{"id":50472,"date":"2023-09-20T09:09:26","date_gmt":"2023-09-20T09:09:26","guid":{"rendered":"https:\/\/medsname.com\/acrotac\/"},"modified":"2026-05-01T10:49:10","modified_gmt":"2026-05-01T10:49:10","slug":"acrotac","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/acrotac\/","title":{"rendered":"Acrotac"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:18px 22px;margin:0 0 24px 0;border-radius:4px;\">\n<h3 class=\"wp-block-heading\" style=\"margin:0 0 8px 0;font-size:16px;font-weight:700;\">\u26a1 Rychl\u00e1 odpov\u011b\u010f \u2014 Co je Acrotac?<\/h3>\n<p style=\"margin:0;\"><strong>Acrotac<\/strong> obsahuje <strong>acitretin 10 \/ 25 mg<\/strong> \u2014 druh\u00fd generace retinoid (analog vitaminu-A) od Torrent Pharmaceuticals, pou\u017e\u00edv\u00e1n pro syst\u00e9movou l\u00e9\u010dbu <strong>z\u00e1va\u017en\u00fdch forem psori\u00e1zy (chronick\u00fd plak, erytrodermick\u00fd, generalizovan\u00fd pustul\u00e1rn\u00ed, palmoplant\u00e1rn\u00ed pustul\u00e1rn\u00ed)<\/strong>, z\u00e1va\u017en\u00fdch poruch keratinizace (<strong>Darierova choroba<\/strong>vrozen\u00e9 ichthy\u00f3zy. <strong>Standardn\u00ed d\u00e1vka: 25-50 mg jednou denn\u011b s hlavn\u00edm j\u00eddlem dne po dobu 3-6 m\u011bs\u00edc\u016f<\/strong>; dlouhodob\u00e1 udr\u017eovac\u00ed l\u00e9\u010dba 25-50 mg\/den nebo obdenn\u00ed d\u00e1vkov\u00e1n\u00ed se n\u011bkdy pou\u017e\u00edv\u00e1. <strong>KRITICK\u00c9: Acitretin je FDA t\u011bhotensk\u00e1 kategorie X \u2014 teratogenn\u00ed po T\u0158I ROKY po vysazen\u00ed<\/strong> (rekonverze esteru etretin\u00e1tu v tukov\u00e9 tk\u00e1ni). \u017deny v reproduk\u010dn\u00edm v\u011bku mus\u00ed pou\u017e\u00edvat dv\u011b spolehliv\u00e9 metody antikoncepce za\u010d\u00ednaj\u00edc\u00ed 1 m\u011bs\u00edc p\u0159ed l\u00e9\u010dbou, po celou dobu l\u00e9\u010dby a <strong>po dobu 3 let po vysazen\u00ed<\/strong>. <strong>\u017d\u00e1dn\u00fd alkohol b\u011bhem l\u00e9\u010dby A po dobu 2 m\u011bs\u00edc\u016f po vysazen\u00ed<\/strong> (alkohol podporuje rekonverzi na etretin\u00e1t). \u010cast\u00e9 vedlej\u0161\u00ed \u00fa\u010dinky: cheilitida (popraskan\u00e9 rty), such\u00e1 k\u016f\u017ee a sliznice, \u0159\u00eddnut\u00ed vlas\u016f, p\u0159echodn\u00e9 zv\u00fd\u0161en\u00ed jatern\u00edch test\u016f a triglycerid\u016f. Vy\u017eadov\u00e1ny vstupn\u00ed a m\u011bs\u00ed\u010dn\u00ed jatern\u00ed a lipidov\u00e9 testy po celou dobu l\u00e9\u010dby.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f4f8fb;border:1px solid #d8e3eb;padding:12px 16px;margin:16px 0;border-radius:4px;font-size:14px;\">\n<strong>Co z\u00edsk\u00e1te s MedsBase:<\/strong> V\u00fdrobce certifikovan\u00fd WHO-GMP \u00b7 Diskr\u00e9tn\u00ed balen\u00ed \u00b7 Celosv\u011btov\u00e1 doprava \u00b7 V\u00edce ne\u017e 1 400 ov\u011b\u0159en\u00fdch <a href=\"https:\/\/medsbase.com\/cs\/reviews\/\">recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\"><strong>Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n<h3>Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n<p>Na\u0161e generick\u00e9 l\u00e9ky poch\u00e1zej\u00ed od v\u00fdrobc\u016f certifikovan\u00fdch WHO-GMP a jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm, nen\u00e1padn\u00e9m balen\u00ed \u2013 na vn\u011bj\u0161\u00ed stran\u011b bal\u00edku nen\u00ed uveden n\u00e1zev l\u00e9ku. Platby kartou jsou sm\u011brov\u00e1ny prost\u0159ednictv\u00edm regulovan\u00e9ho procesoru (popisky na v\u00fdpisu zahrnuj\u00ed regulovan\u00e9ho procesora plateb kartou \u2013 nikdy \u201cMedsBase\u201d nebo n\u00e1zev l\u00e9ku). P\u0159ij\u00edm\u00e1me tak\u00e9 kryptom\u011bny a bankovn\u00ed p\u0159evody SEPA. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed politikou p\u0159eposl\u00e1n\u00ed.<\/p>\n<h2 class=\"wp-block-heading\">Co je Acrotac?<\/h2>\n<p>Acrotac je peror\u00e1ln\u00ed p\u0159\u00edpravek ve form\u011b <strong>acitretin 10 \/ 25 mg<\/strong> tobolek vyr\u00e1b\u011bn\u00fdch spole\u010dnost\u00ed Torrent Pharmaceuticals, dod\u00e1van\u00fdch v balen\u00edch po 10 \/ 30 \/ 60 \/ 90 tobolk\u00e1ch. Acitretin je aktivn\u00ed metabolit etretin\u00e1tu (p\u016fvodn\u00ed retinoid druh\u00e9 generace, sta\u017een\u00fd z trhu kv\u016fli jeho extr\u00e9mn\u011b dlouh\u00e9mu polo\u010dasu). Mezin\u00e1rodn\u011b zna\u010den jako <strong>Soriatane (USA, Stiefel\/GSK)<\/strong> a <strong>Neotigason (UK\/EU, Roche)<\/strong>.