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Alitretinoin Gel

Trade/other name(s): Panretin

Why would this drug be used?

Altretinoin gel helps stop the growth of Kaposi sarcoma (KS) cells and is used to treat KS skin lesions. It does not help with KS that is inside the body, and does not cure KS.

How does this drug work?

Alitretinoin gel 0.1% is used as a molecular targeted therapy. Retinoids are compounds related to vitamin A that help to regulate the gene functions that allow cells to grow and divide. Retinoids help the cells to mature and divide more normally. Alitretinoin gel activates certain retinoid receptors on the cancer cell to control cancer cell growth and division.

Before taking this medicine

Tell your doctor…

  • If you are allergic to anything, including medicines, dyes, additives, or foods.
  • If you work outside or cannot avoid sun exposure. People who are using alitretinoin gel may get sunburns more quickly than usual.
  • If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. The topical form of this drug has not been studied in pregnant women. If the drug is absorbed through the skin into the body, it may cause birth defects if taken at the time of conception or during pregnancy. It is important to check with your doctor about what kinds of birth control can be used with this medicine.
  • If you are breast-feeding. If the drug is absorbed into the body, it may pass into breast milk and affect the baby.
  • About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.

Interactions with other drugs

Alitretinoin gel can cause large amounts of DEET (from insect repellant) to be absorbed through the skin and get into your blood. This can raise the risk of toxic effects from DEET.

Check with your doctor, nurse, or pharmacist about other medicines, vitamins, herbs, and supplements, and whether alcohol can cause problems with this medicine.

Interactions with foods

No serious interactions with food are known at this time. Check with your doctor, nurse, or pharmacist about whether foods may be a problem.

Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.

How is this drug taken or given?

Alitretinoin gel is applied to KS skin lesions, usually starting at twice a day. Your doctor may tell you to increase the frequency to 3 times a day, and if you have no problem with that, 4 times a day. The dose depends upon the size of the lesions. How often you apply it depends on whether you have any problems with it.

Apply just enough to cover the lesion, avoiding the normal skin around it. You can spread the gel with a cotton swab or your fingers. If you use your fingers, wash your hands thoroughly afterward so that none of the medicine gets into your eyes, nose, or mouth. Never use the gel near mucous membranes (the moist pink tissues of the eyes, nose, mouth, rectal area, penis, or vagina). Wait until the gel completely dries before covering it with clothing. Do not bandage the area where the gel is applied unless your doctor tells you to do so. Responses are sometimes seen as soon as 2 to 4 weeks after starting use, but may take up to 14 weeks.

Take this drug exactly as directed by your doctor. If you do not understand the instructions, ask your doctor or nurse to explain them to you. Keep the medicine in a tightly closed container out of heat, light, and humidity, and out of the reach of children and pets.

If serious skin irritation develops, your doctor or nurse may instruct you to stop using the gel for a few days until it improves.

Precautions

Sunlight, sun lamps, and tanning beds may cause severe sunburn while you are using alitretinoin gel. Cover your skin if you must be outside during daylight hours.

Side effects are mainly skin reactions in the area where the gel is used. This is usually mild to moderate and begins as redness of the skin. It may progress to swelling. Rarely, some patients may go on to develop more severe reactions, such as intense redness, severe swelling, or blisters. Stop using the gel and call your doctor or nurse if this occurs.

If you develop cracking, crusting, oozing, or peeling skin where the gel is applied, stop the gel and call your doctor or nurse.

This treatment will not stop new KS lesions from growing. Let your doctor know if you notice 10 or more new KS lesions in a month, or if you have lymphedema (swelling of arm, leg, or other part of your body). You may need systemic (whole-body) treatment. Call your doctor right away if you have shortness of breath, abdominal pain, or notice lesions in your mouth or nose.

Avoid pregnancy while taking this drug. It is not known whether it absorbs through the skin enough to harm the fetus or cause birth defects.

Be sure to see your doctor for follow-up appointments while you are using alitretinoin, so that your doctor can tell whether the drug is working as it should.

Possible side effects

You will probably not have most of the following side effects, but if you have any talk to your doctor or nurse. They can help you understand the side effects and cope with them.

Common

  • redness or swelling of the area where the gel is applied*

Less common

  • blisters where the gel is applied*
  • rash on the area where the gel is applied
  • pain in the area where the gel is applied
  • itching of the area where the gel is applied

Rare

  • peeling or scaling of the skin where the gel is applied*
  • cracking, crusting of the skin where the gel is applied*
  • oozing or draining of the skin where the gel is applied*
  • stinging or tingling of the skin where the gel is applied

*See "Precautions" section for more detailed information.

There are other side effects not listed above that can also occur in some patients. Tell your doctor or nurse if you develop these or any other problems.

FDA approval

Yes – first approved in 1999.

Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your medical needs.

Last Medical Review: 02/22/2010
Last Revised: 02/22/2010