Alitretinoin

PANRETIN

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Pronunciation: a-li-TRE-ti-noyn

Alitretinoin ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Alitretinoin ballicule

What it isTopical retinoid receptor agonist for cutaneous lesions of AIDS-related Kaposi sarcoma.

Why this oneTreats limited skin disease locally and can defer systemic chemotherapy.

What limits itLocal inflammation and photosensitivity often limit adherence; avoid pregnancy and application near mucosal surfaces.

Alitretinoin molecular structure (skeletal formula) — Molecular structure: Alitretinoin

FDA-approved for

Kaposi sarcoma (topical) (1999)
chronic hand eczema (non-US)

FDA label

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FDA dosing	Population	Start	Target	Max
Cutaneous AIDS-related Kaposi sarcoma		Apply BID	Increase up to QID as tolerated

Renal Undefined

Hepatic Undefined

Instructions

Topical use only; do not use occlusive dressings
Apply to coat entire cutaneous KS lesions; avoid normal skin and mucosal surfaces
Gradually increase up to 4 times daily as tolerated; reduce frequency or interrupt for severe irritation
Allow gel to dry 3-5 minutes before covering with clothing
Do not use concurrently with DEET-containing products

Available strengths

gel 0.1 %

Contraindications

Hypersensitivity to retinoids

Cautions

Embryo-fetal toxicity — advise contraception
Photosensitivity — minimize sunlight/sunlamp exposure
Increased DEET toxicity — avoid DEET-containing products

Adverse reactions

Application-site rash, pain, paresthesia, pruritus, exfoliative dermatitis, edema, skin disorder

Pregnancy Can cause fetal harm (animal teratogenicity/embryolethality). Verify pregnancy status; use effective contraception during and 1 week after last dose.

Lactation Breastfeeding not recommended during treatment and for 1 week after the last dose.

Cost

Alitretinoin (PANRETIN)

Strength		#/mo	generic $/unit	CostPlus
0.1 %	gel	per unit		not offered

NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Alitretinoin is dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.

Generic entryNo US generic

NO BOXED WARNINGS

Principal riskembryo-fetal toxicity; avoid pregnancy

Classes and tags

Clinical profile

Therapeutic safety burden0 / 4

Overdose danger0 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk1 / 4

Legacy pregnancy categoryUnknown / historical label unavailable

Defining liabilityLocal irritation, sensitization or administration-site injury; negligible systemic toxicity at usual use.

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