Uses of Retin: - Acne Acute promyelocytic leukaemia Hypersensitivity to retinoids. Application to eczematous, sunburnt or abraded skin. Pregnancy, lactation.

Topical retinoid and related preparations

Tretinoin is structurally and pharmacologically related to vitamin A. Current evidence suggests that topical Tretinoin decreases cohesiveness of follicular epithelial cells with decreased microcomedone formation. Additionally, Tretinoin stimulates mitotic activity and increases turnover of follicular epithelial cells, causing extrusion of the comedones

How to use Tretinoin: This medicine is for external use only. Use it in the dose and duration as advised by your doctor. Check the label for directions before use. Clean and dry the affected area and apply the cream. Wash your hands after applying, unless hands are the affected area. Administration: Should be taken with food. Adult Dose: Oral Acute promyelocytic leukaemia Adult: Remission induction: 45 mg/m2 daily in 2 divided doses. Treatment is continued until 30 days after complete remission or up to 90 days, whichever occurs first. Hepatic impairment: Reduce dose to 25 mg/m2 daily. Child Dose: Oral Acute promyelocytic leukaemia Child: Remission induction: 1-16 yr 45 mg/m2 daily in 2 divided doses. Treatment is continued until 30 days after complete remission or up to 90 days, whichever occurs first. Hepatic impairment: Reduce dose to 25 mg/m2 daily. Renal Dose: Renal impairment: Reduce dose to 25 mg/m2 daily.

Enhances percutaneous absorption of minoxidil. Increased risk of fatal thrombotic complications with antifibrinolytic. Increased tretinoin concentrations with azole antifungals. Enhances peeling action of sulphur, resorcinol, benzoyl peroxide, salicylic acid. Increased photosensitivity with photosensitising medications eg, thiazides, tetracyclines, fluoroquinolones, phenothiazines and sulfonamides. Potentially Fatal: Increased risk of intracranial pressure with tetracyclines.

Hypersensitivity to retinoids. Application to eczematous, sunburnt or abraded skin. Pregnancy, lactation.

Common - Erythema (skin redness) - Skin irritation - Dry skin - Dry lips - Pale red skin - Increased sensitivity to light >10% Headache (86%),Fever (83%),Bone pain (77%),Dry mucous membranes (77%),Malaise (67%),URI (63%),Shivering (60%),Dyspnea (60%),Hemorrhage (60%),Elevated liver function tests (50-60%),Hyperlipidemia (60%).Infections (58%),Nausea and vomiting (57%),Rash (54%),Peripheral edema (52%),Leukocytosis (40%),Pain (37%),Abdominal pain (31%),DIC (26%),Respiratory insufficiency (26%),Mucositis (26%),GI disorder (26%),Retinoic acid-APL syndrome (25%),Ear ache (23%),Diarrhea (23%),Pleural effusion (20%),Dizziness (20%),Pruritus (20%),Sweating (20%),Anxiety (17%),Paresthesia (17%),Constipation (17%),Vision changes (17%),Dyspepsia (14%),Depression(14%),Insomnia (14%),Alopecia (14%),Skin changes (14%),Confusion (11%),Abdominal distention (11%),Renal insufficiency (11%) 1-10% (selected) Cardiac failure,Pseudotumor cerebri,Ulcer Potentially Fatal: Retinoic acid syndrome, cardiac arrthythmia, disseminated intravascular coagulation, blood dyscrasias, cardiac arrest, cerebral haemorrhage.

Tretinoin is contraindicated in pregnancy or suspected pregnancy. The drug should be avoided by breast feeding mothers.

Precaution: Children, hepatic or renal impairment. Reduce dose if intractable headache occurs. Discontinue temporarily if LFT exceed 5 times upper limit of normal. Monitor closely for leukocytosis or respiratory compromise. Monitor haematologic profile, coagulation parameters, LFT, serum triglyceride and cholesterol concentrations regularly. Lactation: Unknown if excreted in breast milk; do not breast-feed, because of potential for serious adverse reactions in infant

Store in a cool and dry place, away from light. Keep out of reach of children.

Tretinoin is a trans-retinoic acid form of vitimin A. It stimulates mitosis and turnover of follicular epithelial cells and reduce their cohesiveness. This facilitates extrusion of existing comedones and prevents formation of new comedone. It also exhibits thinning effect on the stratum corneum. In acute promyelocytic leukaemia, it induces cellular differentiation and decreases proliferations.