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Care During Chemotherapy and Beyond

Alitretinoin

(a lit RET in OH in)

Trade name: Panretin®

Alitretinoin is the generic name for the trade name drug Panretin. In some cases, health care professionals may use the trade name Panretin when referring to the generic drug name Alitretinoin.

Drug type: Alitretinoin 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 Alitretinoin 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 Alitretinoin 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 this gel away from your mouth, eyes, and nose. Wash your hands well if touching the gel.
  • It is recommended to wait 20 minutes after batjing before applying gel. You should avoid bathing, showering, or swimming for 3 hours after applying 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 peopole will not experience all of the side effects listed.
  • Alitretinoin side effects are often predictable in terms of their onset, duration, and severity.
  • Alitretinoin side effects will improve after therapy is complete.
  • Alitretinoin side effects may be quite manageable. Therea are many options to help minimize or prevent the side effects of Alitretinoin.

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

  • Skin reactions-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.
  • Photosensitivity-You will become more sensitive to sunlight

The following are less common side effects (occuring in less than 10%) for patients receiving alitertinoin:

Not all side effects are listed above. Side effects that are very rare--occurring in less than about 10 percent of patients - are not listed here. But 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 an emergency. 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.). 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 in unavoidable.
  • Do not use products that contain DEET (N-diethl-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.
  • Alitretinoin gel may contain alcohol, which is flammable. Do not use Alitretinoin gel near an open flame or while smoking.
  • Inform your health care professional if you are pregnant or may become 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: Use contraceptives, and do not conceive a child (get pregnant) while using 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 using Alitretinoin.

Self-Care Tips:

  • Avoid applying the gel to unaffected skin. This will decrease irritation to healthy, surrounding tissues near the site of the tumor.
  • You may start to see an improvement in 2 to 4 weeks. However, you may need to take the medication longer, according to your health care provider's recommendations. Do not stop using the medication without first discussing with your health care 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 30 (or higher) sun block.
  • This drug may cause harm if swallowed. Keep out of reach of pets and children. If the drug is swallowed, contact a poison control center or doctor immediately.
  • Wash your hands with soap and water immediately before and after use.
  • Store this medication in a dry place at room temperature; do not store in the bathroom.
  • You should discuss the proper method to dispose of this medication with your health care provider.

If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or off other suggestions that are effective in managing such problems.

Monitoring and Testing While Taking Alitretinoin:

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 Alitretinoin 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 these 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.

References:

Alitretinoin.Lexicomp Online® [updated 2015 August 25; cited 2015 September 3 12]. Lexi-Drugs®. Hudson, Ohio: Lexi-Comp, Inc.; September 3, 2015.

Panretin® [package insert]. Woodcliff Lake, NJ: Eisai; 2012.

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