<\/p>\n<p>Acitretin je vyhrazen pro <strong>t\u011b\u017ek\u00e9<\/strong> psori\u00e1zu a poruchy keratinizace, kter\u00e9 nereagovaly dostate\u010dn\u011b na lok\u00e1ln\u00ed terapii (kortikosteroidy, analogy vitaminu D, tazaroten), fototerapii (NB-UVB, PUVA), nebo u pacient\u016f, kde jsou tyto metody kontraindikov\u00e1ny nebo nepraktick\u00e9. Je to jedna z m\u00e1la syst\u00e9mov\u00fdch mo\u017enost\u00ed pro t\u011b\u017ekou psori\u00e1zu, kter\u00e1 nen\u00ed imunosupresivn\u00ed \u2014 co\u017e ji \u010din\u00ed vhodnou pro pacienty, u kter\u00fdch jsou biologika nebo methotrex\u00e1t kontraindikov\u00e1ny.<\/p>\n<h2 class=\"wp-block-heading\">Jak funguje Acitretin?<\/h2>\n<p>Acitretin je <strong>syst\u00e9mov\u00fd retinoid druh\u00e9 generace<\/strong>. Mechanismus \u00fa\u010dinku:<\/p>\n<ul>\n<li>V\u00e1\u017ee se na jadern\u00e9 receptory kyseliny retinov\u00e9 (RAR-\u03b1, -\u03b2, -\u03b3) a retinoidov\u00e9 X receptory (RXR), \u010d\u00edm\u017e moduluje transkripci gen\u016f kontroluj\u00edc\u00edch proliferaci a diferenciaci epiderm\u00e1ln\u00edch bun\u011bk.<\/li>\n<li>Normalizuje hyperproliferativn\u00ed keratinizaci u psoriatick\u00fdch plak\u016f a poruch rohov\u011bn\u00ed, \u010d\u00edm\u017e sni\u017euje \u0161upinat\u011bn\u00ed, tlou\u0161\u0165ku plak\u016f a eryt\u00e9m.<\/li>\n<li>Protiz\u00e1n\u011btliv\u00fd \u00fa\u010dinek d\u00edky redukci neutrofiln\u00ed infiltrace epidermis (relevantn\u00ed pro pustul\u00f3zn\u00ed formy psori\u00e1zy).<\/li>\n<li>Inhibuje angiogenezi v psoriatick\u00e9 k\u016f\u017ei.<\/li>\n<\/ul>\n<p>Kl\u00ed\u010dov\u00fdm farmakologick\u00fdm rysem Acitretinu je jeho <strong>esterifikace zp\u011bt na etretin\u00e1t<\/strong> v p\u0159\u00edtomnosti alkoholu. Etretin\u00e1t m\u00e1 velmi dlouh\u00fd polo\u010das (~120 dn\u00ed), kumuluje se v tukov\u00e9 tk\u00e1ni a z\u016fst\u00e1v\u00e1 detekovateln\u00fd v s\u00e9ru 1-3 roky po pod\u00e1n\u00ed \u2014 proto je u Acitretinu po\u017eadavek na antikoncepci a\u017e 3 roky po ukon\u010den\u00ed l\u00e9\u010dby.<\/p>\n<p>Viditeln\u00e9 zlep\u0161en\u00ed psori\u00e1zy se obvykle objevuje za 4-8 t\u00fddn\u016f; pln\u00fd \u00fa\u010dinek nast\u00e1v\u00e1 po 12-16 t\u00fddnech pravideln\u00e9ho u\u017e\u00edv\u00e1n\u00ed.<\/p>\n<h2 class=\"wp-block-heading\">Schv\u00e1len\u00e9 indikace<\/h2>\n<ul>\n<li><strong>T\u011b\u017ek\u00e1 chronick\u00e1 lo\u017eiskov\u00e1 psori\u00e1za<\/strong> neodpov\u00eddaj\u00edc\u00ed na lok\u00e1ln\u00ed l\u00e9\u010dbu nebo fototerapii \u2014 zejm\u00e9na siln\u00e9, \u0161upinat\u00e9 plaky<\/li>\n<li><strong>Erytrodermick\u00e1 psori\u00e1za<\/strong> \u2014 psori\u00e1za postihuj\u00edc\u00ed &gt;90% t\u011blesn\u00e9ho povrchu<\/li>\n<li><strong>Generalizovan\u00e1 pustul\u00e1rn\u00ed psori\u00e1za<\/strong> (von Zumbusch typ) \u2014 forma l\u00e9ka\u0159sk\u00e9 pohotovosti; acitretin je prvn\u00ed volbou syst\u00e9mov\u00e9 l\u00e9\u010dby<\/li>\n<li><strong>Palmoplant\u00e1rn\u00ed pustul\u00e1rn\u00ed psori\u00e1za<\/strong><\/li>\n<li><strong>Darierova choroba (kerat\u00f3za folikul\u00e1rn\u00ed) \u2014 vz\u00e1cn\u00e1 forma; acitretin je prvn\u00ed volbou syst\u00e9mov\u00e9 l\u00e9\u010dby<\/strong><\/li>\n<li><strong>Vrozen\u00e9 ichty\u00f3zy<\/strong> \u2014 lamel\u00e1rn\u00ed ichty\u00f3za, X-v\u00e1zan\u00e1 ichty\u00f3za, harlek\u00fdnsk\u00e1 ichty\u00f3za<\/li>\n<li><strong>Lichen planus<\/strong><\/li>\n<li><strong>\u2014 lichen planus, kerat\u00f3za folikul\u00e1rn\u00ed<\/strong> \u2014 druh\u00e1 volba po lok\u00e1ln\u00ed terapii<\/li>\n<li><strong>Kut\u00e1nn\u00ed T-bun\u011b\u010dn\u00fd lymfom (mycosis fungoides)<\/strong> \u2014 vybran\u00e9 p\u0159\u00edpady<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">D\u00e1vkov\u00e1n\u00ed p\u0159\u00edpravku Acrotac a zp\u016fsob u\u017e\u00edv\u00e1n\u00ed<\/h2>\n<ul>\n<li><strong>Po\u010d\u00e1te\u010dn\u00ed d\u00e1vka: 25\u201350 mg jednou denn\u011b<\/strong> s hlavn\u00edm j\u00eddlem dne. Potrava v\u00fdznamn\u011b zvy\u0161uje absorpci acitretinu (3\u00d7), proto v\u017edy u\u017e\u00edvejte s j\u00eddlem \u2013 ide\u00e1ln\u011b s j\u00eddlem obsahuj\u00edc\u00edm tuky.