Home Drug Guide Alitretinoin

Drug Guide

Generic Name

Alitretinoin

Brand Names Panretin

Classification

Therapeutic: Antineoplastic, Topical treatment for Kaposi's Sarcoma

Pharmacological: Retinoid, Vitamin A derivative

FDA Approved Indications

  • Treatment of cutaneous manifestations of Kaposi's sarcoma in HIV-positive patients

Mechanism of Action

Alitretinoin modulates gene expression by activating retinoid receptors, leading to cell differentiation and apoptosis, which helps in controlling tumor growth in Kaposi's sarcoma.

Dosage and Administration

Adult: Apply topical gel (0.1%) to involved lesions twice daily

Pediatric: Not approved for pediatric use

Geriatric: No specific adjustments; monitor for skin reactions and tolerability

Renal Impairment: No specific dosage adjustment needed

Hepatic Impairment: Not established; use with caution and monitor hepatic function

Pharmacokinetics

Absorption: Minimal systemic absorption when used topically

Distribution: Primarily localized in skin

Metabolism: Metabolized in the liver via hydroxylation

Excretion: Primarily biliary and fecal excretion

Half Life: Unknown; systemic levels are low due to topical application

Contraindications

  • Known hypersensitivity to alitretinoin or other retinoids

Precautions

  • Avoid in pregnancy due to teratogenicity, use effective contraception during and 1 month after treatment; monitor for skin irritation, sun sensitivity

Adverse Reactions - Common

  • Redness, peeling, dryness of skin (Common)
  • Skin irritation or dermatitis (Common)

Adverse Reactions - Serious

  • Severe skin reactions, hypersensitivity (Rare)
  • Teratogenic effects if used during pregnancy (Serious, contraindicated in pregnancy)

Drug-Drug Interactions

  • Concomitant use with other retinoids or tetracyclines may increase the risk of intracranial hypertension

Drug-Food Interactions

  • No significant food interactions identified

Drug-Herb Interactions

  • No known interactions

Nursing Implications

Assessment: Monitor skin for irritation; assess lesion response; confirm pregnancy status in women of childbearing potential

Diagnoses:

  • Impaired skin integrity related to medication effects

Implementation: Apply gel as instructed; advise on sun protection; counsel on pregnancy prevention

Evaluation: Assess improvement of lesions and monitor for adverse skin reactions

Patient/Family Teaching

  • Use only as prescribed; do not apply to unaffected skin areas
  • Avoid sun exposure and use sun protection measures
  • Women of childbearing potential must use effective contraception during treatment and for 1 month after
  • Report any signs of skin irritation or allergic reactions

Special Considerations

Black Box Warnings:

  • Contraindicated in pregnancy due to teratogenicity

Genetic Factors: Not specifically affected by genetic factors

Lab Test Interference: None noted

Overdose Management

Signs/Symptoms: Skin irritation, headache, or systemic symptoms unlikely due to topical route but monitor for adverse effects

Treatment: Discontinue use; symptomatic management; no specific antidote

Storage and Handling

Storage: Store at room temperature away from light and moisture

Stability: Stable when stored properly, use within expiration date

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.