Generic Name: tretinoin (Oral route)
Medically reviewed by Drugs.com. Last updated on Mar 21, 2019.
Patients with acute promyelocytic leukemia (APL) can have severe adverse reactions to tretinoin including retinoic acid-APL (RA-APL) syndrome characterized by fever, dyspnea, acute respiratory distress, weight gain, radiographic pulmonary infiltrates, pleural and pericardial effusions, edema, and hepatic, renal, and multi-organ failure. High-dose steroids given at the first suspicion of the RA-APL syndrome appear to reduce morbidity and mortality. Patients can also develop rapidly evolving leukocytosis during therapy which can lead to an increased risk of life-threatening complications. There is a high risk that a severely deformed infant will result if tretinoin is administered during pregnancy. Pregnancy testing is necessary prior to initiation of treatment in women of childbearing potential and the patient must be instructed in the need to use two reliable forms of contraception simultaneously during therapy and for 1 month following discontinuation of therapy. Pregnancy testing and contraception counseling should be repeated monthly throughout the period of tretinoin treatment .
The Vesanoid brand name has been discontinued in the U.S. If generic versions of this product have been approved by the FDA, there may be generic equivalents available.
Commonly used brand name(s)
In the U.S.
Available Dosage Forms:
- Capsule, Liquid Filled
Therapeutic Class: Antineoplastic Agent
Chemical Class: Retinoid
Uses for Vesanoid
Tretinoin belongs to the group of medicines known as retinoids (RET-i-noyds). It is used to treat a form of leukemia (acute promyelocytic leukemia [APL]).
Tretinoin has side effects that can be very serious. Be sure that you discuss with your doctor the good that this medicine can do as well as the risks of taking it.
This medicine is available only with your doctor's prescription.
Before using Vesanoid
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:
Studies in a limited number of children between 1 and 16 years of age have shown that children may be especially sensitive to the effects of this medicine, and may be more likely than adults to experience severe headaches and some other side effects during treatment.
Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of tretinoin in the elderly with use in other age groups.
|All Trimesters||D||Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.|
Interactions with medicines
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aminocaproic Acid
- Paclitaxel Protein-Bound
- Tranexamic Acid
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Interactions with food/tobacco/alcohol
Proper use of Vesanoid
It is very important that you take tretinoin only as directed by your doctor . Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.
- For oral dosage form (capsules):
- For acute promyelocytic leukemia (APL):
- Adults—Dose is based on body size and must be determined by your doctor. The usual dose is 45 milligrams (mg) for each square meter of body surface area a day, given in two equally divided doses.
- Children—The dose will be determined by your doctor.
- For acute promyelocytic leukemia (APL):
If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
If it is almost time for your next dose, check with your health care professional to find out how much medicine to take for the next dose.
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Precautions while using Vesanoid
Your doctor should check your progress at regular visits to make sure that the medicine is working properly and to check for unwanted effects.
Tretinoin causes fever, headache, tiredness, and weakness in most people who take it. It is very important that you continue taking the medicine even if it makes you feel ill. Your health care professional may be able to suggest ways to relieve some of these effects. However, if you develop a very severe headache or a headache that occurs together with nausea, vomiting, or vision problems, check with your doctor right away.
Tretinoin sometimes causes a severe reaction that affects the lungs at first, but can later spread to other parts of the body. Signs of this reaction include breathing problems, bone pain, chest pain, and fever. Check with your doctor right away if any of these effects occur during treatment .
Vesanoid side effects
Check with your doctor immediately if any of the following side effects occur:
- Black, tarry stools
- bloody stools
- bone pain
- difficulty in moving
- discomfort or pain in chest
- enlarged heart
- feeling of pressure
- joint pain
- paleness of skin
- shortness of breath, troubled breathing, tightness in chest, or wheezing
- sweating increased
- swollen joints
- unusual tiredness or weakness
- vomiting of blood or material that looks like coffee grounds
- warmness at site
- weight gain (occurring together with any of the other symptoms listed before)
- Blue lips and fingernails
- convulsions (seizures)
- difficulty in speaking, slow speech, or inability to speak
- feeling of heaviness in chest
- headache (severe)
- inability to move arms, legs, or muscles of the face
- nausea and vomiting (occurring together with a headache)
- no blood pressure or pulse
- pain in back or left arm
- painful, red lumps under the skin, mostly on the legs
- prominent superficial veins over affected area
- stopping of heart
- vision problems (occurring together with a headache)
Check with your doctor as soon as possible if any of the following side effects occur:
- Any change in vision (not occurring with a headache)
- coughing, sneezing, sore throat, and stuffy or runny nose
- cracked lips
- crusting, redness, pain, or sores in mouth or nose
- decreased urination
- earache or feeling of fullness in the ear
- increase or decrease in blood pressure
- irregular heartbeat
- mental depression
- pain in stomach, side, abdomen or back
- pain and swelling in leg or foot
- skin rash
- swelling of abdomen (stomach area)
- swelling of face, fingers, hands, feet, or lower legs
- Bone swelling
- cramping or pain in stomach (severe)
- difficult or painful urination
- drowsiness (very severe and continuing)
- hallucinations (seeing, hearing, or feeling things that are not there)
- hearing loss
- heartburn, indigestion, or nausea (severe and continuing)
- mood, mental, or personality changes
- pain in lower back or side
- swollen area that feels sore and tender
- yellow eyes or skin
- Acid or sour stomach
- blurred vision
- burning, crawling, or tingling feeling in the skin
- darkened urine
- dryness of skin, mouth, or nose
- fast heartbeat
- general feeling of discomfort or illness
- hair loss
- headache (mild and not occurring together with other side effects)
- itching of skin
- loss of appetite
- mood or mental changes
- muscle pain
- nausea and vomiting (not occurring together with a headache)
- trouble sleeping
- weight loss
- Anxiety and restlessness (occurring together)
- clumsiness or unsteadiness when walking
- difficulty sleeping
- frequent urination
- low body temperature
- redness, soreness or itching skin
- sores, welting or blisters
- sores on genitals
- swelling of feet or lower legs
- trembling, sometimes with a flapping movement
- weak or feeble pulse
- weakness in legs
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- Drug class: miscellaneous antineoplastics