Chlorthalidone: (Moderate) A manufacturer of topical tretinoin states that tretinoin, ATRA should be administered with caution in patients who are also taking drugs known to be photosensitizers, such as thiazide diuretics, as concomitant use may augment phototoxicity. Olmesartan; Hydrochlorothiazide, HCTZ: (Moderate) A manufacturer of topical tretinoin states that tretinoin, ATRA should be administered with caution in patients who are also taking drugs known to be photosensitizers, such as thiazide diuretics, as concomitant use may augment phototoxicity. Wash hands immediately after applying.Gel: Apply lightly to the affected area.
With the exception of the 0.05% lotion (approved for use in children 9 years and older) and 0.05% gel (approved for use in children 10 years and older) formulations, safety and efficacy of topical tretinoin have not been established in neonates, infants and children under 12 years of age. High initial leukocyte counts or rapidly increasing leukocyte counts during treatment may be predictive of retinoic acid-acute promyelocytic leukemia (RA-APL) syndrome (see Adverse Reactions). Fluticasone; Salmeterol: (Minor) Because systemically administered corticosteroids exhibit immunosuppressive effects when given in high doses and/or for extended periods, additive effects may be seen with other immunosuppressives or antineoplastic agents. endstream
endobj
startxref
Early signs and symptoms include papilledema, headache, nausea, vomiting, and visual disturbances. 53 0 obj <>/Filter/FlateDecode/ID[<8ADFC281A2B79448BF5EE5A3EF09D0D5>]/Index[22 72]/Length 128/Prev 496184/Root 23 0 R/Size 94/Type/XRef/W[1 2 1]>>stream Sunlight (UV) exposure potentiates the inflammatory effects of tretinoin. Patients should take care and use proper techniques to limit sunlight and UV exposure of treated areas. Azelastine; Fluticasone: (Minor) Because systemically administered corticosteroids exhibit immunosuppressive effects when given in high doses and/or for extended periods, additive effects may be seen with other immunosuppressives or antineoplastic agents. |%#2?$h%9q A#"!xW+ >B%$ Mometasone: (Minor) Because systemically administered corticosteroids exhibit immunosuppressive effects when given in high doses and/or for extended periods, additive effects may be seen with other immunosuppressives or antineoplastic agents. Methotrexate: (Moderate) Concomitant use of systemic retinoids, such as tretinoin, and methotrexate could increase risk of liver-related side effects of methotrexate and such patients should be monitored closely during methotrexate therapy. The distribution of tretinoin has not been determined. Patients should take care and use proper techniques to limit sunlight and UV exposure of treated areas. 5-iZw)hDIC)7}q{s]wq#gX67pF@4`H 'Ih;5;$MxyG]eY_pP58u])Y (Pxa=;%PuUY>n!cglI&N[ 9`3tF37. Concomitant use with other photosensitizing agents may increase the risk of a photosensitivity reaction. Patients with high-risk APL received: idarubicin 5 mg/m2/dose IV on days 1, 2, 3, 4, and 4 and cytarabine 1,000 mg/m2/day IV on days 1, 2, 3, and 4 (course 1); mitoxantrone 10 mg/m2/dose IV on days 1, 2, 3, 4, and 5 and etoposide 100 mg/m2/dose IV on days 1, 2, 3, 4, and 5 (course 2); and idarubicin 12 mg/m2/dose IV on day 1, cytarabine 150 mg/m2 subcutaneously every 8 hours on days 1, 2, 3, 4, and 5, and 6-thioguanine 70 mg/m2 PO every 8 hours on days 1, 2, 3, 4, and 5 (course 3). Promethazine; Phenylephrine: (Moderate) A manufacturer of topical tretinoin states that tretinoin, ATRA should be administered with caution in patients who are also taking drugs known to be photosensitizers, such as phenothiazines, as concomitant use may augment phototoxicity. The majority of patients do not require discontinuation of tretinoin therapy during RA-APL syndrome. Ultraviolet irradiation induces three metalloproteinases in human skin: collagenase, 92-kd gelatinase, and stromelysin-1.
Oral tretinoin should not be administered to patients who have paraben hypersensitivity.
Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ: (Moderate) A manufacturer of topical tretinoin states that tretinoin, ATRA should be administered with caution in patients who are also taking drugs known to be photosensitizers, such as thiazide diuretics, as concomitant use may augment phototoxicity.
