Tazarotene

Pronunciation: tazz-AHR-oh-teen
Class: Retinoid

Trade Names

Avage
- Cream 0.1%

Tazorac
- Cream 0.05%
- Cream 0.1%
- Gel 0.05%
- Gel 0.1%

Pharmacology

Undefined; however, inhibits cornified envelope formation, which is an element of psoriatic scales.

Slideshow: Psoriasis: Treatment Options to Manage Your Symptoms

Indications and Usage

Treatment of acne ( Tazorac cream and gel), psoriasis ( Tazorac gel); as an adjunctive agent in mitigation of facial fine wrinkling, facial mottled hyper- and hypopigmentation, and benign facial lentigines in patients who use comprehensive skin care and sunlight avoidance programs ( Avage ).

Contraindications

Pregnancy; hypersensitivity to any component of the product.

Dosage and Administration

Acne
Adults and Children (12 yr of age and older)

Topical After gently cleansing and drying the face, apply a thin film (2 mg/cm 2 ) once daily in the evening where acne lesions appear.

Psoriasis
Adults (18 yr of age and older)

Topical Apply once a day in the evening to psoriatic lesions, using enough (2 mg/cm 2 ) to cover only the lesion with a thin film.

Wrinkling, Hyper- and Hypopigmentation, Lentigines
Adults (18 yr of age and older)

Topical Apply pea-sized amount once daily at bedtime to lightly cover the entire face, including the eyelids if desired.

Storage/Stability

Store gel at controlled room temperature (59° to 86°F). Cream may be stored in refrigerator or at room temperature (23° to 86°F). Keep tube tightly capped.

Drug Interactions

None well documented.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Dermatologic

Skin pain ( Tazorac ); skin inflammation, worsening of psoriasis, rash ( Tazorac for psoriasis); desquamation; stinging; dry skin; erythema; pruritus; skin irritation; burning sensation; fissuring localized edema, skin discoloration ( Tazorac gel for acne); irritant contact dermatitis; fissuring; bleeding ( Tazorac gel for psoriasis); contact dermatitis; dermatitis; eczema; peripheral edema ( Tazorac cream for psoriasis); irritant contact dermatitis; acne; rash; cheilitis ( Avage ).

Metabolic

Hypertriglyceridemia ( Tazorac cream for psoriasis)

Precautions

Pregnancy

Category X .

Lactation

Undetermined.

Children

Safety and efficacy not established in patients younger than 18 yr of age with psoriasis or younger than 12 yr of age with acne (cream). Safety and efficacy not established in children younger than 12 yr of age (gel). Safety and efficacy not established in patients younger than 17 yr of age with facial fine wrinkling, facial mottled hypo- and hyperpigmentation, and benign facial lentigines ( Avage ).

Special Risk Patients

Avoid use on eczematous skin and avoid concurrent use of medications and cosmetics that have a strong drying effect; assess facial pigmented lesions before use.

Photosensitivity

Use with caution if patient is known to be taking a photosensitizing drug because of increased risk of photosensitivity.

Overdosage

Symptoms

Marked redness, peeling, discomfort.

Patient Information

  • Advise patient to carefully read the patient information leaflet before using the first time and with each refill.
  • Advise patient that medication is applied topically to skin lesions once daily at nighttime.
  • Teach patient with psoriasis proper technique for applying medication: ensure that skin is dry if shower or bath were taken; wash hands; apply a thin film of cream or gel to cover skin areas with psoriasis plaques or scales; wash medication off unaffected areas that may have had medication applied. Wash hands after applying medication unless medication is being used to treat psoriasis on hands.
  • Teach patient with acne proper technique for applying medication: wash hands; cleanse area with mild or soapless cleanser first, then apply a thin film of cream or gel to cover skin areas with acne lesions. Wash hands after applying medication.
  • Teach patient with winkling, hypo- or hyperpigmentation or lentigines proper technique for applying medication: wash hands; cleanse area with mild soap first, allow to dry, and then apply a “pea-sized” amount of cream and lightly spread to cover the entire face, including the eyelids if desired. Wash hands after applying medication. Remind patient that facial moisturizers may be used as frequently as desired and to always apply a moisturizing sunscreen, SPF 15 or greater, each morning.
  • Advise patient using creams or lotions to soften or lubricate skin to apply medication only after ensuring that the cream or lotion has been absorbed and the skin is dry.
  • Caution patient not to cover treated areas with bandages or dressings.
  • Inform patient that a mild sensation of warmth or slight stinging or burning may be felt shortly after application and that this is expected and should be of no concern.
  • Warn patient that applying medication more often than prescribed or in excessive quantities will not produce more rapid improvement or better results, but will result in greater adverse reactions, such as redness, scaling, and discomfort.
  • Advise patient that if they miss an application to not try to make it up but to return to normal application schedule as soon as possible.
  • Warn patient to avoid contact with the eyes, eyelids, lips, and mucous membranes.
  • Advise patient that if cream or gel comes in contact with the eyes to wash eyes with large amounts of cool water and to contact health care provider if eye irritation persists.
  • Advise patient to not apply to skin areas with eczema or that are sunburned.
  • Advise patient with psoriasis that plaques and scales will begin to improve in 1 to 4 wk, but that the redness may take longer to improve and to continue using the medication.
  • Advise patient with acne that improvement may not be seen for at least 4 wk and to continue using the medication.
  • Advise patient that local redness, drying, scaling, burning, or itching are the most common adverse reactions and to notify health care provider if becoming bothersome.
  • Advise patient that if severe dermal reactions occur to stop using the medication and contact health care provider.
  • Advise patient to talk to health care provider before using any other topical agents (eg, medicated soaps, astringents, cosmetics, other acne products) on treated skin.
  • Warn patient to avoid unnecessary exposure to sun and sun lamps while using this medication. Advise patient to use sunscreens, with minimum SPF of 15, and protective clothing over treated areas when exposure cannot be avoided.
  • Caution patient that while using the medication, exposure to extreme weather conditions (eg, wind, cold air) may be irritating to the treated areas.

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