<\/li>\n<li>Pokud je d\u00e1vka 25 mg\/den dob\u0159e sn\u00e1\u0161ena a \u00fa\u010dinek je po 4 t\u00fddnech nedostate\u010dn\u00fd, zvy\u0161te d\u00e1vku na 50 mg\/den.<\/li>\n<li>Maxim\u00e1ln\u00ed d\u00e1vka: <strong>75 mg\/den<\/strong> (z\u0159\u00eddka pot\u0159ebn\u00e1; ne\u017e\u00e1douc\u00ed \u00fa\u010dinky se nad 50 mg\/den disproporcion\u00e1ln\u011b zhor\u0161uj\u00ed).<\/li>\n<li>D\u00e9lka l\u00e9\u010dby: <strong>3\u20136 m\u011bs\u00edc\u016f pro akutn\u00ed l\u00e9\u010dbu<\/strong>; n\u011bkte\u0159\u00ed pacienti vy\u017eaduj\u00ed dlouhodobou udr\u017eovac\u00ed l\u00e9\u010dbu n\u00edzk\u00fdmi d\u00e1vkami (10\u201325 mg\/den nebo obden).<\/li>\n<li>Kombinujte s lok\u00e1ln\u00ed terapi\u00ed (kalcipotriol, topick\u00e9 steroidy) a fototerapi\u00ed (NB-UVB nebo PUVA) pro synergick\u00fd efekt \u2013 protokol \u201cRePUVA\u201d umo\u017e\u0148uje ni\u017e\u0161\u00ed d\u00e1vky acitretinu A ni\u017e\u0161\u00ed d\u00e1vky UV z\u00e1\u0159en\u00ed.<\/li>\n<li><strong>D\u011bti:<\/strong> 0,5\u20131 mg\/kg\/den u t\u011b\u017ek\u00e9 pustul\u00f3zn\u00ed psori\u00e1zy nebo vrozen\u00fdch ichty\u00f3z, nezbytn\u00fd dohled pediatrick\u00e9ho dermatologa. Obavy z p\u0159ed\u010dasn\u00e9ho uzav\u0159en\u00ed epif\u00fdz p\u0159i dlouhodob\u00e9m u\u017e\u00edv\u00e1n\u00ed.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">T\u011aHOTENSTV\u00cd KATEGORIE X \u2013 T\u0158\u00cdLET\u00c9 KONTRACEP\u010cN\u00cd PRAVIDLO<\/h2>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:14px 18px;margin:14px 0;border-radius:4px;\">\n<strong>\u26a0\ufe0f Acitretin pat\u0159\u00ed mezi nejv\u00edce teratogenn\u00ed l\u00e9ky pou\u017e\u00edvan\u00e9 v klinick\u00e9 praxi.<\/strong> Teratogenn\u00ed \u00fa\u010dinky nejsou omezeny pouze na obdob\u00ed u\u017e\u00edv\u00e1n\u00ed \u2013 acitretin se esterifikuje na etretin\u00e1t (polo\u010das ~120 dn\u00ed), kter\u00fd se hromad\u00ed v tukov\u00e9 tk\u00e1ni a je postupn\u011b uvol\u0148ov\u00e1n po dobu n\u011bkolika let. <strong>T\u011bhotenstv\u00ed je kontraindikov\u00e1no b\u011bhem l\u00e9\u010dby A\u017d PO 3 ROKY od posledn\u00ed d\u00e1vky.<\/strong>\n<\/div>\n<p><strong>Povinn\u00e9 po\u017eadavky na prevenci t\u011bhotenstv\u00ed u \u017een v reproduk\u010dn\u00edm v\u011bku:<\/strong><\/p>\n<ul>\n<li>Negativn\u00ed t\u011bhotensk\u00fd test p\u0159ed zah\u00e1jen\u00edm l\u00e9\u010dby (do 1 t\u00fddne p\u0159ed prvn\u00ed d\u00e1vkou)<\/li>\n<li><strong>Dv\u011b spolehliv\u00e9 formy antikoncepce<\/strong> za\u010d\u00ednaj\u00edc\u00ed nejm\u00e9n\u011b 1 m\u011bs\u00edc p\u0159ed l\u00e9\u010dbou, po celou dobu l\u00e9\u010dby a po dobu <strong>3 let od posledn\u00ed d\u00e1vky<\/strong><\/li>\n<li>P\u0159ijateln\u00e9 kombinace antikoncepce: kombinovan\u00e1 peror\u00e1ln\u00ed antikoncepce + bari\u00e9rov\u00e1 metoda; nitrod\u011blo\u017en\u00ed t\u011bl\u00edsko + bari\u00e9rov\u00e1 metoda; podv\u00e1z\u00e1n\u00ed vejcovod\u016f + bari\u00e9rov\u00e1 metoda; vasektomovan\u00fd partner + spolehliv\u00e1 hormon\u00e1ln\u00ed\/bari\u00e9rov\u00e1 metoda. <strong>Mini-pilulka (pouze progestin) NEN\u00cd pova\u017eov\u00e1na za dostate\u010dn\u011b spolehlivou samostatn\u011b.<\/strong><\/li>\n<li>M\u011bs\u00ed\u010dn\u00ed t\u011bhotensk\u00e9 testy b\u011bhem l\u00e9\u010dby (povinn\u00e9 v n\u011bkter\u00fdch programech prevence t\u011bhotenstv\u00ed)<\/li>\n<li>T\u011bhotensk\u00fd test na konci l\u00e9\u010dby<\/li>\n<li>Pou\u010dte pacientky, aby okam\u017eit\u011b vyhledaly l\u00e9ka\u0159skou pomoc, pokud dojde k t\u011bhotenstv\u00ed kdykoli b\u011bhem t\u0159\u00edlet\u00e9ho obdob\u00ed<\/li>\n<li><strong>\u017d\u00c1DN\u00dd alkohol b\u011bhem l\u00e9\u010dby a po dobu nejm\u00e9n\u011b 2 m\u011bs\u00edc\u016f po posledn\u00ed d\u00e1vce<\/strong> \u2014 alkohol zp\u016fsobuje re-esterifikaci acitretinu na etretin\u00e1t, co\u017e dramaticky zvy\u0161uje z\u00e1t\u011b\u017e metabolit\u016f s dlouh\u00fdm polo\u010dasem<\/li>\n<li><strong>NE darovat krev b\u011bhem l\u00e9\u010dby a po dobu 3 let po jej\u00edm ukon\u010den\u00ed<\/strong> \u2014 chr\u00e1n\u00ed t\u011bhotn\u00e9 p\u0159\u00edjemkyn\u011b krevn\u00edch produkt\u016f p\u0159ed expozic\u00ed teratogen\u016fm<\/li>\n<\/ul>\n<p><strong>\u00da\u010dinky na plod:<\/strong> kraniofaci\u00e1ln\u00ed malformace, abnormality CNS (hydrocefalus, mikrocefalie), kardiovaskul\u00e1rn\u00ed defekty, hypoplazie thymu, abnormality p\u0159\u00ed\u0161t\u00edtn\u00fdch t\u011bl\u00edsek, defekty kon\u010detin. Expozice v kter\u00e9mkoli bod\u011b prvn\u00edho trimestru nese velmi vysok\u00e9 (~20-30%) riziko z\u00e1va\u017en\u00fdch malformac\u00ed.