Panretin (alitretinoin)
Topical Antineoplastic Retinoids Topical Gel (Gram)
Last reviewed · Source: First Databank (FDB) drug data
Overview
Alitretinoin (9-cis-retinoic acid), a derivative of vitamin A, is a naturally occurring endogenous retinoid that exhibits topical antineoplastic activity.
Alitretinoin (9-cis-retinoic acid), a derivative of vitamin A, is a naturally occurring endogenous retinoid. Alitretinoin binds to and activates both intracellular retinoic acid receptors (RAR) (e.g., RARalpha, RARbeta, RARgamma) and retinoid X receptors (RXR) (e.g., RXRalpha, RXRbeta, RXRgamma) that appear to enhance gene transcription. The exact mechanism of action of alitretinoin in the management of lesions associated with Kaposi's sarcoma has not been fully elucidated; however, the drug appears to affect expression of genes that inhibit cell proliferation, induce cell differentiation, and trigger apoptosis (programmed cell death) in both healthy and cancer cells.
In vitro, alitretinoin appears to inhibit Kaposi's sarcoma cell growth.
Limited data indicate that alitretinoin is not substantially absorbed systemically following topical application of the drug. Following repeated multiple topical applications of alitretinoin 0.1% gel in patients with cutaneous lesions associated with Kaposi's sarcoma, plasma concentrations of 9-cis-retinoic acid were similar to those of naturally occurring 9-cis-retinoic acid found in healthy untreated patients. Although there were no detectable plasma concentrations of 9-cis-retinoic acid metabolites following topical application of alitretinoin 0.1% gel, in vitro studies indicate that alitretinoin is metabolized by cytochrome P-450 (CYP) isoenzymes 2C9, 3A4, 1A1, and 1A2.
USES: This medication is used to treat skin sores in patients with a certain type of AIDS-related cancer (Kaposi's sarcoma). Alitretinoin belongs to a class of medications called retinoids. It works by affecting the growth of skin cells.
This medication should not be used when medications taken by mouth are needed to treat the Kaposi's sarcoma (for example, if you have had more than 10 new skin sores in the previous month, or if the disease affects the lungs or other organs).
Generic name: alitretinoin
Pronunciation: (AL-i-TRET-i-noyn)
Drug class: Topical Antineoplastic Retinoids
Therapeutic class: Dermatological
Reference product & biosimilars
No reference, biosimilar or interchangeable associated with this drug.
Today’s intelligence on Panretin
Indications
The following indications are listed for Panretin:
- Kaposi's Sarcoma Skin Lesion
Also known as: Kaposi's Sarcoma Cutaneous Lesions, Kaposi's Sarcoma Of Skin.
Dosing
No dosing information is available for this tab.
No dosing information is available for this tab.
| Drug label | Dosing type | Instructions |
|---|---|---|
| Panretin 0.1% Gel | Maintenance | Apply to the affected area(s) by topical route 2 times per day. |
No dosing information is available for this tab.
Drug interactions
There is no enhanced messaging for this drug.
Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient.
Alitretinoin; Bexarotene/Diethyltoluamide (Deet)
SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient.
MECHANISM OF ACTION: The exact mechanism is unknown. Alitretinoin(1) and bexarotene(2) may increase the absorption of diethyltoluamide (DEET).
CLINICAL EFFECTS: The concurrent application of alitretinoin(1) or bexarotene(2) with diethyltoluamide (DEET) may increase the toxicity of diethyltoluamide.
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The manufacturer of alitretinoin states that patients applying alitretinoin should not concurrently use products that contain diethyltoluamide (DEET).(1) The manufacturer of bexarotene states that patients who are applying bexarotene should not concurrently use products that contain DEET.(2)
DISCUSSION: Because animal toxicity studies indicated an increase in diethyltoluamide (DEET) toxicity when DEET was included as a part of the alitretinoin formulation, the manufacturer states that patients applying alitretinoin should not concurrently use products containing DEET.(1) Because animal toxicity studies indicated an increase in DEET toxicity when DEET was included as a part of the bexarotene formulation, the manufacturer states that patients applying bexarotene should not concurrently use products containing DEET.(2)
There are no severe interactions for this drug.
There are no moderate interactions for this drug.
Contraindications
Known hypersensitivity to retinoids or any ingredient in the formulation.
- Lactation
- Pregnancy
There are no severe contraindications for this drug.
There are no moderate contraindications for this drug.
Adverse reactions
Adverse effects occurring in 5% or more of patients receiving alitretinoin include rash, pruritus, exfoliative dermatitis, skin disorders (excoriation, cracking, scabbing, crusting, drainage, eschar, fissure, or oozing), pain, paresthesia, and edema.
More Frequent
- Exfoliative dermatitis
- Paresthesia
- Skin fissure
- Skin irritation
- Skin rash
- Skin swelling
- Superficial skin ulcer
More Frequent
- Pruritus of skin
Less Frequent
- Skin photosensitivity
Precautions
No enhanced messaging available.
Safety and efficacy in children younger than 18 years of age have not been established.
Category D. (See Users Guide.) See Fetal/Neonatal Morbidity and Mortality under Warnings/Precautions: Warnings, in Cautions.
Not known whether alitretinoin or its metabolites are distributed into milk; discontinue nursing because of risk in nursing infants.
Experience in those 65 years of age and older insufficient to determine whether they respond differently from younger adults.
ICD codes
| Code | Type | Description |
|---|---|---|
| Kaposi's sarcoma skin lesion | ||
| C46.0 | ICD10CM | Kaposi's sarcoma of skin |
ICD code information from First Databank (FDB).
Formulary status
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Last reviewed · Source: First Databank (FDB) drug data
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