Generic Name

Alitretinoin

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Classification

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

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