Early signs and symptoms of pseudotumor cerebri include papilledema, headache, nausea, vomiting, and visual disturbances. If tolerated, this should not be considered a reason to discontinue therapy. There were 4 deaths during induction therapy. Avoid use of topical tretinoin over large areas of skin or for prolonged periods. Acetohexamide: (Moderate) A manufacturer of topical tretinoin states that tretinoin, ATRA should be administered with caution in patients who are also taking drugs known to be photosensitizers, such as sulfonylureas, as concomitant use may augment phototoxicity. If sun exposure cannot be avoided during topical tretinoin therapy, sunscreen products and physical sun blocks (protective clothing, hats) are recommended for protection of treated areas. Mechanism of Action: Retinoids are intracrine and paracrine mediators of cell differentiation and proliferation, apoptosis (programmed cell death), and reproduction. Temporary discontinuation or reduction in application frequency may be necessary until the patient is able to tolerate the treatment. In 13 patients who had received oral tretinoin daily for 4 consecutive weeks, a 72% increase in mean tretinoin plasma AUC was observed when ketoconazole (400 mg to 1200 mg PO) was given 1 hour before the tretinoin dose. Triamcinolone: (Minor) Because systemically administered corticosteroids exhibit immunosuppressive effects when given in high doses and/or for extended periods, additive effects may be seen with other immunosuppressives or antineoplastic agents. Interferon Alfa-2b; Ribavirin: (Moderate) Use of alpha interferons are associated with myelosuppression; additive myelosuppressive effects may be seen when alpha interferons are given concurrently with other myelosuppressive agents, such as antineoplastic agents or immunosuppressives. endstream endobj startxref This is thought to be due to the persistent procoagulant tendency often associated with systemic tretinoin, ATRA therapy. Application of excessive amounts may result in 'caking' or 'pilling' and will not provide incremental efficacy.
Budesonide; Formoterol: (Minor) Because systemically administered corticosteroids exhibit immunosuppressive effects when given in high doses and/or for extended periods, additive effects may be seen with other immunosuppressives or antineoplastic agents.
Concurrent application of these agents on areas treated with tretinoin should be avoided. kn[cUb>ayL1h Metolazone: (Moderate) A manufacturer of topical tretinoin states that tretinoin, ATRA should be administered with caution in patients who are also taking drugs known to be photosensitizers, such as thiazide diuretics, as concomitant use may augment phototoxicity.
Thioridazine: (Moderate) A manufacturer of topical tretinoin states that tretinoin, ATRA should be administered with caution in patients who are also taking drugs known to be photosensitizers, such as phenothiazines, as concomitant use may augment phototoxicity. Hydrochlorothiazide, HCTZ; Moexipril: (Moderate) A manufacturer of topical tretinoin states that tretinoin, ATRA should be administered with caution in patients who are also taking drugs known to be photosensitizers, such as thiazide diuretics, as concomitant use may augment phototoxicity. Benzoyl Peroxide; Sulfur: (Moderate) Benzoyl peroxide can potentiate the skin irritation caused by topical tretinoin. The bacterium involved in acne, Propionibacterium acnes, and sebum production are unaffected. Ticagrelor: (Moderate) An additive risk of bleeding may occur when platelet inhibitors are used with agents that cause clinically significant thrombocytopenia including antineoplastic agents, such as tretinoin. Methyclothiazide: (Moderate) A manufacturer of topical tretinoin states that tretinoin, ATRA should be administered with caution in patients who are also taking drugs known to be photosensitizers, such as thiazide diuretics, as concomitant use may augment phototoxicity.
Resin deionized water may also contain pathogens and it may inactivate benzalkonium chloride.
Concurrent application of these agents on areas treated with tretinoin should be avoided. Following topical application, a minimal amount of drug is absorbed systemically. Budesonide; Glycopyrrolate; Formoterol: (Minor) Because systemically administered corticosteroids exhibit immunosuppressive effects when given in high doses and/or for extended periods, additive effects may be seen with other immunosuppressives or antineoplastic agents. Monitor for decreased clinical effects while receiving concomitant therapy.
It is not intended to be a substitute for the exercise of professional judgment.
