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Targretin
Targretin (generic name: bexarotene) is a retinoid medication used for the treatment of cutaneous T-cell lymphoma (CTCL), a type of non-Hodgkin's lymphoma that affects the skin. It works by affecting the growth of cells and may be prescribed when other treatments, such as chemotherapy or radiation, are not effective or suitable. Targretin is available in both oral capsule and topical gel forms, depending on the specific treatment needs of the patient.
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Frequently Asked Questions
How long does it take for Targretin to start working?
It may take several weeks to months for Targretin to show noticeable improvements in cutaneous T-cell lymphoma symptoms. Regular monitoring by your healthcare provider is necessary to evaluate the effectiveness of the treatment.
Can I take Targretin if I’m pregnant?
No, Targretin is highly teratogenic and can cause severe birth defects. It should not be used during pregnancy, and effective contraception is required for both men and women during treatment and for at least one month after stopping the medication.
What should I do if I miss a dose of Targretin?
If you miss a dose of Targretin, take it as soon as you remember. If it is close to the time for your next dose, skip the missed dose and take your next dose at the regular time. Do not double the dose to make up for the missed one.
How does Targretin affect cholesterol levels?
Targretin can cause significant increases in cholesterol and triglyceride levels. Regular blood tests are required to monitor lipid levels, and your healthcare provider may prescribe medications such as statins to manage this side effect.
Can Targretin cause vision problems?
Yes, long-term use of Targretin can increase the risk of cataracts, so patients should have regular eye exams while using this medication.
Comprehensive Drug Guide
How Does Targretin Work?
Targretin works by binding to retinoid X receptors (RXRs) in the body, which regulate gene expression related to cell growth and differentiation. By modulating these receptors, Targretin affects the growth of cancerous T-cells, slowing their proliferation and promoting apoptosis (cell death). This helps reduce the symptoms and progression of cutaneous T-cell lymphoma (CTCL).
Common Dosages
- Initial dose: 300 mg/m²/day, taken orally with food.
- Dosage may be adjusted based on tolerance, response, and side effects.
Targretin gel is applied topically:
- Applied once or twice daily to the affected areas of the skin.
Typical Dosing
- Oral capsule: The recommended starting dose for adults is 300 mg/m²/day taken with food. The dose may be adjusted by your healthcare provider based on your response and side effects.
- Topical gel: Apply a thin layer of Targretin gel to the lesions on the skin once or twice daily, depending on the severity of the condition.
Typical Dosing
FDA Approved Indications
- Cutaneous T-cell lymphoma (CTCL) in patients who have not responded well to other therapies, including chemotherapy, radiation, or biological treatments.
Who Shouldn't Take Targretin?
- Known hypersensitivity to bexarotene or any other components of Targretin.
- Pregnancy: Targretin is highly teratogenic (can cause birth defects) and should not be used during pregnancy.
- Severe liver dysfunction or uncontrolled lipid disorders.
Advice From The Pharmacist
- Take with food: If you are prescribed Targretin capsules, take them with food to improve absorption.
- Avoid sun exposure: Both the oral and topical forms of Targretin can make your skin more sensitive to sunlight. Use sunscreen and wear protective clothing when outdoors.
- Monitor lipid levels: Targretin can increase cholesterol and triglyceride levels, so regular blood tests to monitor lipid levels are important. Your doctor may prescribe medications to manage high cholesterol while on Targretin.
- Pregnancy prevention: Both male and female patients must use effective contraception during treatment with Targretin due to the risk of serious birth defects.
Side Effects of Targretin
Common Side Effects
- Hyperlipidemia (elevated cholesterol or triglycerides)
- Hypothyroidism
- Fatigue
- Headache
- Skin rash or dryness
- Itching
Uncommon/Severe Side Effects
- Pancreatitis: Targretin can cause elevated triglycerides, which may lead to acute pancreatitis.
- Liver toxicity: Liver function tests should be monitored regularly.
- Cataracts: Long-term use may increase the risk of developing cataracts.
Risks and Warnings of Targretin
- Hyperlipidemia: Targretin can significantly raise cholesterol and triglyceride levels. Regular lipid testing is required, and medications such as statins may be prescribed to manage these effects.
- Teratogenicity: Targretin is highly teratogenic and can cause serious birth defects. Both men and women must use effective contraception during treatment and for at least one month after stopping the medication.
- Liver Toxicity: Targretin can affect liver function, and regular monitoring of liver enzymes is necessary.
- Hypothyroidism: Targretin can lower thyroid hormone levels, so thyroid function tests should be performed regularly.
Interactions with Targretin
Common Drug Interactions
- Cholesterol-lowering medications: Targretin may require concurrent use of statins or fibrates to manage high cholesterol and triglyceride levels.
- Thyroid hormones: Patients on Targretin may need to take thyroid hormone replacement therapy if the medication causes hypothyroidism.
- Strong CYP3A4 inhibitors: Medications such as ketoconazole or ritonavir may increase the effects of Targretin by slowing its metabolism.
- Vitamin A supplements: Avoid taking Vitamin A supplements while using Targretin, as it may increase the risk of retinoid-related side effects.
Alternatives to Targretin
- Methotrexate: An oral or injectable chemotherapy agent used for treating CTCL and other cancers.
- Phototherapy: A treatment that uses ultraviolet (UV) light to manage skin conditions like CTCL.
- Topical corticosteroids: Used to manage skin lesions caused by CTCL.
- Vorinostat (Zolinza): An oral HDAC inhibitor used to treat CTCL.
- Romidepsin (Istodax): A histone deacetylase inhibitor used in patients with CTCL who have not responded to other treatments.
