Tretinoin / ATRA (Vesanoid)

Uses

Side Effects

Handling

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Uses

What is Tretinoin / ATRA (Vesanoid) for?

Tretinoin is a medication used for the treatment of acute promyelocytic leukemia (APL).

How should I take or use Tretinoin / ATRA (Vesanoid)?

Tretinoin is usually taken twice daily, preferably at the same time each day.

It is important to take Tretinoin exactly as directed by your doctor.

Tretinoin should be taken with food as this helps to increase the absorption of the medication.

Swallow the capsules whole with a glass of water. Do not open, crush or chew the capsules.

If your child is unable to swallow the capsules, please consult a pharmacist.

What should I do if I forget to take or use Tretinoin / ATRA (Vesanoid)?

If you forget a dose, take it as soon as you remember. If it is nearer to the time of the next dose, skip the missed dose. Do not take two doses at the same time.

If you have missed more than two doses, consult your doctor or pharmacist.

Do not repeat dose if vomiting occurs after dose has been administered, wait until the next scheduled dose. Contact the pharmacist or doctor if you repeatedly miss doses due to vomiting, even with the administration of anti-vomiting medicine.

Side Effects

What are some common side effects of Tretinoin / ATRA (Vesanoid)?

Possible side effects from Tretinoin and their management are listed below

Side Effects	Management
Retinoic acid syndrome (Fever, weight gain, difficulty breathing)	Seek medical advice immediately if your child experiences any of the listed side effects, especially during the first month of treatment.
Drowsiness, dizziness, fatigue, weakness	Avoid performing tasks that require your child to be mentally alert.
Increased risk of bleeding	Be safety conscious and avoid activities that may cause bruising or bleeding. If your child experiences bleeding that does not stop, or unusual bleeding (e.g. blood in the urine), please seek medical help immediately.
Headache, bone/muscle ache	You may give your child paracetamol to decrease/stop the headache and bone/muscle aches. If your child experiences severe aches that are not relieved by paracetamol, or a headache which occurs with nausea and vomitting or changes in eyesight/hearing, consult a doctor immediately.
Photosensitivity Your child may be more prone to sunburns when exposed to sunlight.	Avoid too much sunlight. Use sunscreen regularly and dress your child in clothes e.g. long sleeved tops that can protect your child's skin from the sunlight.
Dry, itchy skin	Apply moisturiser to skin several times a day.
Dry mouth and lips	Use lip balm several times a day. Drink plenty of water to keep hydrated. Sucking on hard candy may help.
Constipation or diarrhea	Constipation: Get some exercise if possible, but be sure to check with the doctor before becoming more active. Drink plenty of fluids, unless otherwise instructed by your doctor. Take fibre-rich foods e.g. wholemeal bread, brown rice, fresh fruits, vegetables. Diarrhea: Avoid oily or spicy foods, dairy products and caffeine. Drink plenty of fluids. Seek medical help immediately if diarrhea is persistent, bloody, or associated with fever or severe abdominal pain.
Nausea and vomiting	Eat small but frequent meals. Refrain from lying down for at least two hours after each meal. Seek medical help immediately if your child experiences persistent vomiting, or vomiting accompanied by a headache.

Handling

How should I store Tretinoin / ATRA (Vesanoid)?

Keep away from children
Keep in a cool, dry place, away from direct sunlight
Store at room temperature

How do I throw away Tretinoin / ATRA (Vesanoid) safely?

Any excess capsules should be returned to the hospital for disposal.

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What else should I know about Tretinoin / ATRA (Vesanoid)?

Do not use this medicine if your child is allergic to Tretinoin, Vitamin A, retinoids or soybean oil.

Before starting Tretinoin, do inform your doctor of any other medications that your child is already on. Always check with your doctor or pharmacist if you want to give any other medicines, supplements or herbal products to your child. Avoid foods and supplements with high content of Vitamin A.

Pregnant women should avoid contact with this medicine as it may cause harm to the fetus.

Disclaimers

Please take note that the above is not a complete list of all possible side effects. If you have any concerns about your medication or if you have other side effects that you think are caused by this medication, please consult your doctor or pharmacist.

If you take more than the recommended dose, please seek medical advice immediately. The information provided on this page does not replace information from your healthcare professional. Please consult your healthcare professional for more information.

This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (National Healthcare Group, National University Health System, and SingHealth), community pharmacies (Guardian, Unity, and Watsons), and the Pharmaceutical Society of Singapore. The content does not reflect drug availability and supply information in pharmacies and healthcare institutions. You are advised to check with the respective institutions for such information.