Tretinoin (all trans retinoic acid ATRA)

What is Tretinoin (all trans retinoic acid ATRA)

Tretinoin, also known as all-trans-retinoic acid (ATRA), is a naturally occurring derivative of vitamin A.

As vitamin A (retinol) derivatives, retinoids are important regulators of cell reproduction, and cell proliferation and differentiation; however, unlike vitamin A, retinoids are not converted into rhodopsin, which is needed for night vision.

Topical tretinoin is indicated in the treatment of mild to moderate acne (e.g., grades I-III) and photodamaged skin.

Topical tretinoin has also been used in the symptomatic management of keratinization disorders such as ichthyosis and keratosis follicularis. Tretinoin represents a new class of anticancer drugs, differentiating agents.

Oral tretinoin is used in the treatment of acute promyelocytic leukemia (APL) and is undergoing phase III investigation in the treatment of Kaposi’s sarcoma.

In the treatment of APL, tretinoin offers a less toxic means to induce complete remission than conventional chemotherapy; however, approximately 25% of patients who receive tretinoin for the treatment of APL have experienced acute promyelocytic leukemia differentiation syndrome.

Indications

  1. acne rosacea
  2. acne vulgaris
  3. actinic keratosis
  4. acute promyelocytic leukemia
  5. facial wrinkles
  6. ichthyosis
  7. Kaposi’s sarcoma
  8. keloids
  9. keratosis follicularis
  10. melasma
  11. photoaging

Side Effects

  1. abdominal pain
  2. agitation
  3. agnosia
  4. alopecia
  5. anorexia
  6. anxiety
  7. aphasia
  8. arrhythmia exacerbation
  9. ascites
  10. asterixis
  11. ataxia
  12. bleeding
  13. bone pain
  14. cardiac arrest
  15. cardiomyopathy
  16. coma
  17. confusion
  18. constipation
  19. depression
  20. diaphoresis
  21. diarrhea
  22. differentiation syndrome
  23. disseminated intravascular coagulation (DIC)
  24. dizziness
  25. drowsiness
  26. dysarthria
  27. dyspepsia
  28. dyspnea
  29. dysuria
  30. edema
  31. elevated hepatic enzymes
  32. encephalopathy
  33. erythema
  34. erythema nodosum
  35. fatigue
  36. fever
  37. flank pain
  38. fluid retention
  39. flushing
  40. GI bleeding
  41. hallucinations
  42. headache
  43. hearing loss
  44. heart failure
  45. hepatitis
  46. hepatomegaly
  47. hypercalcemia
  48. hypercholesterolemia
  49. hyperlipidemia
  50. hypertension
  51. hypertriglyceridemia
  52. hypervitaminosis A
  53. hyporeflexia
  54. hypotension
  55. hypothermia
  56. hypoxia
  57. impaired cognition
  58. increased intracranial pressure
  59. increased urinary frequency
  60. insomnia
  61. intracranial bleeding
  62. laryngeal edema
  63. leukocytosis
  64. malaise
  65. myalgia
  66. myocardial infarction
  67. myocarditis
  68. nausea
  69. otalgia
  70. pallor
  71. pancreatitis
  72. papilledema
  73. paresthesias
  74. peptic ulcer
  75. pericardial effusion
  76. pericarditis
  77. peripheral edema
  78. phlebitis
  79. photosensitivity
  80. pleural effusion
  81. pruritus
  82. pseudotumor cerebri
  83. pulmonary edema
  84. pulmonary hypertension
  85. rash
  86. renal failure (unspecified)
  87. renal tubular necrosis
  88. respiratory depression
  89. seizures
  90. shivering
  91. skin hyperpigmentation
  92. skin hypopigmentation
  93. skin irritation
  94. splenomegaly
  95. spontaneous fetal abortion
  96. stomatitis
  97. stroke
  98. teratogenesis
  99. thrombocytosis
  100. thrombosis
  101. tremor
  102. vesicular rash
  103. visual impairment
  104. vomiting
  105. weakness
  106. weight gain
  107. weight loss
  108. wheezing
  109. xerosis