<\/p>\n<p><strong>Acitretin u mu\u017e\u016f:<\/strong> n\u00edzk\u00e9 koncentrace v semenu a teoretick\u00e9 riziko pro plod, pokud partnerka ot\u011bhotn\u00ed. U mu\u017esk\u00fdch pacient\u016f se doporu\u010duje pou\u017eit\u00ed bari\u00e9rov\u00e9 antikoncepce b\u011bhem l\u00e9\u010dby a po dobu alespo\u0148 1 m\u011bs\u00edce po jej\u00edm ukon\u010den\u00ed; dlouhodob\u00e9 teratogenn\u00ed riziko u mu\u017e\u016f je diskutabiln\u00ed, ale zd\u00e1 se n\u00edzk\u00e9.<\/p>\n<h2 class=\"wp-block-heading\">Vedlej\u0161\u00ed \u00fa\u010dinky<\/h2>\n<p><strong>Velmi \u010dast\u00e9 (v\u00edce ne\u017e 1 z 10):<\/strong><\/p>\n<ul>\n<li><strong>Cheilitida<\/strong> (praskl\u00e9, olupuj\u00edc\u00ed se rty) \u2014 t\u00e9m\u011b\u0159 univerz\u00e1ln\u00ed; \u0159e\u0161te \u010dast\u00fdm pou\u017e\u00edv\u00e1n\u00edm zvl\u00e1\u010d\u0148uj\u00edc\u00edho balz\u00e1mu na rty<\/li>\n<li>Sucho v \u00fastech, such\u00e9 o\u010di, such\u00e1 nosn\u00ed sliznice (s epistax\u00ed)<\/li>\n<li>Such\u00e1 poko\u017eka, olupuj\u00edc\u00ed se dlan\u011b a chodidla, k\u0159ehk\u00e1 poko\u017eka<\/li>\n<li>\u0158\u00eddnut\u00ed vlas\u016f (telogenn\u00ed efluvium; obvykle reverzibiln\u00ed po vysazen\u00ed)<\/li>\n<li>P\u0159echodn\u00e9 zv\u00fd\u0161en\u00ed jatern\u00edch enzym\u016f (jatern\u00ed testy)<\/li>\n<li>P\u0159echodn\u00e9 zv\u00fd\u0161en\u00ed triglycerid\u016f a cholesterolu<\/li>\n<\/ul>\n<p><strong>\u010cast\u00e9 (1 z 100 a\u017e 1 z 10):<\/strong><\/p>\n<ul>\n<li>Bolest hlavy, \u00fanava<\/li>\n<li>Zv\u00fd\u0161en\u00e1 citlivost na slunce<\/li>\n<li>Zm\u011bny neht\u016f (paronychie, dystrofie neht\u016f)<\/li>\n<li>Poruchy chuti<\/li>\n<li>Bolesti kloub\u016f a sval\u016f (artralgie, myalgie)<\/li>\n<li>P\u0159echodn\u00e9 sv\u011bd\u011bn\u00ed<\/li>\n<li>Zm\u011bny vid\u011bn\u00ed (zhor\u0161en\u00e9 no\u010dn\u00ed vid\u011bn\u00ed, such\u00e9 o\u010di ovliv\u0148uj\u00edc\u00ed sn\u00e1\u0161enlivost kontaktn\u00edch \u010do\u010dek)<\/li>\n<\/ul>\n<p><strong>M\u00e9n\u011b \u010dast\u00e9, ale z\u00e1va\u017en\u00e9:<\/strong><\/p>\n<ul>\n<li>Hepatitida (1-5%); vz\u00e1cn\u011b z\u00e1va\u017en\u00e1<\/li>\n<li>Pankreatitida (spojen\u00e1 s t\u011b\u017ekou hypertriglycerid\u00e9mi\u00ed)<\/li>\n<li>Pseudotumor cerebri (idiopatick\u00e1 intrakrani\u00e1ln\u00ed hypertenze) \u2014 zejm\u00e9na p\u0159i sou\u010dasn\u00e9m u\u017e\u00edv\u00e1n\u00ed tetracyklin\u016f<\/li>\n<li>Kostn\u00ed hyperost\u00f3za (DISH-like zm\u011bny) p\u0159i dlouhodob\u00e9m u\u017e\u00edv\u00e1n\u00ed vysok\u00fdch d\u00e1vek<\/li>\n<li>P\u0159ed\u010dasn\u00e9 uzav\u0159en\u00ed r\u016fstov\u00fdch plot\u00e9nek u d\u011bt\u00ed p\u0159i dlouhodob\u00e9m u\u017e\u00edv\u00e1n\u00ed<\/li>\n<li>Zm\u011bny n\u00e1lady, deprese (diskutabiln\u00ed; m\u00e9n\u011b konzistentn\u00ed ne\u017e u isotretinoinu)<\/li>\n<li>Hyperkeratotick\u00e1 erupce (\u201cretinoidn\u00ed dermatitida\u201d) p\u0159i vy\u0161\u0161\u00edch d\u00e1vk\u00e1ch<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Povinn\u00e9 monitorov\u00e1n\u00ed<\/h2>\n<p><strong>V\u00fdchoz\u00ed vy\u0161et\u0159en\u00ed (p\u0159ed prvn\u00ed d\u00e1vkou):<\/strong><\/p>\n<ul>\n<li>T\u011bhotensk\u00fd test (u \u017een v reproduk\u010dn\u00edm v\u011bku)<\/li>\n<li>Kompletn\u00ed lipidov\u00fd profil (triglyceridy, celkov\u00fd + HDL + LDL cholesterol)<\/li>\n<li>Jatern\u00ed testy (ALT, AST, GGT, bilirubin)<\/li>\n<li>Ren\u00e1ln\u00ed funkce (kreatinin, eGFR)<\/li>\n<li>Kompletn\u00ed krevn\u00ed obraz<\/li>\n<li>Glyk\u00e9mie nala\u010dno \/ HbA1c (u diabetik\u016f nebo rizikov\u00fdch pacient\u016f)<\/li>\n<li>P\u0159i dlouhodob\u00e9 terapii: v\u00fdchoz\u00ed rentgen p\u00e1te\u0159e (pro monitorov\u00e1n\u00ed kostn\u00ed hyperost\u00f3zy)<\/li>\n<\/ul>\n<p><strong>B\u011bhem l\u00e9\u010dby:<\/strong><\/p>\n<ul>\n<li>M\u011bs\u00ed\u010dn\u00ed jatern\u00ed testy a lipidov\u00fd profil po prvn\u00ed 3 m\u011bs\u00edce, pot\u00e9 \u010dtvrtletn\u011b<\/li>\n<li>M\u011bs\u00ed\u010dn\u00ed