tretinoin topical (Rx)

Brand and Other Names:Retin A, Renova, more...Altreno, Atralin, Avita, Refissa, Retin-A Micro
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

topical cream

  • 0.02% (Renova)
  • 0.025% (Retin-A, Avita)
  • 0.05% (Retin-A, Renova, Refissa)
  • 0.06% (Retin-A Micro Pump)
  • 0.1% (Retin-A)

topical gel

  • 0.01% (Retin-A)
  • 0.025% (Retin-A, Avita)
  • 0.04% (Retin-A Micro)
  • 0.05% (Atralin)
  • 0.08% (Retin-A Micro)
  • 0.1% (Retin-A Micro)

topical solution

  • 0.05% (Retin-A)

topical lotion

  • 0.05% (Altreno)

Acne Vulgaris

Retin-A, Altreno, Atralin, Avita, Retin-A Micro, Tretin-X

  • Apply a pea-sized amount topically qHS to the skin where acne lesions appear, using enough to lightly cover the entire affected area

Facial Wrinkles

Adjunct for mitigation of fine wrinkles, mottled hyperpigmentation, and tactile roughness of facial skin

Renova, Refissa

  • Apply a pea-sized amount (0.02-0.05%) to the affected area qHS

Dosage Forms & Strengths

topical cream

  • 0.02% (Renova)
  • 0.025% (Retin-A, Avita)
  • 0.05% (Retin-A, Renova, Refissa)
  • 0.1% (Retin-A)

topical gel

  • 0.01% (Retin-A)
  • 0.025% (Retin-A, Avita)
  • 0.04% (Retin-A Micro)
  • 0.05% (Atralin)
  • 0.08% (Retin-A Micro)
  • 0.1% (Retin-A Micro)

topical solution

  • 0.05% (Retin-A)

topical lotion

  • 0.05% (Altreno)

Acne Vulgaris

Retin-A, Altreno, Atralin, Avita, Retin-A Micro

  • Altreno; <9 years: Safety and efficacy not established
  • Atralin; <10 years: Safety and efficacy not established
  • Retin-A, Retin-A Micro, Avita; <12 years: Safety and efficacy not established
  • Apply a pea-sized amount topically qHS to the skin where acne lesions appear, using enough to lightly cover the entire affected area
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Interactions

Interaction Checker

and tretinoin topical

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    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

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            Contraindicated (0)

              Serious - Use Alternative (34)

              • aminolevulinic acid oral

                aminolevulinic acid oral, tretinoin topical. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid administering other phototoxic drugs with aminolevulinic acid oral for 24 hr during perioperative period.

              • aminolevulinic acid topical

                tretinoin topical, aminolevulinic acid topical. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Each drug may increase the photosensitizing effect of the other.

              • bendroflumethiazide

                bendroflumethiazide, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • chlorothiazide

                chlorothiazide, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • chlorpromazine

                chlorpromazine, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • chlorthalidone

                chlorthalidone, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • ciprofloxacin

                ciprofloxacin, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Both drugs have increased risk of phototoxicity, use caution with concomitant use.

              • cyclopenthiazide

                cyclopenthiazide, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • demeclocycline

                demeclocycline, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • doxycycline

                doxycycline, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • fleroxacin

                fleroxacin, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • fluphenazine

                fluphenazine, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • gemifloxacin

                gemifloxacin, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • hydrochlorothiazide

                hydrochlorothiazide, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • indapamide

                indapamide, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • levofloxacin

                levofloxacin, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • methotrexate

                methotrexate, tretinoin topical. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive hepatotoxicity.

              • methyclothiazide

                methyclothiazide, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • methyl aminolevulinate

                tretinoin topical, methyl aminolevulinate. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Each drug may increase the photosensitizing effect of the other.

              • metolazone

                metolazone, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • minocycline

                minocycline, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • moxifloxacin

                moxifloxacin, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • ofloxacin

                ofloxacin, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • oxytetracycline

                oxytetracycline, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • perphenazine

                perphenazine, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • prochlorperazine

                prochlorperazine, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • promazine

                promazine, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • promethazine

                promethazine, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • sulfadiazine

                sulfadiazine, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • sulfamethoxazole

                sulfamethoxazole, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • sulfisoxazole

                sulfisoxazole, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • tetracycline

                tetracycline, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • thioridazine

                thioridazine, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • trifluoperazine

                trifluoperazine, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              Monitor Closely (3)

              • mifepristone

                mifepristone will increase the level or effect of tretinoin topical by Other (see comment). Use Caution/Monitor. Inhibits CYP2C8/2C9; use smallest recommended doses for substrates and monitor

              • porfimer

                tretinoin topical will increase the level or effect of porfimer by pharmacodynamic synergism. Use Caution/Monitor. May enhance the photosensitizing effects of porfimer

              • stiripentol

                stiripentol will increase the level or effect of tretinoin topical by Other (see comment). Modify Therapy/Monitor Closely. Stiripentol is a CYP2C8 inhibitor. Consider dosage reduction for CYP2C8 substrates if adverse effects are experienced when coadministered.

              Minor (1)

              • ketoconazole

                ketoconazole increases levels of tretinoin topical by decreasing metabolism. Minor/Significance Unknown.

