Different Approaches to Administering Acitretin Capsules in Children

Dear Editor, Acitretin, a second-generation synthetic retinoid, is extensively used in dermatology. It is frequently used to treat keratinization disorders and psoriasis. There is ample proof that acitretin therapy is safe for adult patients.[1] Acitretin’s therapeutic benefits in treating childhood keratinization disorders, especially psoriasis and ichthyosis, have been well demonstrated.[2,3] However, it might be difficult to provide medications to young patients. For a variety of reasons, including taste, shame, anxiety, or difficulty, children may refuse to take their medications. Lack of pediatric-appropriate formulations exacerbates this issue by limiting prescribing alternatives and raising safety issues. In addition, parents and other caregivers have little information about how to provide medications to children; the majority of information is based on anecdotal reports and personal experience.[4] Moreover, because capsules come in specific dosages, it can be challenging to administer the precise dose required for children. We are writing to share insights on the challenges and practical solutions for administering acitretin capsules to children. Due to the size of the capsules and the bitter taste of the drug, innovative administration methods are often necessary to ensure compliance. Below are some of the methods that have been proven effective: 1 Opening the Capsule: The bitter taste can be covered up by carefully opening the capsule, then sprinkling the contents on food or combining them with liquids such as apple juice, yogurt, and jam. 2 Combining with Fatty Foods: Because acitretin is lipophilic, it can be better absorbed and has a greater effect when taken with fatty foods such as peanut butter, avocado, or milk. It can also be given in yogurt. However, use it in the second spoon since the patient should be able to take the first spoon of yogurt effortlessly because it should taste normal. 3 Freezing the Capsules: For kids who have trouble swallowing pills, freezing the capsules and cutting them to an adequate dose, then crushing and using them with any of the above-mentioned food or liquids, may occasionally make them easier to swallow whole. 4 Compounding Solutions: Dissolving its contents or mixing in a small amount of water, juice, or another suitable liquid. The required dose can then be measured and administered precisely using a syringe or dropper, or pharmacists may compound the drug into a liquid suspension, ensuring the correct dosage Many pharmacies also offer flavouring options to improve medication adherence for children. 5 Daily Dosing with Incentives: Encouraging children to take the medication regularly through reward-based systems (e.g., sticker charts or small treats) can help improve adherence over the long term. Declaration of consent The authors certify that they have obtained all appropriate consent forms, duly signed by the parent(s)/guardian(s) of the patient. In the form, the parent(s)/guardian(s) has/have given his/her/their consent for the images and other clinical information of their child to be reported in the journal. The parents understand that the names and initials of their child/children will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.