Tretinoin (Vesanoid , ATRA)

Tretinoin (Vesanoid®, ATRA)

 TRETINOIN is a natural metabolite of retinol that alters binding of all-trans retinoic acid to a nuclear acid receptor forcing cellular differentiation and inhibition of cell proliferation. Tretinoin is indicated for the treatment of acute promyelocytic leukemia.

Important Precautions  Tretinoin is teratogenic. Women should not become pregnant or breastfeed while taking tretinoin. Tretinoin may be harmful to the unborn child. Two forms of effective contraception must be used while taking tretinoin.

 If sexually active with a partner that is pregnant or who may become pregnant during and 1 month after treatment, two forms of contraception must be used (a condom and another effective form of birth control)

Potential Drug-Drug Interactions  Grapefruit or grapefruit juice  Certain anti-infectives such as rifampin (Rifadin®)  Anti-convulsants, including carbamazepine (Tegretol®) and phenobarbital (Luminal®)  Antivirals like ritonavir (Norvir®), nelfinavir (Viracept®), and saquinavir (Invirase®)  Antidepressants like St. John’s Wort and nefazodone (Serzone®)  Certain antifungals, such as itraconazole (Sporanox®), ketoconazole (Nizoral®)  Antibiotics like ciprofloxacin (Cipro®) and levofloxacin (Levaquin®)  Heart rhythm medications like verapamil (Calan®) and amiodarone (Cordarone®)  Immunosuppressants like cyclosporine (Gengraf® and Neoral®) and tacrolimus (Prograf®)

Side Effect Summary Below are the most common side effects:

 Fatigue  GI Toxicities: Diarrhea, nausea, vomiting, heartburn  Headache  Dry skin/mouth  Liver dysfunction

Below are some less common side effects:

 Blood clots  Differentiation syndrome (edema, fever, weight gain; most common during first month)

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