Tretinoin may cause severe side effects. Tretinoin should be given only under the supervision of a doctor who has experience in treating people who have leukemia (cancer of the white blood cells) and in a hospital where patients can be monitored for severe side effects and treated if these side effects occur.
Tretinoin may cause a serious or life-threatening group of symptoms called retinoic acid-APL(RA-APL) syndrome. Your doctor will monitor you carefully to see whether you are developing this syndrome. If you experience any of the following symptoms, call your doctor immediately: fever; weight gain; swelling of the arms, hands, feet, ankles, or lower legs; shortness of breath; labored breathing; wheezing; chest pain; or cough. At the first sign that you are developing RA-APL syndrome, your doctor will prescribe one or more medications to treat the syndrome.
Tretinoin may cause a rapid increase in the number of white blood cells in the body. This is associated with a higher risk of life-threatening side effects. If you have a very high number of white blood cells before you begin tretinoin treatment, or if you have an increase in the number of white blood cells during your treatment with tretinoin, expecially if you experience any of the symptoms of RA-APL syndrome, your doctor may prescribe one or more medications to treat or prevent the increase in white blood cells.
Keep all appointments with your doctor and the laboratory. Your doctor will order certain tests to check your body's response to tretinoin.
Talk to your doctor about the risk(s) of taking tretinoin.
For female patients:
Tretinoin must not be taken by patients who are pregnant or who may become pregnant. There is a high risk that tretinoin will cause the baby to be born with birth defects (physical problems that are present at birth).
If you can become pregnant, you will need to avoid pregnancy during your treatment with tretinoin. You must use two acceptable forms of birth control during your treatment and for 1 month after your treatment, even if you have infertility (difficulty becoming pregnant) or have experienced menopause ('change of life'; end of monthly menstrual periods). You must use these two forms of birth control at all times unless you can promise that you will not have any sexual contact with a male for 1 month after your treatment. Your doctor will tell you which forms of birth control are acceptable, and will give you full information about birth control.
If you plan to use oral contraceptives (birth control pills) while taking tretinoin, tell your doctor the name of the pill you will use. Microdosed progestin ('minipill') oral contraceptives (Ovrette, Micronor, Nor-D) may not be an effective form of birth control for people who are taking tretinoin.
You must have a negative pregnancy test within 1 week before you begin to take tretinoin. You will also need to be tested for pregnancy in a laboratory each month during your treatment.
Tretinoin is used to treat acute promyelocytic leukemia (APL; a type of cancer in which there are too many immature blood cells in the blood and bone marrow) in people who have not been helped by other types of chemotherapy or whose condition has improved but then worsened following treatment with other types of chemotherapy. Tretinoin is used to produce remission (a decrease or disappearance of signs and symptoms of cancer) of APL, but other medications must be used after treatment with tretinoin to prevent the cancer from returning. Tretinoin is in a class of medications called retinoids. It works by slowing or stopping the growth of cancer cells by causing immature blood cells to develop into normal blood cells.
Tretinoin comes as a capsule to take by mouth. It is usually taken twice a day for up to 90 days. Take tretinoin at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take tretinoin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Continue to take tretinoin even if you feel well. Do not stop taking tretinoin without talking to your doctor.
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
Talk to your doctor about eating grapefruit and drinking grapefruit juice while taking this medicine.
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
feeling of fullness in the ears
loss of appetite
numbness, burning, or tingling in the hands or feet
difficulty falling asleep or staying asleep
hallucinating (seeing things or hearing voices that do not exist)
blurred or double vision, or other vision problems
unusual bruising or bleeding
vomit that is bloody or looks like coffee grounds
bright red or black and tarry stools
Tretinoin may increase the levels of cholesterol and other fats in your blood and may stop your liver from working normally. Your doctor will monitor you carefully to see whether you are experiencing either of these side effects.
Tretinoin may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
red, cracked, and sore lips
loss of coordination
Do not let anyone else take your medication. Ask your pharmacist if you have any questions about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
Last Reviewed - 09/01/2010
AHFS® Consumer Medication Information. © Copyright, 2014. The American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.