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ALITRETINOIN (9-CIS-RETINOIC ACID)

Medical Diagnosis and Drugs, Medications
ALITRETINOIN (9-cis-RETINOIC ACID)
(a-li-tre'ti-noyne)
Panretin
Classifications: antiacne (retinoid);
Therapeutic: antiacne
Prototype: Isotretinoin
Pregnancy Category: D

Availability

0.1% gel

Action

Naturally occurring retinoid that binds to and activates all known retinoid receptors in cells, which regulate cellular differentiation and proliferation in both healthy and neoplastic cells.

Therapeutic Effect

Inhibits the growth of Kaposi's sarcoma (KS) in HIV patients. It does not prevent the development of new KS lesions.

Uses

Treatment of cutaneous lesions of AIDS-related Kaposi's sarcoma.

Unlabeled Uses

Cutaneous T-cell lymphomas.

Contraindications

Hypersensitivity to alitretinoin or other retinoids including vitamin A; when systemic anti-KS therapy is required; pregnancy (category D), lactation.

Cautious Use

Cutaneous T-cell lymphoma. Safety and efficacy in children <18 y, or older adults ≥65 y, are unknown.

Route & Dosage

Cutaneous Kaposi's Sarcoma
Adult: Topical Apply sufficient gel to cover lesions b.i.d., may increase application to 3–4 times daily if tolerated

Administration

Topical
  • Apply gel liberally over lesions; avoid unaffected skin and mucus membranes.
  • Dry 3–5 min before covering with clothes. Do not cover with occlusive dressing.
  • Store at 15°–30° C (59°–86° F).

Adverse Effects (≥1%)

Skin: Erythema, edema, vesiculation, rash, burning pain, pruritus, exfoliative dermatitis, excoriation, paresthesia.

Interactions

Drug: Increased toxicity with insect repellents containing DEET.

Pharmacokinetics

Absorption: Minimal.

Nursing Implications

Assessment & Drug Effects

  • Monitor for S&S of dermal toxicity (e.g., erythema, edema, vesiculation).

Patient & Family Education

  • Allow up to 14 wk for therapeutic response.
  • Avoid exposure of medicated skin to sunlight or sun lamps.
  • Contact physician if inflammation, swelling, or blisters appear on medicated areas.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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