alitretinoin

alitretinoin

 [al″ĭ-tret´ĭ-noin″]

a topical antineoplastic used in the treatment of AIDS-related cutaneous Kaposi's sarcoma.

alitretinoin

Panretin

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.