t\u011bhotensk\u00fd test u \u017een v reproduk\u010dn\u00edm v\u011bku<\/li>\n<li>Zkontrolovat zrak p\u0159i v\u00fdskytu vizu\u00e1ln\u00edch p\u0159\u00edznak\u016f<\/li>\n<li>RTG p\u00e1te\u0159e ka\u017ed\u00fdch 1-2 roky p\u0159i dlouhodob\u00e9 terapii<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Kontraindikace<\/h2>\n<ul>\n<li><strong>T\u011bhotenstv\u00ed<\/strong> (v kter\u00e9mkoli trimestru) a <strong>\u017eeny pl\u00e1nuj\u00edc\u00ed t\u011bhotenstv\u00ed do 3 let od posledn\u00ed d\u00e1vky<\/strong><\/li>\n<li>Kojen\u00ed<\/li>\n<li>T\u011b\u017ek\u00e9 jatern\u00ed po\u0161kozen\u00ed<\/li>\n<li>T\u011b\u017ek\u00e9 po\u0161kozen\u00ed ledvin<\/li>\n<li>Hypervitamin\u00f3za A, anamn\u00e9za toxicity vitaminem A<\/li>\n<li>Sou\u010dasn\u00e1 suplementace vitaminem A &gt;5 000 IU\/den<\/li>\n<li>Hyperlipidemie nekontrolovan\u00e1 jin\u00fdmi prost\u0159edky<\/li>\n<li>P\u0159ecitliv\u011blost na acitretin nebo jin\u00e9 retinoidy<\/li>\n<li>Sou\u010dasn\u00e9 pod\u00e1v\u00e1n\u00ed methotrex\u00e1tu (aditivn\u00ed hepatotoxicita)<\/li>\n<li>Sou\u010dasn\u00e9 pod\u00e1v\u00e1n\u00ed tetracyklin\u016f (riziko pseudotumoru cerebri)<\/li>\n<li>Sou\u010dasn\u00e9 pod\u00e1v\u00e1n\u00ed isotretinoinu nebo jin\u00e9ho syst\u00e9mov\u00e9ho retinoidu<\/li>\n<\/ul>\n<p><strong>Pou\u017e\u00edvejte s opatrnost\u00ed:<\/strong> diabetes mellitus, porucha u\u017e\u00edv\u00e1n\u00ed alkoholu, preexistuj\u00edc\u00ed deprese, kostn\u00ed poruchy, no\u0161en\u00ed kontaktn\u00edch \u010do\u010dek, povol\u00e1n\u00ed vy\u017eaduj\u00edc\u00ed v\u00fdborn\u00e9 no\u010dn\u00ed vid\u011bn\u00ed.<\/p>\n<h2 class=\"wp-block-heading\">Interakce s l\u00e9\u010divy<\/h2>\n<ul>\n<li><strong>Alkohol<\/strong> \u2014 KRITICK\u00c9: zp\u016fsobuje esterifikaci acitretinu na etretin\u00e1t, co\u017e dramaticky prodlu\u017euje teratogenn\u00ed okno. \u017d\u00c1DN\u00dd alkohol b\u011bhem l\u00e9\u010dby ani 2 m\u011bs\u00edce po jej\u00edm ukon\u010den\u00ed.<\/li>\n<li><strong>Tetracykliny<\/strong> (doxycyklin, minocyklin) \u2014 riziko pseudotumoru cerebri; KONTRAINDIKOV\u00c1NO sou\u010dasn\u00e9 u\u017e\u00edv\u00e1n\u00ed<\/li>\n<li><strong>Methotrex\u00e1t<\/strong> \u2014 aditivn\u00ed hepatotoxicita; nekombinujte<\/li>\n<li><strong>Dopl\u0148ky vitaminu A a beta-karotenu<\/strong> \u2014 aditivn\u00ed toxicita; vyhn\u011bte se d\u00e1vk\u00e1m vitaminu A &gt;5 000 IU\/den<\/li>\n<li><strong>Jin\u00e9 retinoidy<\/strong> (isotretinoin, peror\u00e1ln\u00ed nebo topick\u00fd) \u2014 nekombinujte<\/li>\n<li><strong>Kombinovan\u00e9 peror\u00e1ln\u00ed antikoncepce<\/strong> \u2014 kombinovan\u00e1 pilulka je p\u0159ijateln\u00e1, ale progestinov\u00e1 \u201cmini-pilulka\u201d NEN\u00cd pova\u017eov\u00e1na za dostate\u010dn\u011b spolehlivou samostatn\u011b pro prevenci t\u011bhotenstv\u00ed p\u0159i u\u017e\u00edv\u00e1n\u00ed acitretinu<\/li>\n<li><strong>Peror\u00e1ln\u00ed hypoglykemika<\/strong> \u2014 acitretin m\u016f\u017ee ovlivnit gluk\u00f3zovou toleranci<\/li>\n<li><strong>Fenytoin<\/strong> \u2014 acitretin vyt\u011bs\u0148uje fenytoin z albuminu; monitorujte hladiny fenytoinu<\/li>\n<li><strong>T\u0159ezalka te\u010dkovan\u00e1<\/strong> \u2014 sni\u017euje \u00fa\u010dinnost hormon\u00e1ln\u00ed antikoncepce \u2014 VYVARUJTE SE u \u017een u\u017e\u00edvaj\u00edc\u00edch OCP pro prevenci t\u011bhotenstv\u00ed p\u0159i u\u017e\u00edv\u00e1n\u00ed acitretinu<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Jak si Acrotac stoj\u00ed ve srovn\u00e1n\u00ed s dal\u0161\u00edmi l\u00e9\u010dbami t\u011b\u017ek\u00e9 psori\u00e1zy<\/h2>\n<table style=\"width:100%;border-collapse:collapse;margin:14px 0;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">L\u00e9\u010dba<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Nejvhodn\u011bj\u0161\u00ed pro<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\"><strong>Acitretin (Acrotac)<\/strong><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Pustul\u00f3zn\u00ed a erytrodermick\u00e1 psori\u00e1za; neimunosupresivn\u00ed mo\u017enost pro pacienty s HIV\/po transplantaci; kombinace s fototerapi\u00ed<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">Metotrex\u00e1t 7,5-25 mg t\u00fddn\u011b<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Prvn\u00ed