Posted on October 14th, 2010 by
Class: Antineoplastic agent, miscellaneous
Generic Name: Alitretinoin (a-li-TRET-in-oyn)
Trade Name: Panretin®
For which conditions is this drug approved?
Alitretinoin is FDA approved for the treatment of skin lesions (sores) in patients with AIDS-related Kaposi’s sarcoma.
It is important for patients to remember that physicians have the ability to prescribe medication for conditions other than those for which the drug has been approved by the FDA. Patients who have received a prescription of this drug for a condition other than which it is approved may wish to discuss this issue with their physician.
What is the mechanism of action?
Alitretinoin belongs to a group of drugs called retinoids. Retinoids are related to vitamin A and normally have effects on cellular growth, maturation and death. Alitretinoin binds to specific retinoid receptors in a cell, ultimately inhibiting growth of Kaposi’s sarcoma cells..
How is alitretinoin typically given (administered)?
Alitretinoin is a gel that is placed directly on external lesions of the skin. Often, the gel is applied a couple of times per day; however, physicians will instruct patients on the number of daily applications and the duration of use of alitretinoin. Patients should not apply alitretinoin on or near openings of the body (e.g. eyes, mouth, nostrils).
How are patients typically monitored?
Patients will usually have scheduled meetings for follow-up during treatment with alitretinoin. Physicians will assess response and side effects of therapy by the skin’s appearance, as well as perform periodic blood draws to determine functioning of some organs, such as the liver and kidneys.
What are the common (occur in 30% or more of patients) side effects of treatment with alitretinoin?
• Rash at or near the site of application(s).
What are the less common (occur in 10% to 29% of patients) side effects of treatment with alitretinoin?
All of the following side effects occurred at the site of application(s):
• Pain or burning
This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.
Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.
What can patients do to help alleviate or prevent discomfort and side effects?
• Pay careful attention to the physician’s instructions and inform the physician of any side effects.
• Apply gel only to lesions; try to avoid contact with healthy skin surrounding the lesion, as this may cause irritation.
• Allow gel to dry for 3 to 5 minutes before putting on clothing that would cover the treated lesion.
• Do not use occlusive dressings on the treated lesion.
• Wear protective clothing, sunglasses, and sunscreen when exposed to sunlight.
• Avoid sun and sunlamps as alitretinoin may make patients sensitive to sunlight.
Are there any special precautions patients should be aware of before starting treatment?
• During treatment with alitretinoin, patients should avoid using products that contain the bug repellent DEET, as drug reactions between the two agents have been demonstrated with increased toxicity.
• Patients should avoid UV light exposure and use protective clothing and sunscreen when exposed to sunlight.
• Patients should tell their physician if they are pregnant, breastfeeding or planning a family in the near future. This drug may cause birth defects. It is important to use some kind of birth control while undergoing treatment. Also, patients may want to talk to their physician if they are considering having children in the future, since some drugs may cause fertility problems.
• It is important that patients inform their physician of any pre-existing conditions (chicken pox, infection, heart disease, kidney disease, liver disease, lung disease, thyroid disease, etc.) as they may worsen with this drug.
• Patients should inform their physician if they have ever had convulsions or seizures.
• Patients should inform their physician about any other medication they are taking (whether prescription or over the counter, including vitamins, herbs, etc.) as they may interfere with treatment.
• Patients should check with their physician before starting any new drug or nutritional supplement.
• Patients should inform their physician of any known drug or food allergies or any reactions to medications they have experienced in the past.
When should patients notify their physician?
• Excessive skin irritation
• Significant redness
• Extreme skin dryness or scaling
• Prolonged inflammation
What is a package insert?
A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers. A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug. By carefully reviewing the package insert, you will get the most complete and current information about how to safely use this drug. If you do not have the package insert for the drug you are using, your pharmacist or physician may be able to provide you with a copy.
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