Alitretinoin

Pronunciation

(a li TRET i noyn)

U.S. Brand Names

Panretin®

Generic Available

Canadian Brand Names

Panretin®

Use

Orphan drug: Topical treatment of cutaneous lesions in AIDS-related Kaposi's sarcoma

Use - Unlabeled/Investigational

Cutaneous T-cell lymphomas

Pregnancy Risk Factor

Pregnancy Implications

Potentially teratogenic and/or embryotoxic; limb, craniofacial, or skeletal defects have been observed in animal models. If used during pregnancy or if the patient becomes pregnant while using alitretinoin, the woman should be advised of potential harm to the fetus. Women of childbearing potential should avoid becoming pregnant.

Lactation

Excretion in breast milk unknown/not recommended

Contraindications

Hypersensitivity to alitretinoin, other retinoids, or any component of the formulation; pregnancy

Warnings/Precautions

May cause fetal harm if absorbed by a woman who is pregnant. May be photosensitizing (based on experience with other retinoids); minimize sun or other UV exposure of treated areas. Do not use concurrently with topical products containing DEET (increased toxicity may result). Safety in pediatric patients or geriatric patients has not been established.

Adverse Reactions

>10%:

Central nervous system: Pain (0% to 34%)

Dermatologic: Rash (25% to 77%), pruritus (8% to 11%)

Neuromuscular & skeletal: Paresthesia (3% to 22%)

5% to 10%:

Cardiovascular: Edema (3% to 8%)

Dermatologic: Exfoliative dermatitis (3% to 9%), skin disorder (0% to 8%)

Overdosage/Toxicology

There has been no experience with human overdosage of alitretinoin, and overdose is unlikely following topical application. Treatment is symptomatic and supportive.

Drug Interactions

Increased toxicity of DEET may occur if products containing this compound are used concurrently with alitretinoin. Due to limited absorption after topical application, interaction with systemic medications is unlikely.

Stability

Store at room temperature

Mechanism of Action

Binds to retinoid receptors to inhibit growth of Kaposi's sarcoma

Pharmacodynamics/Kinetics

Absorption: Not extensive

Dosage

Topical: Apply gel twice daily to cutaneous Kaposi's sarcoma or T-cell lymphoma (unlabeled use) lesions

Administration

Do not use occlusive dressings.

Patient Education

For external use only. Use exactly as directed; do not overuse. Avoid use of any product such as insect repellents which contain DEET (check with your pharmacist). Wear protective clothing and/or avoid exposure to direct sun or sunlamps. Wash hands thoroughly before applying. Avoid applying skin products that contain alcohol or harsh chemicals during treatment. Do not apply occlusive dressings. Stop treatment and inform prescriber if rash, skin irritation, redness, scaling, or excessive dryness appears. Pregnancy/breast-feeding precautions: Do not get pregnant while taking this medication. Consult prescriber for appropriate contraceptive measures. Breast-feeding is not recommended.

Dental Health: Effects on Dental Treatment

No significant effects or complications reported

Dental Health: Vasoconstrictor/Local Anesthetic Precautions

No information available to require special precautions

Mental Health: Effects on Mental Status

Pain is common

Mental Health: Effects on Psychiatric Treatment

May be photosensitizing; caution with psychotropics

Oncology: Emetic Potential

Very low (<10%)

Dosage Forms

Gel: 0.1% (60 g tube)

International Brand Names

Panretin™ (CA); Panretin® (FR)

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