NutriStack
Acitretin and Alcohol, contraindicated.
Alcohol can convert acitretin back into etretinate, a much more lipophilic retinoid with a very long elimination time. This is especially dangerous for anyone who could become pregnant because it can extend teratogenic risk long after acitretin would otherwise clear. The concern is not solved by separating doses because ethanol changes acitretin metabolism systemically.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
Same shape as the other 1,729 pairs in the public database.
From the interaction database
What the row says.
Every entry follows the same shape: what is happening, the mechanism, the recommendation, and the primary literature.
At a glance
- Pair type
- Contraindicated
- Evidence (highest tier)
- Strong
- Source citations
- 2 sources
- Stack Score effect
- −25 to your Stack Score (per scored contraindication row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Contraindicated · Strong evidence
Contraindicated
What is happening. Alcohol can convert acitretin back into etretinate, a much more lipophilic retinoid with a very long elimination time. This is especially dangerous for anyone who could become pregnant because it can extend teratogenic risk long after acitretin would otherwise clear. The concern is not solved by separating doses because ethanol changes acitretin metabolism systemically.
Mechanism. Ethanol enables ethyl esterification of acitretin to etretinate through an acitretinoyl-CoA intermediate. Etretinate partitions into fat and has a much longer terminal half-life than acitretin, prolonging systemic retinoid exposure and teratogenic potential.
Recommendation. Do not drink alcohol while taking acitretin. If pregnancy is possible, avoid alcohol during treatment and for at least 2 months after stopping acitretin, and follow your prescriber's contraception and pregnancy-testing plan exactly. Tell your prescriber if you drank alcohol while on acitretin.
Sources (2)
- Larsen FG, Jakobsen P, Knudsen J, Weismann K, Kragballe K, Nielsen-Kudsk F. Conversion of acitretin to etretinate in psoriatic patients is influenced by ethanol. J Invest Dermatol. 1993;100(5):623-627. PMID 8491984
- Knights KM, Stresser DM, Miners JO, Crespi CL. In vitro metabolism of acitretin by human liver microsomes: evidence of an acitretinoyl-coenzyme A thioester conjugate in the transesterification to etretinate. Biochem Pharmacol. 2000;60(4):507-516. PMID 10874125
Stack Score
How this pair moves the number.
Effect on the composite score
If both Acitretin and Alcohol are in the same stack, this pair applies −25 to your Stack Score (per scored contraindication row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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