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Tretinoin

Chemotherapy

Brand names:

Vesanoid®, Retin-A®

Other names:

trans-Retinoic Acid, retinoic acid

Often used for:

Acute promyelocytic leukemia (APL)

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About Tretinoin

Tretinoin is a type of medicine called a retinoid. It acts on specific receptors of the cell nucleus to control cell growth. Tretinoin may be used as a chemotherapy to treat a type of leukemia called acute promyelocytic leukemia (APL). 

When used as a chemotherapy, tretinoin is taken as a capsule by mouth. Tretinoin (as Retin-A®) may also be applied to the skin for treatment of acne or skin rashes.

Although retinoids are related to vitamin A (retinol), the actions are very different. It is important to follow the care team’s instructions and warnings when using a retinoid drug.

Female patients of childbearing age will be given a pregnancy test before starting tretinoin chemotherapy. Patients will have regular blood draws to monitor blood counts, lipid levels, and liver function.

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May be taken as a capsule by mouth

 
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May be applied on the skin

 
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Possible Side Effects

  • Dry skin, mouth, nose, and lips
  • Rash, itching
  • Nausea and vomiting
  • Abdominal pain
  • Diarrhea
  • Headache
  • Change in blood counts (may cause increased risk of infection, bleeding, anemia and/or fatigue)
  • APL differentiation syndrome (may cause fever, weight gain, trouble breathing, and/or lung and heart problems)
  • Mouth sores
  • Dry eyes, change in eyesight, or problems wearing contacts
  • Sun sensitivity
  • Loss of appetite
  • Weight loss or gain
  • Fatigue or weakness
  • Muscle or join pain
  • Fever
  • Sweating, flushing
  • Chills
  • Constipation
  • Earache
  • Hair loss
  • Depression, anxiety, or change in behavior
  • Liver problems
  • Increased blood lipid levels

Possible side effects with lotion form:

  • Skin warmth, stinging, redness, or irritation
  • Sensitivity of skin to sun, wind, or cold
  • Change in skin color of treated area

Not all patients who take tretinoin will experience these side effects. Common side effects are in bold, but there may be others. Please report all suspected side effects to your doctor or pharmacist.

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Tips for Families

Be sure to discuss these and other recommendations with your doctor or pharmacist.

  • Patients should not take multivitamins or other dietary supplements containing vitamin A (retinol) while taking this medicine unless recommended by a doctor or pharmacist.
  • While taking tretinoin, patients should not take any medicine that contains tetracycline.
  • Patients should avoid drinking alcohol while on this medicine.
  • Patients should protect their skin from the sun while taking this medicine.
  • Sexually active patients should take steps to prevent pregnancy during treatment and for 1 month after completion of therapy.
  • Patients should tell their doctor if they are pregnant or breastfeeding. Patients should immediately discontinue tretinoin if they become pregnant while taking this medicine.
  • Caregivers should follow instructions for safe handling and disposal of the medicine. Pregnant caregivers should not handle tretinoin.

Tretinoin at home:

  • Capsules taken by mouth:
    • Take the medicine with meals. Take with a full glass of water.
    • Capsules should be swallowed whole. Do not crush, chew, or break before swallowing unless otherwise recommended by a doctor or pharmacist.
    • Tretinoin can be given by feeding tube. Follow the instructions given by your doctor or pharmacist.
    • Store capsules at room temperature. Protect from light.
  • Lotion or gel applied to the skin:
    • Use at bedtime or as otherwise instructed by your doctor or pharmacist.
    • Wash hands before and after applying the medicine.
    • Apply a thin layer to clean, dry skin at least 20 minutes after washing. Rub in gently. Avoid areas around the mouth, nose, and eyes.
    • Store at room temperature.
  • Give a missed dose as soon as possible. If it is near the time of the next dose, skip the dose. Do not give 2 doses at the same time.
  • Do not use the medicine past the expiration date.
  • Follow instructions for safe handling, storage, and disposal.