Tretinoin, Oral

What are other names for this medicine?

Type of medicine: antineoplastic (anticancer)

Generic and brand names: tretinoin, oral; Vesanoid

What is this medicine used for?

This medicine is taken by mouth to treat acute promyelocytic leukemia in people who have not responded to other treatments.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine, or to vitamin A preparations, foods, preservatives, or dyes
• bleeding problems or blood disorders
• high cholesterol
• liver disease
• lung problems

Females of childbearing age: Do not take this medicine during pregnancy because it will harm the baby. You must have a pregnancy test that is negative before you start taking this medicine. During treatment with tretinoin, and for a month after treatment is over, you must use two effective forms of birth control at the same time. Talk to your healthcare provider if you need birth control. Do not breast-feed during this treatment.

How do I take it?

How many doses you need is based on your response to the medicine, your size, and how the medicine affects your blood. Treatment usually stops 30 days after complete remission occurs or after 90 days of treatment, whichever comes first.

Check the label on the medicine for directions about your specific dose. Take this medicine with food. Do not crush, chew, or dissolve the capsules. Swallow them whole.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: headache, dizziness, weakness, flushing, stomach pain, cracked lips.

What should I watch out for?

Almost all people who take this medicine will have some side effects, especially headache, fever, weakness, and fatigue. If you have any other side effects that you think may be caused by this medicine, tell your healthcare provider.

This medicine may raise your cholesterol or triglycerides levels. You will need to have blood tests regularly to see how this medicine affects you. Keep all appointments for these tests.

This medicine may make your skin more sensitive to the sun, which may lead to painful sunburns. While you are taking this medicine, avoid long exposure to the sun. Wear protective clothing, a hat, and sunscreen lotion when you need to be outdoors. Do not use a sunlamp. If you get a severe sunburn, contact your healthcare provider right away.

This medicine may make you dizzy or drowsy. Do not drink alcohol while receiving this medicine. Do not drive or operate machinery unless you are fully alert.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Serious (report these to your healthcare provider right away): Severe headache; nausea; vomiting; vision problems; trouble breathing; chest pain; swelling of fingers, hands, feet, lower legs, or any unexplained swelling; unusual bleeding or bruising; yellow eyes or skin; black or tarry stools; bone pain; seizures; fever; mouth sores.

Other: Dry skin or mouth, dry eyes, loss of appetite, weakness, fatigue, sensitivity to the sun, hair loss, diarrhea, constipation, restlessness, irregular heartbeat, trouble walking, trouble urinating.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• antibiotics such as tetracycline (Sumycin), minocycline (Minocin), doxycycline (Vibramycin), and erythromycin (E-Mycin, Ilotycin, Ery-Tabs, E.E.S.)
• calcium channel blockers such as diltiazem (Cardizem) and verapamil (Calan, Isoptin, Verelan)
• corticosteroids such as cortisone (Cortone), betamethasone (Celestone), dexamethasone, fludrocortisone (Florinef), hydrocortisone (Cortef, Hydrocortone, A-HydroCort), methylprednisolone (Medrol), prednisone (Meticorten), prednisolone (Delta-Cortef), and triamcinolone (Aristocort, Kenacort)
• cimetidine (Tagamet)
• cyclosporine (Sandimmune, Neoral)
• herbal remedies such as dong quai and St. John's wort
• ketoconazole (Nizoral)
• pentobarbital (Nembutal) or phenobarbital
• rifampin (Rifadin)
• vitamin A supplements or multivitamins that contain vitamin A

Other medicines may interact with this one. Be sure your healthcare provider knows about all medicines you are taking or receiving by injection.

Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.

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