Patients should take care and use proper techniques to limit sunlight and UV exposure of treated areas. St. John's Wort, Hypericum perforatum: (Moderate) In theory it is possible that additive photosensitizing effects may result from the concomitant use of St. John's wort with other photosensitizing drugs such as retinoids. Chlorpropamide: (Moderate) A manufacturer of topical tretinoin states that tretinoin, ATRA should be administered with caution in patients who are also taking drugs known to be photosensitizers, such as sulfonylureas, as concomitant use may augment phototoxicity. Prednisolone: (Minor) Because systemically administered corticosteroids exhibit immunosuppressive effects when given in high doses and/or for extended periods, additive effects may be seen with other immunosuppressives or antineoplastic agents. Lithium: (Moderate) The concomitant use of systemic tretinoin, ATRA and lithium should be done cautiously due to the potential for increased intracranial pressure and an increased risk of pseudotumor cerebri. Dipyridamole: (Moderate) An additive risk of bleeding may occur when platelet inhibitors are used with agents that cause clinically significant thrombocytopenia including antineoplastic agents, such as tretinoin. Antineoplastic RetinoidsAnti-wrinkle Agents, RxTopical Retinoids for Acne. In addition, a manufacturer of topical tretinoin states that tretinoin, ATRA should be administered with caution in patients who are also taking drugs known to be photosensitizers, such as tetracyclines, as concomitant use may augment phototoxicity.
After induction therapy with tretinoin, all patients should receive standard consolidation and/or maintenance therapy for APL unless otherwise contraindicated. Amiloride; Hydrochlorothiazide, HCTZ: (Moderate) A manufacturer of topical tretinoin states that tretinoin, ATRA should be administered with caution in patients who are also taking drugs known to be photosensitizers, such as thiazide diuretics, as concomitant use may augment phototoxicity. Following induction therapy with tretinoin (45 mg/m2/day PO in 2 divided daily doses until complete remission (CR) or a maximum of 45 days) plus idarubicin (12 mg/m2/dose IV on days 2, 4, 6, and 8), patients who achieved a hematologic CR received 3 risk-adapted tretinoin- and anthracycline-based consolidation therapy courses in a clinical study (AIDA 2000 study). Frequency of application should be closely monitored by careful observation of the clinical response and skin tolerance; efficacy has not been established for less than once daily application frequency. hZko+`"c54uA([q!
Ciprofloxacin: (Major) Avoid the concomitant use of tretinoin with other drugs known to cause photosensitivity, such as ciprofloxacin.
Erythromycin; Sulfisoxazole: (Moderate) Erythromycin may decrease the CYP450 metabolism of tretinoin, ATRA, potentially resulting in increased plasma concentrations of tretinoin, ATRA. 119 0 obj <> endobj Monitor for decreased clinical effects of tretinoin, ATRA while receiving concomitant therapy.
Early signs and symptoms include papilledema, headache, nausea, vomiting, and visual disturbances. 53 0 obj <>/Filter/FlateDecode/ID[<8ADFC281A2B79448BF5EE5A3EF09D0D5>]/Index[22 72]/Length 128/Prev 496184/Root 23 0 R/Size 94/Type/XRef/W[1 2 1]>>stream Sunlight (UV) exposure potentiates the inflammatory effects of tretinoin. Patients should take care and use proper techniques to limit sunlight and UV exposure of treated areas. Azelastine; Fluticasone: (Minor) Because systemically administered corticosteroids exhibit immunosuppressive effects when given in high doses and/or for extended periods, additive effects may be seen with other immunosuppressives or antineoplastic agents. |%#2?$h%9q A#"!xW+ >B%$ Mometasone: (Minor) Because systemically administered corticosteroids exhibit immunosuppressive effects when given in high doses and/or for extended periods, additive effects may be seen with other immunosuppressives or antineoplastic agents. Methotrexate: (Moderate) Concomitant use of systemic retinoids, such as tretinoin, and methotrexate could increase risk of liver-related side effects of methotrexate and such patients should be monitored closely during methotrexate therapy. The distribution of tretinoin has not been determined. Patients should take care and use proper techniques to limit sunlight and UV exposure of treated areas. 