alitretinoin

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.

See 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.