7 mins read

Overview: Tretinoin is used to treat a type of blood cancer. This medicine can harm a fetus, so use birth control if you can get pregnant or get your partner pregnant. Common side effects include headache, bone pain, and dry skin. Call your health care provider right away if you get a fever, cough, rapid weight gain, vomiting, dizziness, or swelling of your arms or legs. Get emergency help if you have chest pain, vision changes, trouble breathing or speaking, severe headache, or sudden weakness on one side of your body.

Uses

What is tretinoin used for?

Tretinoin is commonly used to treat a certain type of acute myeloid leukemia called acute promyelocytic leukemia (APL).

Tretinoin may also be used for other conditions as determined by your health care provider.

Tretinoin is also available in a form that is applied to the skin. See tretinoin topical for more information.

How does tretinoin work (mechanism of action)?

Tretinoin may help abnormal, immature blood cells called promyelocytes grow into healthy cells and help your bone marrow make new, healthy blood cells. This medicine may help you get complete remission.

How is tretinoin supplied (dosage forms)?

Brands and other names

  • Vesanoid

Dosage forms and strengths

  • 10 mg oral capsules

How should I store tretinoin?

Tretinoin should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place and protect the bottle from light.

Side Effects

What are the most common side effects of tretinoin?

The most common side effects of tretinoin are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Headache
  • Fever
  • Dryness of the skin, mouth, or nose
  • Bone pain
  • Weakness
  • Shivering
  • Shortness of breath
  • Bleeding
  • Infections
  • Nausea, vomiting, and stomach pain
  • Rash
  • Fluid retention
  • High levels of white blood cells (see below)

There may be other side effects of tretinoin that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of tretinoin?

While less common, the most serious side effects of tretinoin are described below, along with what to do if they happen.

Severe Allergic Reactions. Tretinoin may cause allergic reactions, which can be serious. Stop taking tretinoin and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching or skin rash
  • Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Differentiation Syndrome. Tretinoin can cause a dangerous side effect known as differentiation syndrome. This can cause severe organ damage and can cause organ failure if not treated. Tell your health care provider or get emergency help right away if you have any of the following symptoms. 

  • Swelling in your feet, ankles, or legs
  • Low blood pressure or dizziness
  • Trouble breathing or shortness of breath
  • Cough
  • Reduced need to pee
  • Fever
  • Weight gain

High Levels of White Blood Cells. Tretinoin can cause a high level of white blood cells known as leukocytosis. If not treated, this can be a dangerous and even life-threatening side effect. Keep all appointments with your health care provider to have your blood checked, so they can make sure tretinoin is safe for you.

Increased Pressure Around the Brain. Tretinoin can increase the pressure around the brain, a serious condition called increased intracranial pressure or intracranial hypertension. The risk may be higher in children. Stop taking tretinoin and call your health care provider right away if you have any of the following symptoms.

  • Dizziness
  • Nausea and vomiting
  • Severe headache
  • Vision changes
  • Papilledema

High Levels of Cholesterol. Tretinoin may cause high levels of cholesterol in your blood. This is known as hypercholesterolemia or hypertriglyceridemia. Keep all appointments with your health care provider to have your blood checked to make sure tretinoin is safe for you.

Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking tretinoin. Call your health care provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored urine (pee)
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Blood Clots. Tretinoin may cause blood clots in your arteries or veins and could cause a stroke, heart attack, or venous thromboembolism, including a blood clot in the lungs (pulmonary embolism) or deep venous thrombosis (DVT). Stop taking tretinoin and get emergency help if you have any of the following signs of blood clots.

  • Chest pain or pressure
  • Fast or abnormal heartbeat
  • Trouble breathing
  • Pain in your back, jaw, throat, or arm
  • Sweating, upset stomach, vomiting, or dizziness
  • Sudden weakness on one side of your body
  • Sudden and severe headache
  • Slurred speech or trouble understanding speech
  • Pain, swelling, or tenderness in your arm or leg
  • Vision loss
  • Bulging eyes
  • Double vision

Warnings & Precautions

Who should not use tretinoin?

Allergies to Ingredients. People who are allergic to any of the following should not take tretinoin.

  • Tretinoin
  • Vesanoid
  • Any other medicine known as a retinoid
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific tretinoin products they stock.

What should I know about tretinoin before using it?

Do not take tretinoin unless it has been prescribed to you by a health care provider. Take it as prescribed.

Do not share tretinoin with other people, even if they have the same condition as you. It may harm them.

Keep tretinoin out of the reach of children.

Tretinoin should be swallowed whole and should not be chewed, dissolved, or opened. Take this medicine with a meal.

Tretinoin can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how tretinoin affects you.

What should I tell my health care provider before using tretinoin?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if tretinoin is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Liver problems
  • Cholesterol problems
  • Blood cell count problems
  • Bleeding problems or blood clots or previous stroke
  • Heart problems, including a past heart attack

Other Medicines and Supplements. Tretinoin may interact with other medicines and supplements. Before taking tretinoin, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. Tretinoin can cause harm to a fetus. Your health care provider may give you a test to make sure you are not pregnant before starting to take tretinoin. If you are able to get pregnant, you should use two forms of birth control while taking tretinoin and for one month after your last dose. If you are able to get a partner pregnant, you should use birth control, such as condoms, while taking tretinoin and for one week after your last dose. Tell your health care provider right away if you are pregnant or plan to become pregnant.

Breastfeeding. It is not known if tretinoin passes into breast milk. You should not breastfeed while taking tretinoin and for one week after your last dose. Tell your health care provider if you are breastfeeding or plan to breastfeed.

Interactions

Does tretinoin interact with foods or drinks?

There are no known interactions between tretinoin and foods or drinks.

It is unknown if drinking alcohol will affect tretinoin, but heavy drinking can slow your immune response and make it harder for your body to fight infection or cancer.

Does tretinoin interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking tretinoin.

  • Ketoconazole, which is a medicine used for fungal infections
  • A tetracycline, such as doxycycline, minocycline, omadacycline (Nuzyra), sarecycline (Seysara), or tetracycline, which is a medicine used to treat infections or other conditions
  • Vitamin A, which is a supplement used to increase levels of this vitamin
  • Aminocaproic acid (Amicar) or tranexamic acid (Cyklokapron, Lysteda), which are medicines used to treat heavy bleeding

Many other medicines may alter the blood levels of tretinoin. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with tretinoin. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much tretinoin?

If you or someone else has used too much tretinoin, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of tretinoin?

If you miss a dose, take it as soon as you remember. If it is 10 hours or less to your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.

If you vomit after taking a dose of tretinoin, do not take another or an extra dose. Take your next dose as scheduled.