Monitoring Parameters

  • CBC with differential
  • LFTs
  • pregnancy testing
  • serum cholesterol profile
  • serum lipid profile

Contraindications

  • accidental exposure
  • breast-feeding
  • children
  • contraception requirements
  • differentiation syndrome
  • eczema
  • fish hypersensitivity
  • hepatic disease
  • hypercholesterolemia
  • hyperlipidemia
  • hypertriglyceridemia
  • infants
  • leukocytosis
  • neonates
  • ocular exposure
  • paraben hypersensitivity
  • pregnancy
  • pregnancy testing
  • reproductive risk
  • requires a specialized care setting
  • requires an experienced clinician
  • respiratory insufficiency
  • retinoid hypersensitivity
  • skin photosensitivity disorder
  • sunburn
  • sunlight (UV) exposure

Interactions

  • Abciximab
  • Acetohexamide
  • Adapalene; Benzoyl Peroxide
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Alpha interferons
  • Amiloride; Hydrochlorothiazide, HCTZ
  • Aminocaproic Acid
  • Aminolevulinic Acid
  • Amiodarone
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Anagrelide
  • Anticoagulants
  • Antithrombin III
  • Antithymocyte Globulin
  • Apixaban
  • Aprotinin
  • Argatroban
  • Aspirin, ASA; Dipyridamole
  • Atenolol; Chlorthalidone
  • Azelastine; Fluticasone
  • Azilsartan; Chlorthalidone
  • Barbiturates
  • Beclomethasone
  • Benazepril; Hydrochlorothiazide, HCTZ
  • Bendroflumethiazide; Nadolol
  • Benzoyl Peroxide
  • Benzoyl Peroxide; Clindamycin
  • Benzoyl Peroxide; Erythromycin
  • Benzoyl Peroxide; Sulfur
  • Betamethasone
  • Betrixaban
  • Bisoprolol; Hydrochlorothiazide, HCTZ
  • Bivalirudin
  • Budesonide
  • Budesonide; Formoterol
  • Candesartan; Hydrochlorothiazide, HCTZ
  • Captopril; Hydrochlorothiazide, HCTZ
  • Carbamazepine
  • Chlorothiazide
  • Chlorpromazine
  • Chlorpropamide
  • Chlorthalidone
  • Chlorthalidone; Clonidine
  • Cholestyramine
  • Ciclesonide
  • Cilostazol
  • Cimetidine
  • Ciprofloxacin
  • Clopidogrel
  • Clozapine
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Colestipol
  • Corticosteroids
  • Corticotropin, ACTH
  • Cortisone
  • Cyclosporine
  • Dabigatran
  • Dalteparin
  • Danaparoid
  • Danazol
  • Deflazacort
  • Desirudin
  • Dexamethasone
  • Dextromethorphan; Promethazine
  • Diclofenac
  • Diclofenac; Misoprostol
  • Digoxin
  • Diltiazem
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Dipyridamole
  • Echinacea
  • Edoxaban
  • Enalapril; Hydrochlorothiazide, HCTZ
  • Enoxaparin
  • Eprosartan; Hydrochlorothiazide, HCTZ
  • Eptifibatide
  • Eravacycline
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Esomeprazole; Naproxen
  • Etodolac
  • Famotidine; Ibuprofen
  • Felbamate
  • Fenoprofen
  • Filgrastim, G-CSF
  • Fludrocortisone
  • Flunisolide
  • Fluphenazine
  • Flurbiprofen
  • Fluticasone
  • Fluticasone; Salmeterol
  • Fluticasone; Umeclidinium; Vilanterol
  • Fluticasone; Vilanterol
  • Fondaparinux
  • Formoterol; Mometasone
