Tretinoin - Benefits, dosage and side effects

Oral tretinoin is a drug used to treat blood cancer (leukemia). acute promyelocytic leukemia (APPL). Oral tretinoin is used with other drugs to relieve symptoms and reduce the severity of the disease.

APL is a type of acute myeloblastic leukemia (AML). This condition occurs when the number of immature white blood cells increases uncontrollably, damaging other cells, including red blood cells and platelets.

Oral tretinoin works by suppressing the growth of cancer cells and triggering the growth of normal white blood cells. This drug is commonly used in APL patients whose condition has not been resolved with chemotherapy.

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What is Oral Tretinoin

groupPrescription drugs
BenefitTreating leukemia types acute promyelocytic leukemia
Consumed byAdults and children
Oral tretinoin for pregnant and lactating womenCategory D: There is positive evidence of risks to the human fetus, but the benefits may outweigh the risks, for example in dealing with life-threatening situations. It is not known whether oral tretinoin is absorbed into breast milk or not. However, breastfeeding mothers are not advised to take this drug.
Drug formCapsule

Warning Before Mengconsumption Oral Tretinoin

Oral tretinoin should only be used as prescribed by a doctor. Patients taking oral tretinoin should be closely monitored by a doctor. Some things to note before using this drug are:

  • Do not take oral tretinoin if you are allergic to this or other retinoid medicines. Tell your doctor about any allergies you have.
  • Do not take oral tretinoin if you are pregnant, breastfeeding, or planning a pregnancy. Use effective contraception while on treatment with oral tretinoin.
  • Do not donate blood while on treatment with oral tretinoin for up to 1 month afterward.
  • Do not consume alcoholic beverages, grapefruit, or foods rich in vitamin A, while on treatment with oral tretinoin.
  • Tell your doctor if you have or are currently suffering from liver disease, heart disease, high cholesterol, kidney disease, stroke, or depression.
  • Tell your doctor if you are taking certain medications, supplements, or herbal products.
  • Tell your doctor that you are taking oral tretinoin before having any surgical procedure, including dental surgery.
  • Do not drive or do activities that require alertness while taking oral tretinoin, as this drug can cause severe headaches and dizziness.
  • See your doctor right away if you have an allergic drug reaction, serious side effect, or overdose after taking oral tretinoin.

Dosage and Instructions for Use of Oral Tretinoin

The use of tretinoin capsules to treat APL will be determined by the doctor according to each patient's condition, body surface area, and patient response to treatment.

The usual dose of oral tretinoin for adults and children is 45 mg/m² of body surface area per day, divided into 2 consumption schedules, for 30–90 days.

A dose reduction or discontinuation may be required according to the patient's condition and the patient's response to treatment. Especially for pediatric patients, it is possible to reduce the dose to 25 mg/m² if symptoms of drug poisoning appear, such as severe headaches.

Method Taking Oral Tretinoin Correctly

Follow your doctor's recommendations and read the instructions for use on the packaging before taking oral tretinoin. Do not reduce or increase the dose without consulting your doctor as this may increase the risk of serious side effects.

Take tretinoin capsules whole with water. Do not split, chew or crush the medicine.

Take tretinoin capsules at the same time each day, for maximum effect. If you forget to take a tretinoin capsule, it is advisable to do it immediately if the break with the next consumption schedule is not too close. If it is close, ignore it and do not double the dose.

Continue to take treatment according to the doctor's advice even if the condition seems to have improved. Do not stop taking tretinoin capsules before the time prescribed by your doctor, because this can increase the risk of side effects.

During treatment with oral tretinoin, your doctor will ask you to have regular blood tests.

Store tretinoin capsules in a room at room temperature. Do not store it in a humid place or in direct sunlight. Keep medicine out of reach of children.

Interactions of Oral Tretinoin with Other Drugs

The following are a number of interactions that can occur when taking oral tretinoin with other drugs:

  • Increased risk of fatal side effects from excess vitamin A (hypervitaminosis) when taken with other retinoids or vitamin A supplements
  • Increased risk of increased pressure in the brain (intracranial) which can be fatal if taken with tetracyclines
  • Increased risk of complications due to blood clot formation if taken with antifibrinolytic drugs, such as tranexamic acid
  • Impaired absorption of oral tretinoin when taken with rifampicin, corticosteroids, phenobarbital, ketoconazole, verapamil, cimetidine, erythromycin, or diltiazem

Side Effects and Dangers of Oral Tretinoin

Some of the side effects that may appear after taking oral tretinoin are headache, dizziness, dry skin, dry mouth, bone pain, nausea and vomiting, feeling tired and weak, ear pain, and frequent sweating, difficulty sleeping, confusion, or restlessness.

Check with your doctor if the side effects above don't go away or get worse. See your doctor immediately if you have an allergic reaction to the drug or a more serious side effect, such as:

  • Severe headache
  • Nausea and vomiting that won't stop or vomiting blood
  • Swelling in the feet or hands
  • Visual disturbances, such as double vision or blurred vision
  • Hearing loss, such as hearing loss or tinnitus
  • Easy bruising
  • Severe abdominal pain or jaundice
  • Heart palpitations, fast heartbeat, or irregular heartbeat
  • Chest pain