alitretinoin
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alitretinoin
[al″ĭ-tret´ĭ-noin″]alitretinoin
Pharmacologic class: Second-generation retinoid
Therapeutic class: Topical antineoplastic
Pregnancy risk category D
Action
Binds to and activates intracellular retinoid receptor subtypes, regulating expression of genes that control cellular differentiation and proliferation
Availability
Topical gel: 0.1%
Indications and dosages
➣ Treatment of cutaneous lesions in patients with AIDS-related Kaposi's sarcoma
Adults: Apply to lesions b.i.d., gradually increasing to t.i.d. or q.i.d. according to individual lesion tolerance
Contraindications
• Hypersensitivity to retinoids or other drug components
Precautions
Use cautiously in:
• photosensitivity
• concomitant use of insecticides containing diethyltoluamide (DEET)
• elderly patients
• pregnant or breastfeeding patients
• children.
Administration
• Apply generous amount of gel to affected area. Let it dry for 3 to 5 minutes before covering with clothing.
Adverse reactions
CNS: paresthesia
Skin: rash, pruritus, exfoliative dermatitis, skin disorder at application site (such as abrasion, burning, blisters, excoriation, scab, cracking, crusting, drainage, eschar, fissure, oozing, peeling, redness, or swelling), edema
Other: pain, increased sensitivity to sunlight or sun lamps
Interactions
Drug-behaviors. DEET-containing insect repellents: increased adverse reactions to DEET
Patient monitoring
• Monitor patient for serious adverse effects, especially burns caused by exposure to sunlight or sun lamps.
Patient teaching
• Instruct patient to apply generous amount of gel to affected skin area and let dry for 3 to 5 minutes before covering area with clothing.
• Caution patient to avoid applying gel to mucous membranes or to normal skin surrounding lesions.
☞ Inform patient that drug increases sensitivity to sunlight and that exposure to sunlight or sun lamps (even through window glass or on a cloudy day) may cause serious burn of treated areas. Caution him to avoid such exposure.
• Tell patient to avoid insect repellents containing DEET during therapy.
• Emphasize importance of keeping all medical appointments so prescriber can check progress and monitor for unwanted drug effects.
• Advise females of childbearing potential to avoid becoming pregnant while using this drug.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the behaviors mentioned above.