II. Indications
- See Topical Tretinoin and Isotretinoin (Accutane) for Acne Vulgaris related uses
- Acute Promyelocytic Leukemia (APL)
- Neuroblastoma
III. Contraindications
- Paraben Sensitivity
IV. Mechanism
-
Tretinoin is a Retinoic Acid (Vitamin A) analog
- Most commonly used for acne: Topical Tretinoin (Retin-A), and systemically as Isotretinoin (Accutane)
- However, Tretinoin is also used as an antineoplastic drug
- Induces maturation of APL cells, as well as Neuroblastoma cells
V. Dosing
- See other references for disease specific dosing protocols
VI. Adverse Effects
- Alopecia
- Leukocytosis (rapid increase in 40% of patients)
- Hepatotoxicity (increased Liver Function Tests)
- APL Differentiation Syndrome
- Presents with fever and Dyspnea
- Signs include Pulmonary Infiltrates, Pleural Effusions, Pericardial Effusions, weight gain, Cardiomyopathy, Hypotension
- Lipid abnormalities (reversible)
VII. Safety
- Avoid in Lactation
- Avoid in pregnancy (all trimesters)
- Use reliable Contraception (two concurrent forms, similar to Isotretinoin)
- Monitoring
- Complete Blood Count
- Liver Function Tests
- Coagulation tests
- Lipid profile with Cholesterol levels and Serum Triglycerides
VIII. Resources
- Oral Tretinoin (DailyMed)