Tretinoin

All-trans Retinoic acid, Retinoic acid

Mechanism :

Tretinoin is not a cytolytic agent but instead induces cytodifferentiation and decreased proliferation of APL cells. In APL patients, tretinoin treatment produces an initial maturation of the primitive promyelocytes derived from the leukemic clone, followed by a repopulation of the bone marrow and peripheral blood by normal, polyclonal hematopoietic cells in patients achieving complete remission (CR). The exact mechanism of action of tretinoin in APL is unknown.

Indication :

• Acne
• Acute promyelocytic leukemia

Contraindications :

Contraindicated in patients with a known hypersensitivity to any of its components, or other retinoids, in patients who are sensitive to parabens, which are used as preservatives in the gelatin capsule. Avoid contact with eye, nostrils, mouth and mucous membranes. Do not use simultaneously with peeling agent. Do not use ultraviolet lamps and minimize exposure to sunlight.

Dosing :

Adverse Effect :

Headache, fever, weakness, and fatigue. With oral therapy: hemorrhage, infections, gastrointestinal hemorrhage, disseminated intravascular coagulation, pneumonia, septicaemia and cerebral hemorrhage. With topical application: erythema, excessive dryness, scaling, pruritus, photosensitivity, edema, hypo/hyperpigmentation, blistering, stinging, initial acne flares up.

Interaction :

Vitamin A: Patients should be advised against taking vitamin supplements containing vitamin A to avoid additive toxic effects.
Tetracyclines: Concomitant treatment with tetracyclines should be avoided because pseudotumor cerebri (benign intracranial hypertension) has been reported.

Hepatic Dose :