5-iZw)hDIC)7}q{s]wq#gX67pF@4`H 'Ih;5;$MxyG]eY_pP58u])Y (Pxa=;%PuUY>n!cglI&N[ 9`3tF37. Concomitant use with other photosensitizing agents may increase the risk of a photosensitivity reaction. Patients with high-risk APL received: idarubicin 5 mg/m2/dose IV on days 1, 2, 3, 4, and 4 and cytarabine 1,000 mg/m2/day IV on days 1, 2, 3, and 4 (course 1); mitoxantrone 10 mg/m2/dose IV on days 1, 2, 3, 4, and 5 and etoposide 100 mg/m2/dose IV on days 1, 2, 3, 4, and 5 (course 2); and idarubicin 12 mg/m2/dose IV on day 1, cytarabine 150 mg/m2 subcutaneously every 8 hours on days 1, 2, 3, 4, and 5, and 6-thioguanine 70 mg/m2 PO every 8 hours on days 1, 2, 3, 4, and 5 (course 3). Promethazine; Phenylephrine: (Moderate) A manufacturer of topical tretinoin states that tretinoin, ATRA should be administered with caution in patients who are also taking drugs known to be photosensitizers, such as phenothiazines, as concomitant use may augment phototoxicity. The majority of patients do not require discontinuation of tretinoin therapy during RA-APL syndrome. Ultraviolet irradiation induces three metalloproteinases in human skin: collagenase, 92-kd gelatinase, and stromelysin-1.
Oral tretinoin should not be administered to patients who have paraben hypersensitivity.
Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ: (Moderate) A manufacturer of topical tretinoin states that tretinoin, ATRA should be administered with caution in patients who are also taking drugs known to be photosensitizers, such as thiazide diuretics, as concomitant use may augment phototoxicity.
Early signs and symptoms of pseudotumor cerebri include papilledema, headache, nausea, vomiting, and visual disturbances. If tolerated, this should not be considered a reason to discontinue therapy. There were 4 deaths during induction therapy. Avoid use of topical tretinoin over large areas of skin or for prolonged periods. Acetohexamide: (Moderate) A manufacturer of topical tretinoin states that tretinoin, ATRA should be administered with caution in patients who are also taking drugs known to be photosensitizers, such as sulfonylureas, as concomitant use may augment phototoxicity. If sun exposure cannot be avoided during topical tretinoin therapy, sunscreen products and physical sun blocks (protective clothing, hats) are recommended for protection of treated areas. Mechanism of Action: Retinoids are intracrine and paracrine mediators of cell differentiation and proliferation, apoptosis (programmed cell death), and reproduction. Temporary discontinuation or reduction in application frequency may be necessary until the patient is able to tolerate the treatment. In 13 patients who had received oral tretinoin daily for 4 consecutive weeks, a 72% increase in mean tretinoin plasma AUC was observed when ketoconazole (400 mg to 1200 mg PO) was given 1 hour before the tretinoin dose. Triamcinolone: (Minor) Because systemically administered corticosteroids exhibit immunosuppressive effects when given in high doses and/or for extended periods, additive effects may be seen with other immunosuppressives or antineoplastic agents. Interferon Alfa-2b; Ribavirin: (Moderate) Use of alpha interferons are associated with myelosuppression; additive myelosuppressive effects may be seen when alpha interferons are given concurrently with other myelosuppressive agents, such as antineoplastic agents or immunosuppressives. endstream endobj startxref This is thought to be due to the persistent procoagulant tendency often associated with systemic tretinoin, ATRA therapy. Application of excessive amounts may result in 'caking' or 'pilling' and will not provide incremental efficacy.
Budesonide; Formoterol: (Minor) Because systemically administered corticosteroids exhibit immunosuppressive effects when given in high doses and/or for extended periods, additive effects may be seen with other immunosuppressives or antineoplastic agents.
Concurrent application of these agents on areas treated with tretinoin should be avoided. kn[cUb>ayL1h Metolazone: (Moderate) A manufacturer of topical tretinoin states that tretinoin, ATRA should be administered with caution in patients who are also taking drugs known to be photosensitizers, such as thiazide diuretics, as concomitant use may augment phototoxicity.
