| drug | Tretinoin (Retinoids) |
| name | Tretinoin |
| classification | Topical retinoid, Vitamin A derivative |
| pharmacokinetics | | absorption | Tretinoin is readily absorbed through the skin, with variable penetration depending on concentration and formulation. Concentrations peak 2-4 hours post application. Some systemic effects are possible despite topical use. | | distribution | Distributed throughout the body. Primarily acts on the skin, but systemic distribution occurs, albeit limited. | | metabolism | Metabolized in the liver. The major metabolite is retinoic acid. | | excretion | Excreted in the urine and bile. |
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| suggested dosage | | typical initial | 0.025% cream or gel, once daily in the evening, gradually increasing frequency or concentration as tolerated | | adult typical maintenance | 0.05% to 0.1% cream, gel, or solution, once daily at bedtime | | notes | Dosage and frequency will depend on the specific condition being treated, and should be determined and monitored by a physician. |
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| indications | Acne vulgaris, photoaging, wrinkles, fine lines, and some types of skin cancer. |
| safety in pregnancy | Category X. Tretinoin is contraindicated during pregnancy. It can cause severe birth defects. Patients of child-bearing potential must use effective contraception during treatment. |
| safety in breastfeeding | Tretinoin is considered unlikely to be transferred into breast milk in significant amounts. However, due to the potential for harm, it is best avoided during breastfeeding. |
| side effects | | 1 | skin irritation (redness, dryness, scaling, burning, stinging, peeling) | | 2 | photo-sensitivity (increased sun sensitivity) | | 3 | erythema | | 4 | oedema | | 5 | pruritus | | 6 | exacerbation of acne in the initial phase of therapy |
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| alternatives | |
| contraindications | | 1 | known hypersensitivity or allergy to tretinoin or other retinoids | | 2 | active skin infections or inflammation | | 3 | severe skin disorders | | 4 | pregnancy | | 5 | breastfeeding |
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| interactions | May interact with other topical medications, such as topical corticosteroids, increasing the potential for skin irritation or other adverse effects. Should be avoided with isotretinoin (Acutane) and other medications metabolized by the same liver enzymes. |
| warnings and precautions | | 1 | Apply a thin layer to the affected area(s) only. | | 2 | Start with a low concentration and gradually increase the frequency or concentration as tolerated. | | 3 | Avoid using other topical products with tretinoin unless advised by a physician. | | 4 | Use a sunscreen with a high SPF daily. | | 5 | Stop use and consult a physician immediately if any adverse reactions occur. |
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| additional information | | patient specific notes | A 25-year-old male weighing 70kg is a typical patient age and weight range. Dosage and application details need to be tailored by a medical professional based on specific condition, patient tolerance, and other medications being taken | | application instructions | Apply tretinoin to clean, dry skin, ideally at bedtime. Avoid sun exposure after application. |
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| important notes | This information is for general knowledge and informational purposes only, and does not constitute medical advice. It is essential to consult a qualified dermatologist or other healthcare professional for diagnosis and treatment of any skin condition. |
