Find out what tretinoin is, how you have it and other important information about taking tretinoin for acute myeloid leukaemia (AML).
What it is
Tretinoin is also called all trans retinoic acid (ATRA) and its brand name is Vesanoid.
It is not a chemotherapy drug, but you may have it along with chemotherapy to treat a type of acute myeloid leukaemia called promyelocytic leukaemia.
How tretinoin works
Tretinoin treats promyelocytic leukaemia by encouraging the abnormal leukaemic cells to develop normally.
How you have tretinoin
Tretinoin comes as 10mg orange-yellow and reddish-brown soft capsules.
Taking your tablets or capsules
Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.
You should take the right dose, not more or less.
Never stop taking a cancer drug without talking to your specialist first.
You must take the capsules with food or shortly after a meal, as this helps your body to absorb the drug. Don't chew the capsules. Swallow them whole with plenty of water.
When you have tretinoin
You take the capsules twice a day. You usually take tretinoin until there is no sign of your leukaemia (remission) or for a maximum of 90 days.
Tests during treatment
You have blood tests before starting treatment and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
Other medicines, foods and drink
Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.
Pregnancy and contraception
This treatment might harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.
If you are taking the progesterone only pill, your doctor will ask you to stop and they will prescribe a different type of contraceptive for you.
Don’t breastfeed during this treatment because the drug may come through in your breast milk.
Treatment for other conditions
Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.
Don’t have immunisations with live vaccines while you’re having treatment and for at least 6 months afterwards.
In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and shingles vaccine (Zostavax).
- have other vaccines, but they might not give you as much protection as usual
- have the flu vaccine
- be in contact with other people who've had live vaccines as injections
Avoid contact with people who’ve had live vaccines taken by mouth (oral vaccines). This includes the rotavirus vaccine given to babies. The virus is in the baby’s urine for up to 2 weeks and can make you ill. So, avoid changing their nappies for 2 weeks after their vaccination if possible. Or wear disposable gloves and wash your hands well afterwards.
You also need to avoid anyone who has had oral polio or typhoid vaccination recently.
Peanut and soya allergy
Do not take tretinoin if you are allergic to peanuts or soya because tretinoin contains soya bean oil.
Tretinoin contains a type of sugar called sorbitol. If you have an intolerance to some sugars, ask your doctor if tretinoin is safe for you to take.