tretinoin topical (Rx)

Frequency Not Defined

Excessive dryness

Erythema

Scaling

Pruritus

Hyperpigmentation/hypopigmentation

Photosensitivity

Initial acne flare-up

Edema

Blistering

Stinging

Contraindications

Hypersensitivity

Sunburn

Cautions

Extreme caution in eczema (may produce severe irritation of eczematous skin)

Discontinue if sensitivity or chemical irritation occurs

Exposure to UV light (including from sunlamps) increases intensity of inflammatory reaction; use sunscreen of at least SPF 15 and protective clothing during exposure

Concomitant topical medications such as abrasive soaps, cleansers, or cosmetics with strong drying effects may increase skin irritation

Avoid use with weather extremes, such as wind or cold due to potential for increased irritation; excessive dryness, redness, and swollen or blistered skin may occur; reduce amount, frequency, or discontinue use until irritation disappears

Use Atralin Gel with caution if patient allergic to fish due to potential for allergenicity to fish protein; patients who develop pruritus or urticaria should contact their health care provider

Pregnancy category: C

Lactation: Not known whether excreted in breast milk

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

Mechanism of Action

Inhibits microcomedo formation; decreases cohesiveness of keratinocytes in sebaceous follicles, which allows for easy removal; has anti-inflammatory properties

Absorption

Minimal

Elimination

Excretion: Urine (0.1%)

Topical Administration

Instruct patient to

• Apply pea-sized amount sparingly to skin where acne lesions appear
• Apply 20 minutes after skin is cleansed and completely dried
• Avoid lips and directly under eyes
• Avoid UV exposure