Oral tretinoin is a drug to treat blood cancer (leukemia) of the acute promyelocytic leukemia (APL) type. Oral tretinoin is used with other medications to relieve symptoms and reduce the severity of the disease.
APL is a type of acute myeloblastic leukemia (AML). This condition occurs when the number of immature white blood cells increases uncontrollably, destroying other cells, including red blood cells and platelets.
Oral tretinoin works by suppressing the growth of cancer cells and triggering the growth of normal white blood cells. This drug is commonly used in APL patients whose condition has not been resolved with chemotherapy.
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What Is Oral Tretinoin
| class | Prescription drug |
| Category | Retinoids |
| Benefit | Dealing with acute promyelocytic leukemia types of leukemia |
| Consumed by | Adults and children |
| Oral tretinoin for pregnant and lactating women | Category D: There is positive evidence of a risk to the human fetus, but the benefits may outweigh the risks, for example in dealing with a life-threatening situation. Whether oral tretinoin passes into breast milk is not known. However, nursing mothers are not advised to take this drug. |
| Drug form | Capsule |
Precautions Before Taking Oral Tretinoin
Oral tretinoin should only be used as prescribed by a doctor. Patients taking oral tretinoin must be closely monitored by a doctor. Some things to consider before using this drug are:
- Do not take oral tretinoin if you are allergic to it or any other retinoid drug. Tell your doctor about any history of allergies you have.
- Do not take oral tretinoin if you are pregnant, breastfeeding, or planning a pregnancy. Use effective birth control while on oral tretinoin.
- Do not donate blood while being treated with oral tretinoin for up to 1 month afterward.
- Do not consume alcoholic beverages, grapefruit , or foods rich in vitamin A , while taking oral tretinoin .
- Tell your doctor if you have or are currently suffering from liver disease, heart disease, high cholesterol , kidney disease, stroke, or depression .
- Tell your doctor if you are taking certain medications, supplements or herbal products.
- Tell your doctor that you are taking oral tretinoin before having any surgical procedure, including dental surgery.
- Do not drive or do activities that require alertness while having treatment with oral tretinoin, because this drug can cause severe headaches and dizziness.
- Immediately consult a doctor if you experience a drug allergic reaction , serious side effects, or an overdose after taking oral tretinoin.
Dosage and Rules for Use Oral Tretinoin
The use of capsule tretinoin to treat APL will be determined by the doctor according to the condition of each patient, body surface area, and the patient's response to treatment.
The usual dose of oral tretinoin for adults and children is 45 mg/m² body surface area per day, divided into 2 doses, for 30–90 days.
Reduction or discontinuation of dosage may be necessary according to the patient's condition and response to treatment. Especially for pediatric patients, a dose reduction of up to 25 mg/m² can be done if symptoms of drug poisoning appear, such as a severe headache.
How to Take Oral Tretinoin Properly
Follow the doctor 's recommendations and read the instructions for use listed on the package before taking oral tretinoin. Do not reduce or increase your dose without consulting your doctor because this can increase the risk of serious side effects.
Take the whole tretinoin capsule with water. Do not split, chew or crush the medication.
Take tretinoin capsules at the same time every day, for maximum effect. If you forget to take tretinoin capsules, it is advisable to do it immediately if the break with the next consumption schedule is not too close. If it's close, ignore it and don't double the dose.
Continue treatment according to the doctor's recommendations even though the condition is felt to have improved. Do not stop taking tretinoin capsules before the time prescribed by the doctor, because this can increase the risk of side effects.
During treatment with oral tretinoin, your doctor will ask you to have regular blood tests.
Store tretinoin capsules in a room at room temperature. Do not store it in a damp place or in direct sunlight. Keep medicine out of reach of children.
Interactions of Oral Tretinoin with Other Drugs
The following are some of the interactions that can occur when using oral tretinoin with other drugs:
- Increased risk of fatal side effects due to excess vitamin A ( hypervitaminosis ) when taken with other retinoids or vitamin A supplements
- Increased risk of increased pressure in the brain (intracranial) which can be fatal if taken with tetracyclines
- Increased risk of complications due to blood clot formation if taken with antifibrinolytic drugs, such as tranexamic acid
- Impaired absorption of oral tretinoin when taken with rifampicin , corticosteroids , phenobarbital , ketoconazole, verapamil, cimetidine , erythromycin , or diltiazem
Side Effects and Dangers of Oral Tretinoin
Some of the side effects that may appear after taking oral tretinoin are headache, dizziness, dry skin, dry mouth , bone pain, nausea and vomiting, feeling tired and weak, ear pain, and frequent sweating, difficulty sleeping , confusion or anxiety.
Check with your doctor if the side effects above don't go away or get worse. See a doctor immediately if you have an allergic drug reaction or more serious side effects, such as:
- Severe headache
- Nausea and vomiting that doesn't stop or vomiting blood
- Swelling of the feet or hands
- Visual disturbances, such as double vision or blurred vision
- Hearing loss, such as hearing loss or tinnitus
- Easy bruising
- Severe abdominal pain or jaundice
- Palpitations, rapid heartbeat, or irregular heartbeat
- Chest pain