Panretin^®

Generic name: Alitretinoin
Trade name: Panretin^®

Chemocare.com uses generic names in all descriptions of drugs. Panretin is the trade name for Alitretinoin. In some cases, health care professionals may use the trade name Panretin when referring to the generic drug name Alitretinoin.

Drug type: Panretin is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug.  This medication is classified as a "retinoid."  (For more detail, see "How this drug works" section below).

What This Drug Is Used For:

• Treatment of skin sores (lesions) in patients with Kaposi's sarcoma.

Note:  If a drug has been approved for one use, physicians sometimes elect to use this same drug for other problems if they believe it might be helpful.

How This Drug Is Given:

• This medication comes in the form of a gel. It is usually applied directly to the lesions 2 times a day.
• A tight bandage over the sore is not recommended.  Allow the gel to dry for at least 3 to 5 minutes before putting on clothing. 
• This medication is to be applied to the skin only, and is not to be ingested (taken by mouth). Keep the gel away from your mouth, eyes, and nose. Wash your hands well if touching the gel. 
• Your doctor will determine the number of daily applications, and length of time treatment should be continued. 

Side Effects:

Important things to remember about the side effects of alitretinoin:

• Most people do not experience all of the side effects listed.
• Side effects are often predictable in terms of their onset and duration. 
• Side effects are almost always reversible and will go away after treatment is complete.
• There are many options to help minimize or prevent side effects.
• There is no relationship between the presence or severity of side effects and the effectiveness of the medication.

The following side effects are common (occurring in greater than 30%) for patients taking alitretinoin:

• There are no common side effects.

The following are less common side effects (occurring in >10%) for patients receiving alitretinoin:

• You may develop a rash, pain or itching at the site where you apply the gel. Your skin may also become flaky, and you may see some crusting or scaling of the skin. 
• You will be extremely sensitive to sunlight.
• There are no serious side effects from this drug when taken properly.

This list includes common and less common side effects for individuals taking alitretinoin.  Side effects that are very rare, occurring in less than 10% of patients, are not listed here.  However, you should always inform your health care provider if you experience any unusual symptoms.

When to contact your doctor or health care provider:

The following symptoms require medical attention, but are not emergency situations.  Contact your health care provider within 24 hours of noticing any of the following.

• Rash
• Skin irritation
• Redness
• Scaling
• Excessive dryness

Always inform your health care provider if you experience any unusual symptoms.

Precautions:

• Before starting alitretinoin treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.).   Do not take aspirin, products containing aspirin unless your doctor specifically permits this.
• Avoid prolonged exposure to sunlight.  Alitretinoin may increase the sensitivity of the skin to sunlight.  Use sunscreen and wear protective clothing when exposure to the sun is unavoidable.
• Do not use products that contain DEET (N-diethyl-m-toluamide), a common ingredient found in insect repellent products, while using alitretinoin gel.  There is an increased risk of harmful effects from DEET when used with alitretinoin.
• Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (alitretinoin may be hazardous to the fetus.  Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus.) 
• For both men and women: Do not conceive a child (get pregnant) while taking alitretinoin. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
• Do not breast feed while taking this medication.

Self-Care Tips:

• Try to avoid applying the gel to unaffected skin. This will decrease irritation to the healthy, surrounding tissues near the site of the tumor.
• You may start to see an improvement in the sores in about 2 to 4 weeks. However, you may need to take the medication longer, according to your healthcare provider's recommendations. Do not stop the medication without discussing first with your healthcare provider. 
• Do not apply any other lotions or insect repellents on top of the gel. This may cause an adverse reaction with the medication.
• This medication will make you extremely sensitive to the light. You must wear sunglasses when outside, and avoid sun exposure. Do not use a sun lamp. Wear protective clothing, and also wear SPF 15 (or higher) sun block.
• Wash your hands often.

Monitoring and Testing:

You will be checked regularly by your health care professional while you are taking alitretinoin, to monitor side effects and check your response to therapy.  Periodic blood work to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver) will also be ordered by your doctor as necessary.   

How This Drug Works:

Retinoids are drugs that are relatives of vitamin A.  Retinoids control normal cell growth, cell differentiation (the normal process of making cells different from each other), and cell death during embryonic development and in certain tissues later in life.  Retinoids effects on the cells are controlled by receptors on the nucleus of each cell (nuclear receptors). 

There are two major classes of retinoid nuclear receptors:  retinoic acid receptors (RAR) and retinoid-X-receptors (RXR).  There are also subtypes within each class.  Each of these types of receptors has different functions in different tissues.  The different retinoid drugs work by binding to different receptors; which, in turn, affect cell growth and differentiation.

Retinoids are relatively new types of anti-cancer drugs.  They have been used alone or in combination to treat a variety of cancers such as skin cancers, cutaneous T-cell lymphoma, acute promyelocytic leukemia, lung cancer, breast cancer, ovarian cancer, bladder cancer, kidney cancer, and head and neck cancers.  Retinoids have also been used experimentally in an attempt to prevent certain types of cancer.  There is ongoing research to determine their role in both cancer treatment and prevention.

Retinoids have been associated with side effects such as skin problems (dryness, peeling, itching, sun sensitivity), reversible elevation in liver enzymes, temporary abnormal lipid levels, low thyroid levels (hypothyroidism), and headaches.  Taking supplemental doses of vitamin A may increase the side effects.  Vitamin supplementation should be discussed with your physician.

Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice. 

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