Vesanoid

Vesanoid10mg

Type:100 Capsules

Generic Name:Tretinoin

Manufacturer:

Price:31011.00

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Indication

Acute promyelocytic leukaemia

Administration

Should be taken with food.

Adult Dose

Oral Acute promyelocytic leukaemia Adult: Remission induction: 45 mg/m2 daily in 2 divided doses. Treatment is continued until 30 days after complete remission or up to 90 days, whichever occurs first. Hepatic impairment: Reduce dose to 25 mg/m2 daily.

Child Dose

Oral Acute promyelocytic leukaemia Child: Remission induction: 1-16 yr 45 mg/m2 daily in 2 divided doses. Treatment is continued until 30 days after complete remission or up to 90 days, whichever occurs first. Hepatic impairment: Reduce dose to 25 mg/m2 daily.

Renal Dose

Renal impairment: Reduce dose to 25 mg/m2 daily.

Contraindication

Hypersensitivity to retinoids. Application to eczematous, sunburnt or abraded skin. Pregnancy, lactation.

Mode of Action

Tretinoin is a trans-retinoic acid form of vitimin A. It stimulates mitosis and turnover of follicular epithelial cells and reduce their cohesiveness. This facilitates extrusion of existing comedones and prevents formation of new comedone. It also exhibits thinning effect on the stratum corneum. In acute promyelocytic leukaemia, it induces cellular differentiation and decreases proliferations.

Precaution

Children, hepatic or renal impairment. Reduce dose if intractable headache occurs. Discontinue temporarily if LFT exceed 5 times upper limit of normal. Monitor closely for leukocytosis or respiratory compromise. Monitor haematologic profile, coagulation parameters, LFT, serum triglyceride and cholesterol concentrations regularly. Lactation: Unknown if excreted in breast milk; do not breast-feed, because of potential for serious adverse reactions in infant

Side Effect

>10% Headache (86%),Fever (83%),Bone pain (77%),Dry mucous membranes (77%),Malaise (67%),URI (63%),Shivering (60%),Dyspnea (60%),Hemorrhage (60%),Elevated liver function tests (50-60%),Hyperlipidemia (60%).Infections (58%),Nausea and vomiting (57%),Rash (54%),Peripheral edema (52%),Leukocytosis (40%),Pain (37%),Abdominal pain (31%),DIC (26%),Respiratory insufficiency (26%),Mucositis (26%),GI disorder (26%),Retinoic acid-APL syndrome (25%),Ear ache (23%),Diarrhea (23%),Pleural effusion (20%),Dizziness (20%),Pruritus (20%),Sweating (20%),Anxiety (17%),Paresthesia (17%),Constipation (17%),Vision changes (17%),Dyspepsia (14%),Depression(14%),Insomnia (14%),Alopecia (14%),Skin changes (14%),Confusion (11%),Abdominal distention (11%),Renal insufficiency (11%) 1-10% (selected) Cardiac failure,Pseudotumor cerebri,Ulcer Potentially Fatal: Retinoic acid syndrome, cardiac arrthythmia, disseminated intravascular coagulation, blood dyscrasias, cardiac arrest, cerebral haemorrhage.

Interaction

Enhances percutaneous absorption of minoxidil. Increased risk of fatal thrombotic complications with antifibrinolytic. Increased tretinoin concentrations with azole antifungals. Enhances peeling action of sulphur, resorcinol, benzoyl peroxide, salicylic acid. Increased photosensitivity with photosensitising medications eg, thiazides, tetracyclines, fluoroquinolones, phenothiazines and sulfonamides. Potentially Fatal: Increased risk of intracranial pressure with tetracyclines.

Alternative brand of Vesanoid