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Mequinol / tretinoin topical Side Effects

For the Consumer

Applies to mequinol / tretinoin topical: topical solution

In some animal studies, mequinol and tretinoin has been shown to cause skin tumors to develop faster when the treated area is exposed to ultraviolet light (sunlight or artificial sunlight from a sunlamp). Other studies have not shown the same result and more studies need to be done. It is not known if mequinol and tretinoin topical solution causes skin tumors to develop faster in humans.

In addition to its needed effects, some unwanted effects may be caused by mequinol / tretinoin topical. In the event that any of these side effects do occur, they may require medical attention.

Severity: Moderate

If any of the following side effects occur while taking mequinol / tretinoin topical, check with your doctor or nurse as soon as possible:

More common:
  • Burning feeling or stinging skin (severe)
  • itching (severe)
  • peeling of skin (severe)
  • redness of skin (severe)
Less common:
  • Allergic reaction
  • large blisters on the skin

Minor Side Effects

Some of the side effects that can occur with mequinol / tretinoin topical may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common:
  • Burning feeling, stinging, or tingling of skin (mild)—lasting for a short time after first applying the medicine
  • itching (mild)
  • chapping or slight peeling of skin (mild)
  • lightening of skin around treated area
  • lightening of skin on treated area
  • redness of skin (mild)
  • skin irritation
  • unusually warm skin (mild)
Less common:
  • Crusting of skin
  • dry skin
  • skin rash

For Healthcare Professionals

Applies to mequinol / tretinoin topical: topical solution

General

In general, topical adverse reactions have been primarily mild to moderate in intensity, and occurred in 66% and 30% of patients, respectively. The majority of these reactions were limited to the skin. Approximately 6% of patients discontinued study participation due to adverse reactions.[Ref]

Dermatologic

Dermatological side effects have included skin reactions in 64% of patients within 8 weeks of therapy. The most frequently reported side effects have included erythema (49%), burning, stinging, or tingling (26%), desquamation (14%), pruritus (12%), and skin irritation (5%). Temporary hypopigmentation of treated lesions or of the skin surrounding treated lesions in 5% and 7% of patients, respectively have been reported. Halo hypopigmentation, dry skin, rash, crusting, vesicular bullae rash, dermatitis, skin discomfort, and irritant dermatitis have been reported in greater than 1% of patients. Rare cases of depigmentation have also been reported in postmarketing experience. Mequinol-tretinoin topical may induce photosensitivity in some individuals, as well as an increased susceptibility to irritation from wind, cold, and dryness.[Ref]

Resolution of hypopigmentation occurred in 89% of patients following discontinuation of treatment to the lesion. Another 8% of patients with hypopigmentation had resolution of symptoms in within 120 days after the end of treatment. Persistence of hypopigmentation occurred in 2.8% of patients beyond 120 days.[Ref]

Hepatic

Hepatic side effects to mequinol-tretinoin topical have not been reported. However, reversible, clinically insignificant changes in liver function tests have been reported following both oral and topical administration of tretinoin. These abnormalities have included elevations in serum bilirubin, alkaline phosphatase, glutamic-oxaloacetic transaminase, and glutamic-pyruvic transaminase.[Ref]

Nervous system

Nervous system side effects have included at least one case of neurotoxicity in a patient who received tretinoin topical therapy.[Ref]

A patient with liver disease developed neurological side effects following 4 weeks of tretinoin therapy. Symptoms included headache, memory loss, truncal ataxia, and dysarthria, all of which improved upon temporary discontinuation of medication and recurred when the patient resumed usage. Upon withdrawal of medication a second time, the symptoms resolved within 4 weeks.[Ref]

Ocular

Ocular side effects to topical tretinoin have included ectropions which have developed infrequently and were reversible. In addition, a transient and harmless stinging of the eye has occurred when tretinoin was applied onto the surrounding skin, and has generally lasted about 30 to 60 seconds.[Ref]

References

1. "Product Information. Solag (mequinol-tretinoin topical)" Westwood Squibb Pharmaceutical Corp, Buffalo, NY.

2. Heel RC, Brogden RN, Speight TM, Avery GS "Vitamin A acid: a review of its pharmacological properties and therapeutic use in the topical treatment of acne vulgaris." Drugs 14 (1977): 401-19

3. Bernstein AL, Leventhal-Rochon JL "Neurotoxicity related to the use of topical tretinoin (Retin-A)." Ann Intern Med 124 (1996): 227-8

4. Brodell LP, Asselin D, Brodell RT "Reversible ectropion after long-term use of topical tretinoin on photodamaged skin." J Am Acad Dermatol 27 (1992): 621-2

Not all side effects for mequinol / tretinoin topical may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

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