Description and Brand Names

Drug information provided by: Merative, Micromedex®

US Brand Name

  1. Vesanoid

Descriptions


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.

This product is available in the following dosage forms:

  • Capsule, Liquid Filled

Before Using

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:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

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.

Geriatric

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.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

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
  • Aprotinin
  • Carbamazepine
  • Chlortetracycline
  • Clarithromycin
  • Demeclocycline
  • Doxycycline
  • Eravacycline
  • Itraconazole
  • Lymecycline
  • Meclocycline
  • Methacycline
  • Minocycline
  • Omadacycline
  • Oxytetracycline
  • Paclitaxel
  • Paclitaxel Protein-Bound
  • Palovarotene
  • Rolitetracycline
  • Sarecycline
  • Tetracycline
  • Tigecycline
  • 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.

  • Fluconazole
  • Ketoconazole
  • Voriconazole

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Proper Use

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.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • 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.

Missed Dose

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.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions

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 .

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

  1. Black, tarry stools
  2. bleeding
  3. blistering
  4. bloody stools
  5. bone pain
  6. burning
  7. coldness
  8. difficulty in moving
  9. discomfort or pain in chest
  10. enlarged heart
  11. feeling of pressure
  12. fever
  13. hives
  14. infection
  15. inflammation
  16. joint pain
  17. lumps
  18. numbness
  19. paleness of skin
  20. rash
  21. redness
  22. scaring
  23. seizures
  24. shortness of breath, troubled breathing, tightness in chest, or wheezing
  25. soreness
  26. stinging
  27. sweating increased
  28. swelling
  29. swollen joints
  30. tenderness
  31. tingling
  32. ulceration
  33. unusual tiredness or weakness
  34. vomiting of blood or material that looks like coffee grounds
  35. warmness at site
  36. weight gain (occurring together with any of the other symptoms listed before)

Less common

  1. Blue lips and fingernails
  2. convulsions (seizures)
  3. difficulty in speaking, slow speech, or inability to speak
  4. faintness
  5. feeling of heaviness in chest
  6. headache (severe)
  7. inability to move arms, legs, or muscles of the face
  8. nausea and vomiting (occurring together with a headache)
  9. no blood pressure or pulse
  10. pain in back or left arm
  11. painful, red lumps under the skin, mostly on the legs
  12. prominent superficial veins over affected area
  13. stopping of heart
  14. unconsciousness
  15. vision problems (occurring together with a headache)
  16. warmth

Check with your doctor as soon as possible if any of the following side effects occur:

More common

  1. Any change in vision (not occurring with a headache)
  2. coughing, sneezing, sore throat, and stuffy or runny nose
  3. cracked lips
  4. crusting, redness, pain, or sores in mouth or nose
  5. decreased urination
  6. earache or feeling of fullness in the ear
  7. increase or decrease in blood pressure
  8. irregular heartbeat
  9. mental depression
  10. pain in stomach, side, abdomen or back
  11. pain and swelling in leg or foot
  12. skin rash
  13. swelling of abdomen (stomach area)
  14. swelling of face, fingers, hands, feet, or lower legs

Less common

  1. Bone swelling
  2. cramping or pain in stomach (severe)
  3. difficult or painful urination
  4. drowsiness (very severe and continuing)
  5. hallucinations (seeing, hearing, or feeling things that are not there)
  6. hearing loss
  7. heartburn, indigestion, or nausea (severe and continuing)
  8. mood, mental, or personality changes
  9. pain in lower back or side
  10. swollen area that feels sore and tender
  11. yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  1. Acid or sour stomach
  2. agitation
  3. anxiety
  4. belching
  5. blurred vision
  6. bloating
  7. burning, crawling, or tingling feeling in the skin
  8. chills
  9. confusion
  10. constipation
  11. darkened urine
  12. diarrhea
  13. dizziness
  14. dryness of skin, mouth, or nose
  15. fast heartbeat
  16. flushing
  17. general feeling of discomfort or illness
  18. hair loss
  19. headache (mild and not occurring together with other side effects)
  20. indigestion
  21. irritability
  22. itching of skin
  23. loss of appetite
  24. mood or mental changes
  25. muscle pain
  26. nausea and vomiting (not occurring together with a headache)
  27. shivering
  28. trouble sleeping
  29. weakness
  30. weight loss

Less common

  1. Anxiety and restlessness (occurring together)
  2. clumsiness or unsteadiness when walking
  3. difficulty sleeping
  4. disorientation
  5. forgetfulness
  6. frequent urination
  7. lethargy
  8. lightheadedness
  9. low body temperature
  10. redness, soreness or itching skin
  11. sores, welting or blisters
  12. sores on genitals
  13. swelling of feet or lower legs
  14. thirst
  15. trembling, sometimes with a flapping movement
  16. weak or feeble pulse
  17. weakness in legs

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Portions of this document last updated: March 01, 2024

Original article: https://www.mayoclinic.org/drugs-supplements/tretinoin-oral-route/description/DRG-20066502