Medications for Psoriasis

Antineoplastics

Common name: methotrexate (Folex, Folex PFS, Methotrexate LPF, Rheumatrex)

This medication is taken on a weekly (NOT daily) basis, in either oral or injectable form. It is very helpful in reducing psoriasis symptoms. It works by interfering with certain types of skin cell growth, thus slowing the process of psoriasis cell reproduction.

Possible side effects include:

• Nausea and vomiting
• Diarrhea
• Rash
• Mild hair loss
• Headache
• Mouth sores
• Reduced immune function, and increased risk of infection
• More serious problems may include:
  • Blood problems
  • Kidney problems
  • Stomach or liver problems
  • Cancer

Immunosuppressive Agents

Common name: cyclosporine (Neoral, Sandimmune, SangCya)

Cyclosporine works by suppressing certain immune functions. Note: Do not take this medication with grapefruit or grapefruit juice, as it will increase its effect.

Possible side effects may include:

• High blood pressure
• Headaches
• Joint pain
• Body hair growth
• Bleeding, tender or enlarged gums
• Reduced immune function, and increased risk of infection
• Kidney damage

Retinoids

Common names include:

• Tazarotene (Tazorac) (topical treatment)
• Acitretin (Soriatane) (oral treatment)

Retinoids are vitamin-A related medications that may be prescribed as either topical treatments, (such as gels), or oral medication. Oral retinoids are used for treating severe cases of psoriasis, while topical retinoids can be used in mild or moderate cases.

Tazarotene is used in psoriasis treatment to help reduce skin reddening, and reduce the size and number of lesions. It may be prescribed alone or in conjunction with topical steroids. It is available as a gel or cream that is applied once a day and is used for skin, scalp, and nail psoriasis.

Possible side effects include:

• Skin irritation, especially when used by itself
• Burning or stinging of the skin (severe)
• Changes in color of treated skin
• Deep grooves or lines in skin
• Dryness, itching, peeling, or redness of the skin (severe)
• Pain or swelling of treated skin

Contraindications:

• Should not be used during pregnancy
• Do not expose skin to sunlight after treatment
• Do not use around eyes, lips, or near the inside of the nose

Acitretin is used to control and relieve severe skin disorders such as psoriasis. It works by allowing normal growth and development of skin.

Possible side effects include:

• Back pain
• Bone or joint pain
• Difficulty in moving or walking
• Headache
• Nausea or vomiting
• Stiff, painful muscles

Contraindications:

• Cannot be used by women who are pregnant or planning to have children
• Do not drink alcohol during treatment and for 2 months after discontinuing usage
• Blood should not be donated during treatment, and 2 to 3 years after discontinuing usage
• Avoid skin products that contain alcohol, such as aftershave
• Avoid skin products containing spices or limes, which increase sun sensitivity
• Avoid acne products that contain peeling agents
• Do not take vitamin A, since doses greater than the minimum daily requirement may increase your chance of developing side effects.

Topical Medications

Common names include:

• Anthralin
• Salicylic Acid
• Corticosteroids
• Calcipotriene

The following topical prescription medications are generally considered step 1 therapies, and are used as first line treatment for mild to moderate psoriasis.

Anthralin

Anthralin can be very effective for treating mild to moderate psoriasis, particularly the tough-to-treat thick patches. Often used in conjunction with ultraviolet light treatments. This treatment has no known long-term side effects, but may irritate skin and stain clothes.

Salicylic Acid

This medication is used to soften and remove scale from psoriasis plaques. When scales are removed, other medications may penetrate the skin and promote healing. Salicylic acid is available in many strengths and types of preparations. Milder strengths are available without prescription.

Corticosteroids

Corticosteroids are used for treating inflammation of mild to moderate psoriasis. Available in many forms (such as ointments, creams, sprays) and strengths, they are a synthetic version of hormones that occur naturally in the body. The weaker, over-the-counter strengths are usually not effective in treating psoriasis.

Calcipotriene

Calcipotriene is a synthetic form of vitamin D used for treating mild to moderate psoriasis. Sold as Dovonex in the U.S., it is a prescription medication that is available as a cream, ointment, or scalp solution. It can be used in conjunction with other treatments, but should be used in limited amounts to avoid side effects such as local irritation, rash, or worsening of psoriasis. It is not recommended for facial psoriasis.