tretinoin at a glance
Medicine class
Retinoid anticancer treatment, also called all-trans retinoic acid or ATRA
Licensed role
Combination treatment for acute promyelocytic leukaemia
Administration
Swallow soft capsules whole with water; do not chew them
Food
Take with a meal or shortly afterwards
Specialist treatment
Requires close supervision by an experienced haematology or oncology team
What is tretinoin used for?
The selected oral capsule is licensed for:
Newly diagnosed acute promyelocytic leukaemia.
Acute promyelocytic leukaemia that has relapsed or is refractory to chemotherapy.
Use with arsenic trioxide or chemotherapy rather than as routine treatment on its own.
How does tretinoin work?
APL cells contain an abnormal PML–RARα fusion protein that blocks immature blood cells from developing normally. Tretinoin promotes breakdown of this protein, allowing leukaemia cells to mature and reducing their proliferation.
tretinoin preparations and strengths
Capsule
Route: Oral
Strengths: 10 mg
How to take tretinoin
Follow the specialist treatment plan exactly and do not alter treatment yourself.
Swallow capsules whole with water.
Do not chew or open capsules.
Take with a meal or shortly afterwards.
Tell the team promptly if swallowing is difficult or side effects prevent treatment.
tretinoin side effects
Common or expected effects
- Headache or dizziness
- Dry mouth, nose, skin or lips
- Nausea, vomiting, abdominal discomfort, diarrhoea or constipation
- Reduced appetite
- Rash, itching or redness
- Bone or joint pain
- Hair loss
- Difficulty sleeping, anxiety, low mood or confusion
- Changes in liver enzymes, cholesterol or triglycerides on blood tests
Get urgent medical advice
- Fever, breathlessness, swelling, rapid weight gain, low blood pressure or organ problems suggesting differentiation syndrome
- Severe headache, vomiting, double vision or altered awareness suggesting raised intracranial pressure
- Chest pain, sudden breathlessness or painful leg swelling suggesting arterial or venous thrombosis
- Severe abdominal pain spreading to the back suggesting pancreatitis
- New or worsening irregular heartbeat, particularly with arsenic trioxide
- Severe or rapidly spreading painful skin infection
tretinoin in pregnancy
Oral tretinoin is highly teratogenic and can cause severe fetal malformations. Pregnancy should be avoided during treatment and for one month afterwards, with reliable contraception and pregnancy testing as directed by the specialist team; the low-dose progestogen-only pill is inadequate. Any pregnancy or suspected pregnancy requires immediate joint haematology and obstetric assessment rather than stopping treatment without specialist direction.
tretinoin while breastfeeding
Breastfeeding is contraindicated and must stop if oral tretinoin treatment is started. Discuss feeding options with the specialist team.
tretinoin interactions
The specialist team should review prescribed, non-prescription and complementary products before treatment.
Vitamin A supplements
Contraindicated because they can intensify vitamin A-type toxicity.
Other retinoids
Contraindicated because combined exposure can cause excessive retinoid toxicity.
Tetracycline antibiotics
Contraindicated because the combination increases the risk of raised intracranial pressure.
Azole antifungals and other strong CYP3A4 inhibitors
May increase tretinoin toxicity.
Common questions about tretinoin
Answers are fully visible for fast scanning and source review.
Is tretinoin the same as ATRA?
Yes. In APL treatment, ATRA means all-trans retinoic acid, another name for tretinoin.
Is oral tretinoin used for acne?
The selected oral capsule is licensed for acute promyelocytic leukaemia, not acne. Topical tretinoin products are different formulations with different uses and safety considerations.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.