tretinoin topical (Retin A, Renova, Atralin, Avita, Refissa, Retin-A Micro, Tretin-X)
Classes: Acne Agents, Topical
Dosing and uses of Retin A, Renova (tretinoin topical)
Adult dosage forms and strengths
topical cream
- 0.02% (Renova)
- 0.025% (Retin-A, Avita, Tretin-X)
- 0.0375% (Tretin-X)
- 0.05% (Retin-A, Renova, Refissa, Tretin-X)
- 0.075% (Tretin-X)
- 0.1% (Retin-A, Tretin-X)
topical geL
- 0.01% (Retin-A)
- 0.025% (Retin-A, Avita)
- 0.04% (Retin-A Micro)
- 0.05% (Atralin)
- 0.08% (Retin-A Micro)
- 0.1% (Retin-A Micro)
topical solution
- 0.05% (Retin-A)
Acne Vulgaris
Retin-A, Atralin, Avita, Retin-A Micro, Tretin-X
- Apply a pea-sized amount topically qHS to the skin where acne lesions appear, using enough to lightly cover the entire affected area
- Begin therapy with a low-concentration formulation (0.025% cream, 0.04% microsphere gel, or 0.01% gel); may use stronger preparations as tolerated
Facial Wrinkles
Adjunct for mitigation of fine wrinkles, mottled hyperpigmentation, and tactile roughness of facial skin
Renova, Refissa
- Apply a pea-sized amount (0.02-0.05%) to the affected area qHS
Administration
Apply 20 minutes after skin is cleansed and completely dried
Avoid lips and directly under eyes
Avoid UV exposure
Pediatric dosage forms and strengths
topical cream
- 0.02% (Renova)
- 0.025% (Retin-A, Avita, Tretin-X)
- 0.0375% (Tretin-X)
- 0.05% (Retin-A, Renova, Refissa, Tretin-X)
- 0.075% (Tretin-X)
- 0.1% (Retin-A, Tretin-X)
topical geL
- 0.01% (Retin-A)
- 0.025% (Retin-A, Avita)
- 0.04% (Retin-A Micro)
- 0.05% (Atralin)
- 0.08% (Retin-A Micro)
- 0.1% (Retin-A Micro)
topical solution
- 0.05% (Retin-A)
Acne Vulgaris
Retin-A, Atralin, Avita, Retin-A Micro, and Tretin-X
- <12 years old: Safety and efficacy not established
- ≥12 years old: Apply a pea-sized amount topically qHS to the skin where acne lesions appear, using enough to lightly cover the entire affected area
- Begin therapy with a low-concentration formulation (0.025% cream, 0.04% microsphere gel, or 0.01% gel); may use stronger preparations as tolerated
Administration
Apply 20 minutes after skin is cleansed and completely dried
Avoid lips and directly under eyes
Avoid UV exposure
Retin A, Renova (tretinoin topical) adverse (side) effects
Frequency not defined
Excessive dryness
Erythema
Scaling
Pruritus
Hyperpigmentation/hypopigmentation
Photosensitivity
Initial acne flare-up
Edema
Blistering
Stinging
Warnings
Contraindications
Hypersensitivity
Sunburn
Cautions
Extreme caution in eczema (may produce severe irritation of eczematous skin)
Discontinue if sensitivity or chemical irritation occurs
Exposure to UV light (including from sunlamps) increases intensity of inflammatory reaction
Concomitant topical medications such as abrasive soaps, cleansers, or cosmetics with strong drying effects may increase skin irritation
Pregnancy and lactation
Pregnancy category: C
Lactation: Not known whether excreted in breast milk
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Retin A, Renova (tretinoin topical)
Mechanism of action
Inhibits microcomedo formation; decreases cohesiveness of keratinocytes in sebaceous follicles, which allows for easy removal; has anti-inflammatory properties
Absorption
MinimaL
Elimination
Excretion: Urine (0.1%)