volba syst\u00e9mov\u00e9 l\u00e9\u010dby chronick\u00e9 plakovit\u00e9 psori\u00e1zy; levn\u00fd; imunosupresivn\u00ed; t\u00fddenn\u00ed d\u00e1vkov\u00e1n\u00ed<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Cyklosporin 2,5-5 mg\/kg\/den<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Rychl\u00e9 zlep\u0161en\u00ed (t\u00fddny); kr\u00e1tkodob\u00e9 k\u00fary; nefro-\/hepatotoxicita omezuje dlouhodob\u00e9 u\u017e\u00edv\u00e1n\u00ed<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">Biologika (adalimumab, etanercept, infliximab, ustekinumab, secukinumab, ixekizumab, risankizumab)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Vysoce \u00fa\u010dinn\u00e1 p\u0159i st\u0159edn\u011b t\u011b\u017ek\u00e9 a\u017e t\u011b\u017ek\u00e9 psori\u00e1ze; n\u00e1kladn\u00e1; imunosupresivn\u00ed; injek\u010dn\u00ed pod\u00e1n\u00ed<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Fototerapie (NB-UVB, PUVA)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Prvn\u00ed volba nesyst\u00e9mov\u00e9 l\u00e9\u010dby u st\u0159edn\u011b t\u011b\u017ek\u00e9ho onemocn\u011bn\u00ed; prov\u00e1d\u011bn\u00e1 v ordinaci; dob\u0159e kombinovateln\u00e1 s acitretinem (RePUVA)<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">Apremilast 30 mg 2\u00d7 denn\u011b<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Peror\u00e1ln\u00ed, dob\u0159e sn\u00e1\u0161en\u00fd, neimunosupresivn\u00ed; m\u00edrn\u00e1 \u00fa\u010dinnost ve srovn\u00e1n\u00ed s biologiky<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Pro peror\u00e1ln\u00ed isotretinoin (souvisej\u00edc\u00ed retinoid druh\u00e9 generace schv\u00e1len\u00fd pro t\u011b\u017ek\u00e9 akn\u00e9, nikoli psori\u00e1zu) viz <a href=\"https:\/\/medsbase.com\/cs\/isotroin\/\">Isotroin<\/a> a srovn\u00e1vac\u00ed p\u0159\u00edsp\u011bvek <a href=\"https:\/\/medsbase.com\/cs\/isotretinoin-vs-tretinoin\/\">Isotretinoin vs Tretinoin<\/a>.<\/p>\n<h2 class=\"wp-block-heading\">Skladov\u00e1n\u00ed a doba pou\u017eitelnosti<\/h2>\n<p>Skladujte tobolky Acrotac p\u0159i teplot\u011b pod 25\u00b0C v p\u016fvodn\u00edm blistru, chr\u00e1n\u011bn\u00e9 p\u0159ed sv\u011btlem. Uchov\u00e1vejte mimo dosah d\u011bt\u00ed. Nepou\u017e\u00edvejte po uplynut\u00ed data expirace.<\/p>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3 class=\"wp-block-heading\">Pro\u010d je po\u017eadavek na antikoncepci b\u011bhem t\u011bhotenstv\u00ed 3 ROKY, a ne 1 m\u011bs\u00edc jako u isotretinoinu?<\/h3>\n<p>Acitretin se zp\u011btn\u011b esterifikuje na <strong>etretin\u00e1t<\/strong>, retinoid s mnohem del\u0161\u00edm polo\u010dasem rozpadu (termin\u00e1ln\u00ed polo\u010das ~120 dn\u00ed), v p\u0159\u00edtomnosti alkoholu. Etretin\u00e1t se hromad\u00ed v t\u011blesn\u00e9m tuku (tukov\u00e9 tk\u00e1ni) a je pomalu uvol\u0148ov\u00e1n po dobu n\u011bkolika let. Detekovateln\u00e9 hladiny etretin\u00e1tu v s\u00e9ru byly hl\u00e1\u0161eny a\u017e 2 roky po posledn\u00ed d\u00e1vce acitretinu a metabolity a\u017e 3 roky. Pro zaji\u0161t\u011bn\u00ed bezpe\u010dnosti proti teratogenn\u00ed expozici plodu je po\u017eadavek na antikoncepci 3 roky od posledn\u00ed d\u00e1vky. Isotretinoin (pravidlo 1 m\u011bs\u00edce) neproch\u00e1z\u00ed touto zp\u011btnou esterifikac\u00ed a vylu\u010duje se b\u011bhem t\u00fddn\u016f.<\/p>\n<h3 class=\"wp-block-heading\">Pro\u010d se mus\u00edm vyh\u00fdbat alkoholu p\u0159i u\u017e\u00edv\u00e1n\u00ed acitretinu?<\/h3>\n<p>Alkohol podporuje reakci zp\u011btn\u00e9 esterifikace acitretinu\u2192etretin\u00e1tu v j\u00e1trech, co\u017e dramaticky zvy\u0161uje tvorbu tohoto teratogenu s dlouh\u00fdm polo\u010dasem rozpadu. Proto se z\u00e1kaz alkoholu prodlu\u017euje o 2 m\u011bs\u00edce po ukon\u010den\u00ed u\u017e\u00edv\u00e1n\u00ed acitretinu \u2014 aby se umo\u017enilo vylou\u010den\u00ed zb\u00fdvaj\u00edc\u00edho acitretinu a aby se zabr\u00e1nilo p\u0159em\u011bn\u011b jak\u00e9hokoli zbyl\u00e9ho acitretinu na etretin\u00e1t p\u016fsoben\u00edm alkoholu. Pacienti, kte\u0159\u00ed pij\u00ed alkohol b\u011bhem l\u00e9\u010dby acitretinem, by m\u011bli b\u00fdt pova\u017eov\u00e1ni za osoby s de-facto expozic\u00ed etretin\u00e1tu se v\u0161emi jeho d\u016fsledky spojen\u00fdmi s dlouh\u00fdm polo\u010dasem rozpadu.