  • Fosinopril; Hydrochlorothiazide, HCTZ
  • Gemifloxacin
  • Gentamicin
  • Glimepiride
  • Glimepiride; Pioglitazone
  • Glimepiride; Rosiglitazone
  • Glipizide
  • Glipizide; Metformin
  • Glyburide
  • Glyburide; Metformin
  • Griseofulvin
  • Heparin
  • Hydantoins
  • Hydralazine; Hydrochlorothiazide, HCTZ
  • Hydrochlorothiazide, HCTZ
  • Hydrochlorothiazide, HCTZ; Irbesartan
  • Hydrochlorothiazide, HCTZ; Lisinopril
  • Hydrochlorothiazide, HCTZ; Losartan
  • Hydrochlorothiazide, HCTZ; Methyldopa
  • Hydrochlorothiazide, HCTZ; Metoprolol
  • Hydrochlorothiazide, HCTZ; Moexipril
  • Hydrochlorothiazide, HCTZ; Olmesartan
  • Hydrochlorothiazide, HCTZ; Propranolol
  • Hydrochlorothiazide, HCTZ; Quinapril
  • Hydrochlorothiazide, HCTZ; Spironolactone
  • Hydrochlorothiazide, HCTZ; Telmisartan
  • Hydrochlorothiazide, HCTZ; Triamterene
  • Hydrochlorothiazide, HCTZ; Valsartan
  • Hydrocodone; Ibuprofen
  • Hydrocortisone
  • Ibuprofen
  • Ibuprofen; Oxycodone
  • Ibuprofen; Pseudoephedrine
  • Indapamide
  • Indomethacin
  • Interferon Alfa-2a
  • Interferon Alfa-2b
  • Interferon Alfa-2b; Ribavirin
  • Interferon Alfa-n3
  • Interferon Alfacon-1
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Ketoconazole
  • Ketorolac
  • Lansoprazole; Naproxen
  • Lepirudin
  • Levofloxacin
  • Lithium
  • Meclofenamate Sodium
  • Mefenamic Acid
  • Meloxicam
  • Meperidine; Promethazine
  • Mesoridazine
  • Methotrexate
  • Methoxsalen
  • Methyclothiazide
  • Methylprednisolone
  • Metolazone
  • Mometasone
  • Moxifloxacin
  • Nabumetone
  • Naproxen
  • Naproxen; Pseudoephedrine
  • Naproxen; Sumatriptan
  • Norfloxacin
  • Ofloxacin
  • Omeprazole; Amoxicillin; Rifabutin
  • Orlistat
  • Oxaprozin
  • Palifermin
  • Pegfilgrastim
  • Peginterferon Alfa-2a
  • Peginterferon Alfa-2b
  • Penicillamine
  • Pentosan
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Phenothiazines
  • Phentermine; Topiramate
  • Phenylephrine; Promethazine
  • Photosensitizing agents (topical)
  • Piroxicam
  • Platelet Inhibitors
  • Porfimer
  • Prasugrel
  • Prednisolone
  • Prednisone
  • Prochlorperazine
  • Promethazine
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Rivaroxaban
  • Salicylic Acid
  • Sodium Thiosulfate; Salicylic Acid
  • St. John’s Wort, Hypericum perforatum
  • Sulfonylureas
  • Sulindac
  • Tbo-Filgrastim
  • Tetracyclines
  • Thiazide diuretics
  • Thiethylperazine
  • Thioridazine
  • Thrombolytic Agents
  • Thyroid hormones
  • Ticagrelor
  • Ticlopidine
  • Tinzaparin
  • Tirofiban
  • Tolazamide
  • Tolbutamide
  • Tolmetin
  • Topiramate
  • Trandolapril; Verapamil
  • Tranexamic Acid
  • Triamcinolone
  • Trifluoperazine
  • Tuberculin Purified Protein Derivative, PPD
  • Verapamil
  • Verteporfin
  • Vorapaxar
  • Voriconazole
  • Warfarin
15585

Sign up to receive the trending updates and tons of Health Tips

Join SeekhealthZ and never miss the latest health information

15856
Scroll to Top