How does it work?

Tretinoin belongs to a group of medicines called retinoids and is a form of vitamin A. It is also sometimes called ATRA - All-Trans Retinoic Acid. Tretinoin is used in a particular form of acute myeloid leukaemia (AML) called M3 (acute promyelocytic leukaemia). It can be used in previously untreated patients or patients who have relapsed or are resistant to standard chemotherapy.Tretinoin is not itself an anticancer (cytotoxic) medicine but is a biological medicine that allows anticancer medicines to work. One of the risks of the M3 type of AML is haemorrhaging and possibly death during the intial anticancer therapy. Tretinoin works by promoting the blood cells in the bone marrow to "grow up" faster. This helps prevent and reverse this risk of severe bleeding and gives the anticancer medicines a chance to work.Tretinoin is given by mouth only.

What is it used for?

• A particular type of leukaemia called acute promyelocytic leukaemia

Warning!

• You should have regular blood tests to monitor your liver function while taking this medicine.
• People taking this medicine should have regular blood tests to check the levels of their blood components.
• Effective contraception is required during treatment and for at least one month after stopping treatment.
• It is recommened that individuals taking this medicine undergo regular monitoring of blood lipid levels.
• Retinoic acid syndrome - contact your doctor immediately if you experience the side effects of fever together with difficulty in breathing, coughing, dizziness, chest pain and abdominal pain
• There is an increased risk of getting a blood clot (thrombosis) during the first month of treatment with this medicine.
• It is recommended to monitor the clotting function of the blood during treatment

Use with caution in

• Decreased kidney function
• Decreased liver function

Not to be used in

• Allergy to any ingredients in this medicine or other medicines of the retinoid group

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

• This medicine should not be used during pregnancy as it may be harmful to the unborn baby. Seek medical advice from your doctor.
• This medicine may pass into breast milk. It should not be used by breastfeeding mothers. Seek medical advice from your doctor.

Label warnings

• Take this medication with or after food.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

• Rash
• Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain
• Liver problems
• Decreased kidney function
• Bone pain
• Skin irritation
• Retinoic acid syndrome
• Disorders of the nervous system such as headache, fever, shivering, numbness, depression, insomnia, and tiredness
• Problems with hearing and sight
• Problems with breathing
• Heart problems such as irregular heart beats and fluid retention
• Dryness of the mucous membranes, eg lips, eyes, nose (causing nosebleeds) and throat (causing hoarseness)

The side effects listed above may not include all of the side effects reported by the drug's manufacturer.For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

Tretinoin reduces the effectiveness of the mini-pill and possibly the combined-oral pill contraceptives.Tretinoin must not be given with any medicine of the tetracycline class of antibiotics as there is an increased risk of raised pressure in the brain.As tretinoin is a type of vitamin A it must not be given with any other medcine containing vitamin A as it may increase the risk of adverse effects.

Other medicines containing the same active ingredients