Tretinoin

Registered South African indications:

• Acne vulgaris
• Sun-damaged skin (cre)

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Acute dermatitis, particularly acute eczema and rosacea (0.05% gel)

Cautions

• Pregnancy
• Breastfeeding
• Ultraviolet light, excessive exposure to sunlight or sunlamps
• Personal or family history of skin cancer
• Eczema
• Flammable (gel)
• Prolonged use
• Fish allergy
• Damaged skin 
• Contact with mucous membranes, eyes, mouth, angles of the nose

Forms avail. in SA and covered in this monograph: cre, gel

Acne vulgaris

• Topical (cre, gel): 0.05%: Apply small quantity to affected area(s), 12-24hrly, in the morning and evening
• Topical (gel): 0.025%: Apply small quantity to affected area(s), dly

Sun-damaged skin

• Topical (cre): 0.05%: Apply small quantity to affected area(s), dly in the evening 

The area to be treated should be thoroughly cleansed with water and a mild, non-medicated soap

The treated area should be washed not more than twice a day

After washing, the skin should be dried gently and completely without rubbing it

Areas of the skin being treated should be allowed to dry for at least 20-30 minutes before application

During the early weeks of therapy, an apparent exacerbation of inflammatory lesions may occur

Not established for use in children

Pregnancy Category

• Caution; positive evidence of risk
• Adverse events have been observed in animal reproduction studies following topical application of tretinoin. Teratogenic effects were also observed in pregnant women following topical use; however, a causal association has not been established. When treatment for acne is needed during pregnancy, other agents are preferred

Breastfeeding

• Caution; not recommended
• It is not known if tretinoin (topical) is excreted into breast milk. Caution should be exercised when administering tretinoin (topical) to nursing women

Renal Impairment

• No dose adjustment recommended

Hepatic Impairment

• No dose adjustment recommended

Elderly

• No dose adjustment recommended

Porphyria Information

• Probably not porphyrinogenic (PNP)

Drugs in Sport

• Permitted - No warnings

Skin and Subcutaneous Tissue Disorders

• Burning sensation
• Skin irritation
• Erythema
• Dermatitis
• Skin oedema

• Aminolevulinic acid
• Multivitamins
• Vitamin A 

None routine

It has been suggested that the therapeutic activity of tretinoin in the treatment of acne results from it increasing the rate of production of loose horny material. This increased production and resulting flow of dehiscing material to the surface prevents the impaction of horny material into comedones.

Cream (per g) 0.5mg

• Airol (Pharmaco) originator
• Ilotycin-A (Aspen Pharmacare)
• Retacnyl (Galderma) originator
• Retin-A (Janssen) originator

Gel (per g) 0.25mg

• Retin-A (Janssen) originator

Gel (per g) 0.5mg

• Ilotycin-A (Pharmacare)