Tretinoin – by mouth

What is tretinoin – by mouth?

When taken by mouth, tretinoin (also called ATRA, all trans-retinoic acid, or Vesanoid^®) is used to treat a type of leukemia known as acute promyelocytic leukemia (APL). Tretinoin is available as a 10mg two-tone (orange-yellow and reddish-brown) capsule taken by mouth.

Important

• Women who are pregnant should not take this medicine, because tretinoin taken by mouth may cause birth defects.
• Women of childbearing age who are taking tretinoin by mouth should use effective birth control methods for at least one (1) month before they start taking tretinoin and for one (1) month after they stop taking it.
• Do not become pregnant while you are taking tretinoin by mouth.

Possible side effects of tretinoin – by mouth

• Headache
• Fever
• Feeling weak and unusually tired
• Bleeding in stomach or colon (may cause black, tarry stools)
• Increased white blood count, but decreased numbers of infection-fighting cells
• Increased risk of bleeding or blood clots
• Changes in vision
• Dry skin and itching
• Rash
• Nausea and vomiting
• Mouth sores
• Increased sweating
• Hair loss
• Skin more sensitive to the sun
• Stomach pain
• Diarrhea or constipation
• Decreased liver function (may cause yellowing of the eyes, skin, or urine)
• High lipid or cholesterol levels in the blood
• Weight changes
• Loss of appetite
• Feeling dizzy
• Agitated or anxious
• Tingling, numbness, or pain in the hands or feet
• Shaking that cannot be controlled
• Feeling depressed
• Trouble sleeping
• Earache or feeling of fullness in ears; hearing loss
• Changes in skin color
• Wheezing, problems breathing, or short of breath
• Blood pressure changes
• Flushing, chest pain, abnormal heart beats, or heart problems
• Seizures

These are the most common side effects, but there may be others. Please report all side effects to the doctor or nurse.

In case of a severe side effect or reaction, call the doctor, nurse, or pharmacist at 595-3300. If you are outside the Memphis area, dial toll-free 1-866-2STJUDE (1-866-278-5833), and press 0 once the call is connected.

Special instructions for tretinoin – by mouth

• Your doctor will monitor you closely for all of the side effects listed above.
• Your doctor will regularly check your blood for cholesterol and lipid levels, liver function, and blood counts. It is very important that you come to the clinic regularly for blood tests.
• Female patients of childbearing age will have a pregnancy test before starting tretinoin and routinely throughout the period of treatment.
• Tell your doctor right away if you have a sudden onset of stomach pain, rectal bleeding, or severe diarrhea while you are taking tretinoin.
• Tell your doctor right away, if you have a sudden onset of headache, nausea and vomiting, or trouble with your vision while you are taking tretinoin.
• It is not known whether tretinoin passes into breast milk. Because this medicine might cause serious harm to a nursing infant, women who are taking tretinoin should not breast feed.
• Do not take multivitamins that contain vitamin A or beta-carotene. These vitamins may make the side effects of tretinoin worse.
• Use sunscreen and limit exposed skin when you are out in the sun.
• Some medicines taken with tretinoin may decrease or increase the levels of tretinoin in the blood. These medicines include:
  • Ketoconazole
  • Cimetidine
  • Erythromycin
  • Verapamil
  • Diltiazem
  • Cyclosporine
  • Rifampin
  • Corticosteroids (such as hydrocortisone, prednisone, or dexamethasone)
  • Pentobarbital
  • Phenobarbital
• Always tell your doctor if you are taking any of these medicines, or if you start taking any new medicine while you are taking tretinoin.

Safe handling of tretinoin – by mouth

All chemotherapy drugs taken by mouth can pose a health hazard to caregivers and patients. You should be careful when handling this medicine and try to keep the drug from touching the skin. Taking precautions will ensure that both the patient and the caregiver are protected as well as possible.

• Prepare a clean area where the drug can be handled safely (away from areas where food is prepared, out of the reach of children, and out from under any air vents or fans).
• We suggest you or the caregiver wear gloves while handling this medicine. Wash your hands right away if your skin comes in contact with the medicine.