough to be antagonistic resulting in an overall unsatisfactory result and worsening in some areas
- the generic is simply not as good as NeoTigason
I've just had my second round of blood tests so I intend contacting my derm with my experience and concerns. I will suggest increasing the dosage to 30mg and see what he thinks.
Other side effects are hardly noticeable with a little dryness and increased sun sensitivity. But this is very mild compared to what happens at my normal dose of 35mg.
I'm wondering if anyone else has had experience with generics when they've previously had excellent and consistent results with the regular brand.
Now I understand that some folks experience flare ups or worsening before improvement but since my long term experience has been quite different it seems very strange to me that this time my reaction is so distressingly different. By now, every time without fail, my rash has been radically reduced and almost cleared, and that's after a major flare-up.
Any thoughts welcome.