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              Adverse Effects

              Frequency Not Defined

              Excessive dryness

              Erythema

              Scaling

              Pruritus

              Hyperpigmentation/hypopigmentation

              Photosensitivity

              Initial acne flare-up

              Edema

              Blistering

              Stinging

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              Warnings

              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

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              Pregnancy & Lactation

              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.

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              Pharmacology

              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%)

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              Administration

              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
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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              Renova topical
              -
              0.02 % cream
              Renova topical
              -
              0.02 % cream
              Renova topical
              -
              0.02 % cream
              Renova topical
              -
              0.02 % cream

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              tretinoin (emollient) topical

              TRETINOIN CREAM - TOPICAL

              (tret-ih-NO-in)

              COMMON BRAND NAME(S): Renova

              USES: This medication is used to improve the appearance of the skin by reducing fine lines and wrinkles, reducing roughness, and improving skin color. It should be used with a skin care and sunlight-avoidance program that includes moisturizer and daily use of an effective sunscreen (minimum SPF 15).Tretinoin belongs to a class of medications called retinoids. It works by affecting the growth of skin cells. Tretinoin does not repair sun-damaged skin or reverse aging due to sun exposure.

              HOW TO USE: Read the Patient Information Leaflet available from your pharmacist before you start using this medication and each time you get a refill. Ask your doctor or pharmacist if you have any questions.Gently clean your face with a mild or soapless cleanser and pat skin dry. Wait 20-30 minutes before applying this medication. Apply a pea-sized amount of cream, using just enough to cover your entire face lightly, usually once a day before bedtime or as directed by your doctor. Be careful to avoid your eyes, nostrils and mouth. Do not wash your face or apply another skin care product for at least 1 hour after using this product.Do not use more of this medication than prescribed or use it more often. It will not give you faster or better results, but will increase the risk of developing redness, peeling and pain. Do not use on cut, scraped, sunburned, or eczema-affected skin.Avoid getting this medication in your eyes. If this medication gets into your eyes, flush with large amounts of water. Call your doctor if eye irritation develops. Wash your hands after using the medication to avoid accidentally getting it in your eyes.Effects of this medication will appear slowly, with most improvement seen in the first 6 months of use.If used for acne, your condition may worsen at first, then improve.

              SIDE EFFECTS: A brief sensation of warmth or stinging may occur immediately after applying the medication. Skin redness, dryness, itching, scaling, mild burning, or worsening of acne may occur during the first 2-4 weeks of using the medication. These effects usually decrease with continued use. A daytime moisturizer may be helpful for very dry skin (see Notes).If any of these effects persist or worsen, notify your doctor or pharmacist promptly. Your doctor may want you to decrease how often you use tretinoin, change the strength, or have you stop using it.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Notify your doctor if you experience: blistering, crusting, severe burning/swelling of the skin, eye redness and watering (conjunctivitis), eyelid swelling, darkening or lightening of skin color.A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before using tretinoin, tell your doctor or pharmacist if you are allergic to it; or to vitamin A-related drugs (other retinoids such as isotretinoin); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: eczema.This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Weather extremes such as wind or cold may also be irritating to the skin. Use sunscreen daily and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness. Wait until your skin has completely recovered from a sunburn before using tretinoin.Avoid electrolysis, waxing and chemical depilatories for hair removal on the treated areas while using this product.If you have recently used products containing sulfur, resorcinol or salicylic acid, use tretinoin with caution. Wait until the effects of such products on the skin have decreased before using tretinoin.During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. Discuss the risks and benefits with your doctor.It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: See also Precautions section.The effects of some drugs can change if you take other drugs or herbal products at the same time. This can increase your risk for serious side effects or may cause your medications not to work correctly. These drug interactions are possible, but do not always occur. Your doctor or pharmacist can often prevent or manage interactions by changing how you use your medications or by close monitoring.To help your doctor and pharmacist give you the best care, be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products) before starting treatment with this product. While using this product, do not start, stop, or change the dosage of any other medicines you are using without your doctor's approval.Some products that may interact with this drug include: hair perming solutions, alcohol/lime/menthol-containing products (such as astringents, toners, shaving lotions), medicated or abrasive soaps and cleansers, products containing alpha hydroxy acid, products containing glycolic acid, products containing sulfur, resorcinol or salicylic acid, soaps and cosmetics with a strong drying effect, other drugs that may increase your sensitivity to sunlight (including fluoroquinolones such as ciprofloxacin, tetracyclines, thiazide water pills such as hydrochlorothiazide, sulfa drugs such as sulfamethoxazole, phenothiazines such as chlorpromazine).Benzoyl peroxide should not be applied at the same time as this medication.This document does not contain all possible drug interactions. Keep a list of all the products you use. Share this list with your doctor and pharmacist to lessen your risk for serious medication problems.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. This medicine may be harmful if swallowed. Symptoms of overdose may include excessive redness, peeling, and discomfort.

              NOTES: Cosmetics may be used 1 hour after applying tretinoin. Be sure to clean skin well before applying the medication. Daily moisturizer should be used to protect your skin from dryness.Do not share this medication with others.

              MISSED DOSE: If you forget to use this medication, use it as soon as you remember if you remember the same day. If you don't remember until morning, wait until your next dose is scheduled.

              STORAGE: Store at room temperature at 77 degrees F (25 degrees C) away from light and moisture. Brief storage at 59-86 degrees F (15-30 degrees C) is permitted. Do not freeze. Keep all medicines away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

              Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

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              • View the formulary and any restrictions for each plan.
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              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.