Thioridazine: (Moderate) A manufacturer of topical tretinoin states that tretinoin, ATRA should be administered with caution in patients who are also taking drugs known to be photosensitizers, such as phenothiazines, as concomitant use may augment phototoxicity. Hydrochlorothiazide, HCTZ; Moexipril: (Moderate) A manufacturer of topical tretinoin states that tretinoin, ATRA should be administered with caution in patients who are also taking drugs known to be photosensitizers, such as thiazide diuretics, as concomitant use may augment phototoxicity. Benzoyl Peroxide; Sulfur: (Moderate) Benzoyl peroxide can potentiate the skin irritation caused by topical tretinoin. The bacterium involved in acne, Propionibacterium acnes, and sebum production are unaffected. Ticagrelor: (Moderate) An additive risk of bleeding may occur when platelet inhibitors are used with agents that cause clinically significant thrombocytopenia including antineoplastic agents, such as tretinoin. Methyclothiazide: (Moderate) A manufacturer of topical tretinoin states that tretinoin, ATRA should be administered with caution in patients who are also taking drugs known to be photosensitizers, such as thiazide diuretics, as concomitant use may augment phototoxicity.
Resin deionized water may also contain pathogens and it may inactivate benzalkonium chloride.
Concurrent application of these agents on areas treated with tretinoin should be avoided. Following topical application, a minimal amount of drug is absorbed systemically. Budesonide; Glycopyrrolate; Formoterol: (Minor) Because systemically administered corticosteroids exhibit immunosuppressive effects when given in high doses and/or for extended periods, additive effects may be seen with other immunosuppressives or antineoplastic agents. Monitor for decreased clinical effects while receiving concomitant therapy.
It is not intended to be a substitute for the exercise of professional judgment.
Patients should take care and use proper techniques to limit sunlight and UV exposure of treated areas. St. John's Wort, Hypericum perforatum: (Moderate) In theory it is possible that additive photosensitizing effects may result from the concomitant use of St. John's wort with other photosensitizing drugs such as retinoids. Chlorpropamide: (Moderate) A manufacturer of topical tretinoin states that tretinoin, ATRA should be administered with caution in patients who are also taking drugs known to be photosensitizers, such as sulfonylureas, as concomitant use may augment phototoxicity. Prednisolone: (Minor) Because systemically administered corticosteroids exhibit immunosuppressive effects when given in high doses and/or for extended periods, additive effects may be seen with other immunosuppressives or antineoplastic agents. Lithium: (Moderate) The concomitant use of systemic tretinoin, ATRA and lithium should be done cautiously due to the potential for increased intracranial pressure and an increased risk of pseudotumor cerebri. Dipyridamole: (Moderate) An additive risk of bleeding may occur when platelet inhibitors are used with agents that cause clinically significant thrombocytopenia including antineoplastic agents, such as tretinoin. Antineoplastic RetinoidsAnti-wrinkle Agents, RxTopical Retinoids for Acne. In addition, a manufacturer of topical tretinoin states that tretinoin, ATRA should be administered with caution in patients who are also taking drugs known to be photosensitizers, such as tetracyclines, as concomitant use may augment phototoxicity.
After induction therapy with tretinoin, all patients should receive standard consolidation and/or maintenance therapy for APL unless otherwise contraindicated. Amiloride; Hydrochlorothiazide, HCTZ: (Moderate) A manufacturer of topical tretinoin states that tretinoin, ATRA should be administered with caution in patients who are also taking drugs known to be photosensitizers, such as thiazide diuretics, as concomitant use may augment phototoxicity. Following induction therapy with tretinoin (45 mg/m2/day PO in 2 divided daily doses until complete remission (CR) or a maximum of 45 days) plus idarubicin (12 mg/m2/dose IV on days 2, 4, 6, and 8), patients who achieved a hematologic CR received 3 risk-adapted tretinoin- and anthracycline-based consolidation therapy courses in a clinical study (AIDA 2000 study). Frequency of application should be closely monitored by careful observation of the clinical response and skin tolerance; efficacy has not been established for less than once daily application frequency. hZko+`"c54uA([q!
Ciprofloxacin: (Major) Avoid the concomitant use of tretinoin with other drugs known to cause photosensitivity, such as ciprofloxacin.
Erythromycin; Sulfisoxazole: (Moderate) Erythromycin may decrease the CYP450 metabolism of tretinoin, ATRA, potentially resulting in increased plasma concentrations of tretinoin, ATRA. 119 0 obj <> endobj Monitor for decreased clinical effects of tretinoin, ATRA while receiving concomitant therapy.