<\/p>\n<h3 class=\"wp-block-heading\">Za jak dlouho uvid\u00edm v\u00fdsledky?<\/h3>\n<p>Acitretin p\u016fsob\u00ed postupn\u011b. M\u00edrn\u00e9 zlep\u0161en\u00ed se m\u016f\u017ee objevit za 4-6 t\u00fddn\u016f; viditeln\u00e9 sn\u00ed\u017een\u00ed plak\u016f za 8-12 t\u00fddn\u016f; pln\u00e1 klinick\u00e1 odpov\u011b\u010f za 12-16 t\u00fddn\u016f pravideln\u00e9ho u\u017e\u00edv\u00e1n\u00ed. Pustul\u00f3zn\u00ed formy psori\u00e1zy (von Zumbusch, palmoplant\u00e1rn\u00ed) obvykle reaguj\u00ed rychleji (1-2 t\u00fddny) ne\u017e chronick\u00e1 plakovit\u00e1 psori\u00e1za. Kombinujte s lok\u00e1ln\u00ed terapi\u00ed a fototerapi\u00ed (RePUVA) pro synergick\u00fd efekt.<\/p>\n<h3 class=\"wp-block-heading\">Moje rty jsou nesnesiteln\u011b such\u00e9 \u2014 co pom\u016f\u017ee?<\/h3>\n<p>Cheilitida je p\u0159i u\u017e\u00edv\u00e1n\u00ed acitretinu t\u00e9m\u011b\u0159 univerz\u00e1ln\u00ed. Zvl\u00e1dn\u011bte ji: vazel\u00ednou (Vaseline) nebo balz\u00e1mem na rty na b\u00e1zi lanolinu, kter\u00fd se aplikuje velmi \u010dasto (ka\u017ed\u00fdch 30-60 minut); vyhn\u011bte se balz\u00e1m\u016fm s mentolem, kafrem nebo \u201c\u0161imraj\u00edc\u00edmi\u201d \u00fa\u010dinky, kter\u00e9 zhor\u0161uj\u00ed podr\u00e1\u017ed\u011bn\u00ed; hydratujte tak\u00e9 okoln\u00ed k\u016f\u017ei; zvlh\u010dova\u010d vzduchu v lo\u017enici v noci. Cheilitida je tak\u00e9 ukazatelem \u00fa\u010dinn\u00e9ho d\u00e1vkov\u00e1n\u00ed \u2014 t\u00e9m\u011b\u0159 \u00fapln\u00e1 absence cheilitidy nazna\u010duje, \u017ee va\u0161e d\u00e1vka m\u016f\u017ee b\u00fdt p\u0159\u00edli\u0161 n\u00edzk\u00e1.<\/p>\n<h3 class=\"wp-block-heading\">Mohu u\u017e\u00edvat Acrotac, pokud koj\u00edm?<\/h3>\n<p>Ne \u2014 acitretin se vylu\u010duje do mate\u0159sk\u00e9ho ml\u00e9ka a tk\u00e1n\u011b d\u00edt\u011bte jsou na retinoidy je\u0161t\u011b citliv\u011bj\u0161\u00ed ne\u017e tk\u00e1n\u011b matky. Acitretin je b\u011bhem kojen\u00ed kontraindikov\u00e1n. Pokud je l\u00e9\u010dba nezbytn\u00e1, standardn\u00edm p\u0159\u00edstupem je p\u0159echod na jinou modalitu l\u00e9\u010dby psori\u00e1zy (lok\u00e1ln\u00ed terapie, NB-UVB, cyklosporin pod odborn\u00fdm dohledem) a\u017e do odstaven\u00ed d\u00edt\u011bte.<\/p>\n<h3 class=\"wp-block-heading\">Mohou mu\u017ei u\u017e\u00edvat Acrotac, pokud by jejich partnerka mohla ot\u011bhotn\u011bt?<\/h3>\n<p>Ano \u2014 acitretin se v semenu vyskytuje ve velmi n\u00edzk\u00fdch koncentrac\u00edch a teoretick\u00e9 riziko pro plod u partnerky, kter\u00e1 ot\u011bhotn\u00ed b\u011bhem l\u00e9\u010dby mu\u017ee, je pova\u017eov\u00e1no za n\u00edzk\u00e9. Standardn\u00edm doporu\u010den\u00edm je bari\u00e9rov\u00e1 antikoncepce (kondom) b\u011bhem l\u00e9\u010dby mu\u017ee a po dobu 1 m\u011bs\u00edce po n\u00ed. Pravidlo 3 let plat\u00ed pouze pro pacientky (nebo partnerku pacienta, pokud je to ona, kdo u\u017e\u00edv\u00e1 acitretin).<\/p>\n<h3 class=\"wp-block-heading\">Pro\u010d se mus\u00edm vyhnout darov\u00e1n\u00ed krve?<\/h3>\n<p>Na ochranu potenci\u00e1ln\u00edch t\u011bhotn\u00fdch p\u0159\u00edjemc\u016f va\u0161\u00ed krve p\u0159ed expozic\u00ed teratogen\u016fm. Omezen\u00ed d\u00e1rcovstv\u00ed krve plat\u00ed 3 roky po posledn\u00ed d\u00e1vce acitretinu \u2014 odpov\u00edd\u00e1 kontraindika\u010dn\u00edmu obdob\u00ed pro t\u011bhotenstv\u00ed. V\u011bt\u0161ina transfuzn\u00edch slu\u017eeb se explicitn\u011b dotazuje na u\u017e\u00edv\u00e1n\u00ed retinoid\u016f p\u0159i screeningu d\u00e1rc\u016f.<\/p>\n<h3 class=\"wp-block-heading\">Poroste mi vlasy zp\u011bt?<\/h3>\n<p>Ano, t\u00e9m\u011b\u0159 ve v\u0161ech p\u0159\u00edpadech. Acitretin zp\u016fsobuje vypad\u00e1v\u00e1n\u00ed vlas\u016f ve vzoru telogenn\u00edho effluvia (synchronizovan\u00e1 porucha r\u016fstov\u00e9ho cyklu vlas\u016f), kter\u00e9 obvykle ustoup\u00ed 3-6 m\u011bs\u00edc\u016f po ukon\u010den\u00ed l\u00e9\u010dby. U n\u011bkter\u00fdch pacient\u016f m\u016f\u017ee p\u0159etrv\u00e1vat dif\u00fazn\u00ed \u0159\u00eddnut\u00ed \u2014 pokud je to v\u00e1\u0161 p\u0159\u00edpad, proberte to se sv\u00fdm dermatologem. Tot\u00e9\u017e plat\u00ed pro zm\u011bny neht\u016f.<\/p>\n<h3 class=\"wp-block-heading\">Kde si mohu objednat Acrotac online?