Take tretinoin twice daily, with food. Swallow the capsules whole without chewing them.
Please keep your regular clinic appointments so that your doctor can check on your progress.
If you are a woman it is very important that you do not become pregnant while you are taking tretinoin. Ask your doctor about suitable contraception.
About tretinoin capsules
|Type of medicine||A retinoid anti-cancer medicine|
|Used for||Acute promyelocytic leukaemia|
Tretinoin is an anti-cancer medicine used to treat a type of leukaemia called acute promyelocytic leukaemia (APL or APML). This is a cancer where the bone marrow makes large numbers of immature white blood cells. White blood cells usually help the body to fight infection, but in leukaemia the development of these white blood cells goes wrong. The accumulation of the abnormal immature white blood cells in the bone marrow causes an overall reduction in the number of blood cells in the blood. This leads to many of the symptoms of APL, such as anaemia, infection and blood clotting and bleeding problems.
Tretinoin is a medicine which is related to vitamin A. It works by slowing the growth of the abnormal blood cells responsible for the cancer. It will be prescribed for you by a specialist doctor.
Before taking tretinoin capsules
Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking tretinoin it is important that your doctor knows:
- If you are pregnant, trying for a baby or breastfeeding.
- If you have any problems with the way your liver works, or if you have any problems with the way your kidneys work.
- If you are taking any other medicines. This includes any medicines which are available to buy without a prescription, as well as herbal and complementary medicines. It is particularly important that your doctor should know if you are taking any antibiotics or vitamins.
- If you have ever had an allergic reaction to a medicine.
How to take tretinoin capsules
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about tretinoin, and will also provide you with a full list of the side-effects which you could experience from taking it.
- Tretinoin will be prescribed for you by a specialist doctor who is experienced in treating your condition. Your dose will be calculated from your weight and height, so it is important that you take the capsules exactly as your doctor tells you to. You will be asked to take two doses a day, and you will be told how many capsules to take for each dose. This information will also be printed on the label of the pack of capsules to remind you about what the doctor said to you.
- Swallow the capsules with a drink of water at a mealtime. Do not chew or open the capsules. Try to take the doses at the same times of day each day, as this will help you to remember to take tretinoin capsules regularly.
- If you forget to take a dose at your usual time, take it (with something to eat) when you remember. However, if it is nearly time to take your next dose when you remember then leave out the forgotten dose and take the next dose when it is due. Do not take two doses together to make up for a missed dose.
- A course of treatment can last up to three months.
Getting the most from your treatment
- You must try to keep your regular appointments with your doctor or hospital. This is so your doctor can check on your progress. You will need to have regular blood tests and check-ups during your treatment.
- Tretinoin can be harmful to an unborn child, so women must avoid getting pregnant during the treatment and for at least a month afterwards. If this could affect you, make sure you have discussed with your doctor which types of contraception are suitable for you and your partner. Some oral contraceptives are not suitable with tretinoin so it is important that you ask your doctor for advice before you start the treatment.
- If you buy any medicines, check with a pharmacist that they are suitable to take with tretinoin. This includes any preparations which may contain vitamins, as you must not take vitamin A supplements while you are on tretinoin.
Can tretinoin cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with tretinoin. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Very common tretinoin side-effects (these affect more than 1 in 10 people)||What can I do if I experience this?|
|Feeling dizzy||Getting up or moving more slowly may help. Do not drive and do not use tools or machines while you are feeling dizzy|
|Headache||Drink plenty of water and ask your doctor to recommend a suitable painkiller|
|Feeling sick (nausea) or being sick (vomiting), tummy (abdominal) pain||Stick to simple foods - avoid fatty or spicy meals|
|Diarrhoea||Drink plenty of water|
|Constipation||Drink plenty of water and try to eat a well-balanced diet|
|Reduced appetite, confusion, anxiety, mood changes, difficulty sleeping, tingling feelings, difficulties with hearing or seeing, flushing, dry mouth or skin, difficulty breathing, skin rash, loss of hair, increased sweating, pains, heart rhythm changes, and generally feeling unwell||If any become troublesome, discuss them with your doctor|
Important: your doctor will discuss with you the possibility that you may experience some unwanted side-effects that will need immediate treatment. If you develop the following symptoms, you must let your doctor know about them straightaway:
- A high temperature (fever).
- Feeling breathless.
- Chest pain or tummy pain.
- A cough.
If you experience any other symptoms which you think may be due to the capsules, speak with your doctor or pharmacist for further advice.
How to store tretinoin capsules
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Tretinoin 10 mg soft capsules; Cheplapharm Arzneimittel GmbH, The electronic Medicines Compendium. Dated April 2017.
British National Formulary, 77th Edition (Mar 2019); British Medical Association and Royal Pharmaceutical Society of Great Britain, London.