tretinoin (ATRA)
Other Name: Vesanoid®, All-trans retinoin acid (ATRA)
- For treating acute promyelocytic leukemia
- Tell your doctor if you have/had significant medical condition(s), such as heart, liver or kidney problems, high cholesterol or fats in the blood, or if you have any allergies.
- People who have cancer or leukemia are at a higher risk of developing other cancers/leukemias or blood clots. Also, some cancer medications, such as tretinoin, may increase these risks. You should discuss these with your doctor.
- Tretinoin can harm the unborn baby and must never be used in pregnant women.
- Do not use tretinoin if you are pregnant. If there is ANY chance that you or your partner may become pregnant, you and your partner together must: ►Use 2 effective forms of birth control at the same time at least 4 weeks before starting treatment and while taking this drug: Keep using birth control until at least 1 month after the last dose. You must follow birth control measures carefully as directed by your doctor. Discuss with your health care team.
- Tell your doctor right away if you or your partner becomes pregnant.
- Do not breastfeed while on tretinoin treatment.
- Effects on Fertility: Yes
- Effects on Fertility: Yes
- Tretinoin is usually taken twice a day, for a specific timeframe as directed by your doctor. Make sure you understand the instructions.
- Swallow whole with a glass of water, with food.
- Take the dose at about the same times each day.
- If you miss a dose, take it as soon as possible. If it is close to your next dose, do not double the dose. Discuss with your doctor or pharmacist.
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This medication can interact with other medications and can result in the treatment not working as well or cause severe side effects.
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Make sure your health care team knows about all your medications (prescription, over-the-counter, herbals and supplements). Check with your health care team before starting or stopping any of them.
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For mild aches and pain:
- You may take acetaminophen (Tylenol®) tablets. Ask your health care team about the right dose for you.
- Ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or aspirin (acetylsalicylic acid, ASA), including low dose aspirin for heart conditions, may increase your chance of bleeding.
- Talk to your health care team before you start or stop these medications.
- If you feel unwell, take your temperature before taking any of these medications. They may hide a fever.
- Talk to your health care team or go to the closest emergency room right away if you have a fever. See the Fever pamphlet for more information.
- Do not take any vitamins and supplements containing vitamin A as this can increase the chance of getting severe side effects. Check with your doctor or pharmacist before starting any supplements.
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Keep this medication in the original packaging at room temperature in a dry place, away from heat and light. Keep out of sight and reach of children and pets.
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Do not throw out any unused medications at home. Bring them to your pharmacy to be thrown away safely.
The following side effects are common or severe. You may not have all of the side effects. Other side effects may occur. If you have any unusual or bothersome symptoms, discuss with your doctor.
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Dry lips, mouth or skin
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Contact your health care team if no improvement or if severe | ||||
Rash; sensitivity to sunlight
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Contact your health care team if no improvement or if severe | ||||
Headache; mild joint, muscle pain or cramps
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Contact your health care team if no improvement or if severe | ||||
Rapid increase of white blood cells
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Get emergency medical help right away | ||||
Tiredness
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Contact your health care team if no improvement or if severe | ||||
Abnormal liver lab tests
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Contact your health care team if no improvement or if severe | ||||
Unusual bleeding or bruising
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Get emergency medical help right away | ||||
Increased cholesterol or fat levels in the blood
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Contact your health care team if no improvement or if severe | ||||
Fever, chills, infection You have a fever if your temperature taken in your mouth (oral temperature) is:
While you are getting chemotherapy treatments:
If you have a fever, talk to your health care team or go to the closest emergency room. |
Get emergency medical help right away | ||||
Nausea and vomiting
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Contact your health care team if no improvement or if severe | ||||
Bleeding/clotting disorder (may include bleeding from more than 1 site, bruising, signs of blood clots, kidney/liver/lung problems, fever, confusion)
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Get emergency medical help right away | ||||
Mild swelling in arms and legs; puffiness
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Contact your health care team if no improvement or if severe | ||||
Retinoic acid syndrome (group of signs and symptoms that may include fever, fluid buildup around the heart and lungs, lower ability of the lung in absorbing oxygen)
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Get emergency medical help right away |
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Kidney problems |
Get emergency medical help right away | ||||||
Increased pressure in the brain (may include headaches with pain behind the eye/with eye movement, changes or loss in eye sight) |
Get emergency medical help right away | ||||||
Heart problems |
Get emergency medical help right away | ||||||
Fullness/pain in the ear; hearing loss
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Contact your health care team as soon as possible (office hours) | ||||||
Lung problems |
Get emergency medical help right away | ||||||
Blockage of an artery (blood vessel) in your heart, brain, chest, belly, or limbs; this may result in stroke (sudden loss of vision, speech, or the use of your limb(s)) or heart attack (chest pain, shortness of breath), or pain in chest, belly or limb | Get emergency medical help right away | ||||||
Increased calcium levels in the blood |
Get emergency medical help right away | ||||||
Rapid killing of cancer cells when you start treatment may lead to build up of cell waste products
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Get emergency medical help right away | ||||||
Sweets syndrome
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Get emergency medical help right away | ||||||
Pancreas problems |
Get emergency medical help right away | ||||||
Blood clot (limb pain or swelling, hardened vein in limb), may occur in lungs (sudden start of coughing, breathing problems, chest pain, coughing blood) | Get emergency medical help right away |
For more links on how to manage your symptoms go to https://www.cancercareontario.ca/en/symptom-management.
The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.
A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.