<\/h3>\n<p>Acrotac m\u016f\u017eete objednat na MedsBase v balen\u00edch po 10\/30\/60\/90 kapsl\u00edch. Z\u00e1silky jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm balen\u00ed. Acitretin m\u00e1 z\u00e1va\u017en\u00fd teratogenn\u00ed potenci\u00e1l a vy\u017eaduje povinn\u00e9 monitorov\u00e1n\u00ed (vstupn\u00ed + m\u011bs\u00ed\u010dn\u00ed testy jatern\u00edch funkc\u00ed, lipidov\u00fd profil, t\u011bhotensk\u00fd test u \u017een v plodn\u00e9m v\u011bku). P\u0159ed objedn\u00e1vkou se ujist\u011bte, \u017ee m\u00e1te dermatologick\u00fd dohled a zdokumentovan\u00fd pl\u00e1n prevence t\u011bhotenstv\u00ed.<\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:16px 20px;margin:24px 0;border-radius:4px;\">\n<strong>\u2695 L\u00e9ka\u0159sk\u00e9 upozorn\u011bn\u00ed.<\/strong> Tato str\u00e1nka slou\u017e\u00ed pouze pro informa\u010dn\u00ed \u00fa\u010dely a nenahrazuje l\u00e9ka\u0159skou p\u00e9\u010di kvalifikovan\u00e9ho zdravotnick\u00e9ho pracovn\u00edka. Acitretin pat\u0159\u00ed mezi nejteratogenn\u011bj\u0161\u00ed l\u00e9ky pou\u017e\u00edvan\u00e9 v klinick\u00e9 praxi, s t\u0159\u00edletou kontraindikac\u00ed t\u011bhotenstv\u00ed po ukon\u010den\u00ed l\u00e9\u010dby. Vy\u017eaduje vstupn\u00ed a m\u011bs\u00ed\u010dn\u00ed monitorov\u00e1n\u00ed (testy jatern\u00edch funkc\u00ed, lipidy, t\u011bhotensk\u00fd test u \u017een) a dermatologick\u00fd dohled. MedsBase neposkytuje diagn\u00f3zu, p\u0159edpis ani klinick\u00e1 doporu\u010den\u00ed.\n<\/div>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h3 class=\"wp-block-heading\">Souvisej\u00edc\u00ed alternativy<\/h3>\n<p>Dal\u0161\u00ed produkty v <strong>L\u00e9\u010dba akn\u00e9<\/strong> kter\u00e9 z\u00e1kazn\u00edci tak\u00e9 prohl\u00ed\u017eej\u00ed:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/tazret-forte-cream\/\">Tazret Forte kr\u00e9m<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/epiduo-gel\/\">Epiduo gel<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/clincitop-gel\/\">Clincitop Gel<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/melacare-forte-cream\/\">Melacare Forte kr\u00e9m<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/deriva-cms-gel\/\">Deriva CMS gel<\/a><\/li>\n<\/ul>\n<p><!-- medsbase-guide-tretinoin --><\/p>\n<p style=\"margin:20px 0 0;padding:12px 16px;background:#f4f8fb;border-left:3px solid #2c7cb0;border-radius:3px;font-size:14px\">\ud83d\udcda <strong>Zjistit v\u00edce:<\/strong> <a href=\"https:\/\/medsbase.com\/cs\/buy-tretinoin-online\/\">Jak koupit Tretinoin online bez p\u0159edpisu (Pr\u016fvodce 2026)<\/a><\/p>","protected":false},"excerpt":{"rendered":"<p>Acrotac obsahuje acitretin 10 mg nebo 25 mg \u2014 druh\u00fd generick\u00fd peror\u00e1ln\u00ed retinoid od spole\u010dnosti Torrent Pharmaceuticals (generick\u00fd Soriatane \/ Neotigason). Pou\u017e\u00edv\u00e1 se pro t\u011b\u017ekou psori\u00e1zu (chronickou plakovou, erytrodermickou, generalizovanou pustul\u00e1rn\u00ed, palmoplant\u00e1rn\u00ed pustul\u00e1rn\u00ed), poruchy keratinizace (Darierova choroba, ichthy\u00f3zy, pityriasis rubra pilaris) a lichen planus, kde selhala topick\u00e1 terapie. Standardn\u00ed d\u00e1vka 25\u201350 mg jednou denn\u011b s hlavn\u00edm j\u00eddlem. KRITICK\u00c9: T\u011bhotensk\u00e1 kategorie X \u2014 teratogenn\u00ed po dobu 3 let po vysazen\u00ed; \u017e\u00e1dn\u00fd alkohol b\u011bhem l\u00e9\u010dby nebo po dobu 2 m\u011bs\u00edc\u016f po vysazen\u00ed.<\/p>","protected":false},"featured_media":50473,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3215,3223,3942],"product_tag":[3216,3217],"class_list":{"0":"post-50472","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-acne-treatment","7":"product_cat-chronic-conditions","8":"product_cat-eczema-psoriasis-treatment","9":"product_tag-acitretin","10":"product_tag-acrotac","12":"first","13":"instock","14":"shipping-taxable","15":"purchasable","16":"product-type-variable","17":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/50472","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/comments?post=50472"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/50473"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=50472"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=50472"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=50472"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=50472"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}