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MEQUINOL/TRETINOIN

Medical Diagnosis and Drugs, Medications
MEQUINOL/TRETINOIN
(me-qui'nol/tre-ti'noyn)
Solag?
Classifications: retinoid;
Therapeutic: depigmenting agent; retinoid
Prototype: Isotretinoin
Pregnancy Category: X

Availability

2%/0.01% solution

Action

Mequinol is a depigmenting agent and tretinoin is a retinoid used to improve dermatologic changes (e.g., fine wrinkling, mottled hyperpigmentation, roughness) associated with photo-damage and aging. Mequinol's mechanism of depigmentation is probably due to oxidation by tyrosine to cytotoxic products in melanocytes, and/or inhibition of melanin formation. Tretinoin, a retinoid, is used to improve photo-damage to the skin by acting via retinoic acid receptors (RARs).

Therapeutic Effect

Mequinol has depigmenting properties; tretinoin improves sun damaged skin.

Uses

Treatment of solar lentigines (age spots).

Unlabeled Uses

Facial wrinkles.

Contraindications

Pregnancy (category X), lactation, children, hypersensitivity to mequinol, tretinoin.

Cautious Use

History of hypersensitivity to acitretin, isotretinoin, etretinate, or other vitamin A derivatives, or hydroquinone; patients with eczema, moderate to severe skin pigmentation, vitiligo; concurrent use of photosensitive medications (e.g., thiazide diuretics, fluoroquinolones, phenothiazines, sulfonamides), concurrent use of astringents; cold weather; eczema; vitiligo.

Route & Dosage

Solar Lentigines
Adult: Topical Apply to solar lentigines b.i.d. at least 8 h apart

Administration

Topical
  • Apply doses at least 8 h apart; avoid application to unaffected areas.
  • Avoid contact with eyes, lips, mucus membranes, or paranasal creases.
  • Protect from light.

Adverse Effects (≥1%)

Skin: Erythema, burning, stinging, tingling, desquamation, pruritus, skin irritation, temporary hypopigmentation, rash, dry skin, crusting, application site reaction.

Interactions

Drug: thiazide diuretics, tetracyclines, fluoroquinolones, phenothiazines, sulfonamides may augment phototoxicity.

Pharmacokinetics

Absorption: 4.4% through skin. Peak: 1–2 h.

Nursing Implications

Assessment & Drug Effects

  • Monitor for and report peeling, erythema, or hypopigmentation.
  • Monitor for signs of tretinoin toxicity: headache, fever, weakness, and fatigue.

Patient & Family Education

  • Do not apply larger than recommended amounts.
  • Do not wash affected area for at least 6 h after drug application; do not apply cosmetics to affected area for at least 30 min after drug application.
  • Minimize exposure to sunlight or sunlamps. Use extra caution if also taking concurrently other drugs that are photosensitizing (e.g., thiazide diuretics, phenothiazines).
  • Notify physician if vitiligo (hypopigmentation of skin) or S&S of tretinoin toxicity develop (see ASSESSMENT & DRUG EFFECTS).

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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