All-trans retinoic acid
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| Clinical data | |
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| Pronunciation | See pronunciation note |
| Trade names | Vesanoid, Avita, Renova, Retin-a, others |
| AHFS/Drugs.com | Monograph |
| MedlinePlus | a682437 |
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| Routes of administration |
topical, by mouth |
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| Pharmacokinetic data | |
| Protein binding | > 95% |
| Biological half-life | 0.5-2 hours |
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| ECHA InfoCard | 100.005.573 |
| Chemical and physical data | |
| Formula | C20H28O2 |
| Molar mass | 300.4412 g/mol |
| 3D model (JSmol) | |
| Melting point | 180 °C (356 °F) |
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Tretinoin, also known as all-trans retinoic acid (ATRA), is medication used for the treatment of acne and acute promyelocytic leukemia. For acne it is applied to the skin as a cream or ointment. For leukemia it is taken by mouth for up to three months.
Common side effects when used by mouth include shortness of breath, headache, numbness, depression, skin dryness, itchiness, hair loss, vomiting, muscle pains, and vision changes. Other severe side effects include high white blood cell counts and blood clots. When used as a cream side effects include skin redness, peeling, and sun sensitivity. Use during pregnancy is known to harm the baby. It is in the retinoid family of medications.
Tretinoin was patented in 1957 and approved for medical use in 1962. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. Tretinoin is available as a generic medication. In the United Kingdom the cream together with erythromycin costs the NHS about £7.05 per 25 mL while the pills are £1.61 per 10 mg.
Tretinoin is most commonly used to treat acne. It is also used off-label to treat and reduce the appearance of stretch marks by increasing collagen production in the dermis.
In topical form, this drug is pregnancy category C and should not be used by pregnant women.
People using the topical form should not also use any cream or lotion that has a strong drying effect, contains alcohol, astringents, spices, lime, sulfur, resorcinol, or aspirin, as these may interact with tretinoin or exacerbate its side effects.
Tretinoin is used to induce remission in people with acute promyelocytic leukemia who have a mutation (the t(15;17) translocation 160 and/or the presence of the PML/RARα gene) and who don't respond to anthracyclines or can't take that class of drug. It is not used for maintenance therapy.
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