This page tells you about the cancer drug bexarotene. There are sections on
Bexarotene (prounounced becks-a-roh-teen) is also called Targretin (pronounced tar-gree-tin). It is a cancer drug used to treat advanced skin lymphomas called cutaneous T cell lymphomas. These include mycosis fungoides and Sezary syndrome.
Bexarotene is a retinoid. Retinoids are drugs related to vitamin A. They work by slowing or stopping the growth of cells.
Bexarotene is a capsule. You take the capsules once a day. The number of capsules you take each day depends on your individual needs.
Swallow the capsules whole with plenty of water. You should take them with food or immediately after eating. You usually continue taking them for as long as the treatment works.
It is very important that you take capsules according to the instructions your doctor or pharmacist gives you. For example, whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream. So check the pack leaflet and follow the instructions it gives. You should take the right dose, not more or less. And never stop taking a cancer drug without talking to your specialist first.
Bexarotene’s side effects are listed below. You can use the links to find out more about each side effect. For general information, see our cancer drug side effects section.
More than 10 in every 100 people have one or more of these side effects
- Raised levels of fats called triglycerides in the blood happen in about 3 out of 4 people (75%) – you will have regular blood tests to check the levels. Eating a low fat diet can help. You may need to take tablets to reduce the amount of fat in your blood
- Low thyroid hormone levels happen in about 3 out of 10 people (30%). This causes tiredness, constipation and feeling cold. You may need to take tablets to increase the amount of thyroid hormone in your blood
- Raised levels of cholesterol in the blood happen in about 3 out of 10 people (30%) – you will have regular cholesterol level checks. Eating a low fat diet may help and you may need to take tablets to lower the levels
- An increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, a sore throat, pain passing urine, or you may feel cold and shivery. If you have a severe infection this can be life threatening. Contact your treatment centre straight away if you have any of these effects or if your temperature goes above 38°C. You will have regular blood tests to check your blood cell levels
- Headaches affect about 3 out of 10 people (30%)
- Skin changes happen in about 2 out of 10 people (20%) – you may have a rash and your skin may be dry, itchy and scaly
- Sensitivity to sunlight – don’t sit out in the sun, and do cover up or use sun block on exposed skin
- Tiredness and weakness
- Low blood sugar levels may occur in people with diabetes as bexarotene can increase the effect of insulin. If you have diabetes you may need to check your blood sugar levels more regularly
Between 1 and 10 in every 100 people have one or more of these side effects
- Tiredness and breathlessness from a drop in red blood cells (anaemia) – you may need a blood transfusion
- Dry eyes and a feeling of heaviness in your eyes
- Feeling or being sick – this is usually well controlled with anti sickness medicines
- Diarrhoea – drink plenty and tell your doctor or nurse if you are worried about how bad it is, or if it continues for more than 3 days
- Difficulty sleeping
- