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tretinoin

Pronunciation

Generic Name: tretinoin (TRET i noin)
Brand Name: Vesanoid

What is tretinoin?

Tretinoin is a cancer medication that interferes with the growth of cancer cells and slows their growth and spread in the body.

Tretinoin is used to treat acute promyelocytic leukemia (a type of blood cancer).

Tretinoin may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about tretinoin?

Do not use vitamin A supplements or multivitamins that contain vitamin A while you are taking tretinoin.

Do not use this medication without your doctor's consent if you are pregnant. It could cause harm to the unborn baby. Use an effective form of birth control, and tell your doctor if you become pregnant during treatment.

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Tretinoin can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

What should I discuss with my healthcare provider before taking tretinoin?

Before using tretinoin, tell your doctor if you have high cholesterol, or if you have ever had a reaction to another retinoid (such as Accutane, Retin-A, Renova).

If you have any of these conditions, you may not be able to use tretinoin, or you may need a dosage adjustment or special tests during treatment.

FDA pregnancy category D. This medication can cause birth defects, miscarriage, premature birth, or death of a baby. Do not use tretinoin if you are pregnant. Tell your doctor right away if you miss a period or become pregnant during treatment. Use an effective form of birth control while you are using this medication and for at least 1 month after your treatment ends.

You may need to have a pregnancy test every month during your treatment. You must use effective birth control while you are taking tretinoin unless you have had a hysterectomy and no longer have a uterus. Use birth control even if you have been infertile (unable to have children) in the past, or if you have gone through menopause.

It is not known whether tretinoin passes into breast milk or if it could harm a nursing baby. Do not take tretinoin without telling your doctor if you are breast-feeding a baby.

How should I use tretinoin?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor.

Take each dose with a full glass of water.

You may need to continue taking tretinoin for up to 90 days. Follow your doctor's instructions.

Store tretinoin at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Contact your doctor if you miss a dose of tretinoin.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include headache, dizziness, weakness, facial flushing, stomach pain, or dry, cracked lips.

What should I avoid while using tretinoin?

Do not use vitamin A supplements or multivitamins that contain vitamin A while you are taking tretinoin.

This medicine can pass into body fluids (including urine, feces, vomit, semen, vaginal fluid). For at least 48 hours after you receive a dose, avoid allowing your body fluids to come into contact with your hands or other surfaces. Patients and caregivers should wear rubber gloves while cleaning up body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.

Body fluids should not be handled by a woman who is pregnant or who may become pregnant. Use condoms during sexual activity to avoid exposure to body fluids.

Tretinoin can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Tretinoin side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

  • fever, breathing problems, weight gain, swelling of your hands or feet;

  • sudden and severe pain behind your eyes, with nausea, vomiting, and vision problems;

  • black, bloody, or tarry stools; or

  • vomit that looks like blood or coffee grounds.

Less serious side effects may include:

  • feeling tired or weak;

  • headache;

  • fever;

  • dry skin, mouth, or nose;

  • bone pain;

  • nausea and vomiting;

  • rash or itching;

  • white patches or sores inside your mouth or on your lips;

  • increased sweating;

  • vision problems; or

  • hair loss or skin changes.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Tretinoin dosing information

Usual Adult Dose for Acute Promyelocytic Leukemia:

45 mg/m2/day administered as two evenly divided doses until complete remission is documented. Therapy should be discontinued 30 days after achievement of complete remission or after 90 days of treatment, whichever comes first.

Usual Pediatric Dose for Acute Promyelocytic Leukemia:

There are limited clinical data on the pediatric use of tretinoin. The safety and efficacy of tretinoin in patients < 1 year has not been established. Of 15 pediatric patients (1 to 16 years) treated with tretinoin the incidence of complete remission was 67%. Dose reduction may be considered for pediatric patients experiencing serious and/or intolerable toxicity, however, the safety and efficacy of doses less than 45 mg/m2/day have not been evaluated in the pediatric population.

45 mg/m2/day administered as two evenly divided doses until complete remission is documented. Therapy should be discontinued 30 days after achievement of complete remission or after 90 days of treatment, whichever comes first.

What other drugs will affect tretinoin?

Before taking tretinoin, tell your doctor if you are using any of the following drugs:

  • cimetidine;

  • cyclosporine;

  • troleandomycin;

  • rifampin;

  • phenobarbital;

  • fluoxetine, fluvoxamine;

  • steroids;

  • itraconazole, ketoconazole;

  • clarithromycin, erythromycin;

  • a tetracycline antibiotic such as minocycline, doxycycline, demeclocycline;

  • amiodarone, mibefradil, diltiazem, verapamil; or

  • HIV medicines such as indinavir, saquinavir, ritonavir or nelfinavir.

This list is not complete and there may be other drugs that can interact with tretinoin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about tretinoin.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 3.02. Revision Date: 2013-07-09, 12:18:45 PM.

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