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Alitretinoin is used for the treatment of skin sores in patients with a certain type of AIDS-related cancer called Kaposi’s sarcoma. It is a type of condition that forms in the lining of blood and lymph vessels. The tumors of Kaposi’s sarcoma typically appear as painless purplish spots on the feet, legs, and face. Lesions may also appear in the genital area, mouth or lymph nodes. In severe Kaposi’s sarcoma, lesions may develop in the digestive tract and lungs.

The underlying cause of Kaposi’s sarcoma is an infection with a virus called human herpesvirus 8 (HHV-8). In healthy people, HHV-8 infection usually causes no symptoms because the immune system keeps it under control. In people with weakened immune systems, however, HHV-8 has the potential to trigger Kaposi’s sarcoma. Some signs and symptoms of this type of condition may include:

  • Unexplained stomach or intestinal pain
  • Unexplained cough or chest pain
  • Slightly elevated purple, brown, pink, or red blotches or bumps anywhere on the skin or in the mount/throat
  • Diarrhea and blockage of the digestive tract which can be caused by sarcoma lesions that have developed in the gastrointestinal system

Alitretinoin belongs to a class of medications called retinoids. It affects the growth of the skin cells. Retinoids are drugs that are relatives of vitamin A. This controls normal cell growth, cell differentiation, and cell death. Retinoids are also a relatively new type of anti-cancer drug.

This medication intended for topical application only. This product comes in the form of a gel and contains Alitretinoin as an active ingredient. It is a yellow powder that is slightly soluble in ethanol. Alitretinoin gel is a prescription approved by the Food and Drug Administration (FDA).

How does Alitretinoin work?

Alitretinoin alters the activity of the immune system in the skin. This also has an anti-inflammatory effect on the skin.

  • Retinoids play a role in regulating normal cell growth and cell death.
  • Alitretinoin binds to retinoid receptors on the cell nucleus and activates the receptors.
  • Activated receptors regulate the expression of genes that control cell differentiation and growth in both normal and abnormal cells.
  • In this way, Alitretinoin can inhibit the growth of Kaposi’s sarcoma cells.
  • Alitretinoin has demonstrated immune-modulatory and anti-inflammatory effects that are relevant to skin inflammation.

The effectiveness of this medication may be visible in your skin in as little as 2 weeks of treatment. It may take up to 14 weeks of treatment to see the full benefit.

How to use Alitretinoin?

Alitretinoin is to be used on the skin only and is not to be ingested. Wait at least 20 minutes after bathing or showering before applying the medication. Apply enough medication to cover the skin sores well. This medication is usually applied 2 to 4 times a day or as directed by your doctor. It is not necessary to rub the medication into the sore. Allow 3 to 5 minutes for the medication to dry before covering the affected area with clothing.

Wash your hands before and after using Alitretinoin, unless you are using this to treat the hands. Do not bathe, shower, or swim for at least 3 hours after using it. Do not wrap, bandage, or cover the affected area unless directed to do so by your doctor.  

Your doctor will determine the number of daily applications and length of time treatment should be continued. You must use this medication exactly as it is given by your doctor. You should not take more or less than the prescription. Your doctor may direct you to start at a lesser amount and gradually increase it. To get the most benefit from it, use the medication regularly. Remember to use the prescription at the same time and in the same way each day. Let your doctor know if your condition gets worse or if it does not improve. If you missed applying the medication, you should call your doctor for further instructions.

What are the side effects of Alitretinoin?

Common side effects:

  • Tingling or numbness
  • Dryness or cracking of the skin
  • Burning, mild itching, or other skin irritation
  • Dry eyes
  • Dry mouth or nose
  • Flushing
  • Vision problems
  • Mood changes
  • Muscle pain or stiffness
  • Headache
  • Increased sensitivity to sunlight
  • Nosebleeds pain or tenderness of eyes
  • Stomach upset
  • Thinning of hair

Stop using this medicine and call your doctor right away if you have:

  • Peeling or scaly skin
  • Severe redness or swelling of treated skin areas
  • Blistering or oozing of treated skin
  • Scabbing or crusting

Get emergency medical help if you have signs of an allergic reaction:

  • Hives
  • Trouble or difficulty breathing
  • Swelling of your lips, face, throat, or tongue

Warnings and Precautions

  • Before taking a dose, let your doctor know if you have ever had a medical history of certain types of cancer.
  • Do not take this drug again if you have ever had an allergic reaction to it. Taking it again could be fatal.
  • During pregnancy, Alitretinoin should only be used when needed. If you are breastfeeding women, consult your doctor first before using this drug.
  • This drug may cause drowsiness. Don’t drive or do dangerous activities until you know how this affects you.  
  • This medication may make you more sensitive to the sun. Limit your time in the sun. Use sunscreen and wear protective clothing when outdoors.
  • Let your healthcare provider know about all the medicines you take including prescription medicines, vitamins, and herbal supplements.
  • Without the consent of your doctor, you should not receive any vaccination or immunization.
  • You should not share this or any of your prescriptions with others even if they have the same symptoms as yours.
  • Do not use the medication on unaffected skin because doing so may cause increased irritation.
  • Do not apply other skin products on the treated sores except mineral oil.
  • Alitretinoin gel may contain alcohol which is flammable. Do not use this gel near an open flame or while smoking.
  • You should not apply this in or around the eyes, mouth, nose, vagina, anus, or tip of the penis.
  • Keep this drug at room temperature far from heat, moisture, and from the reach of children.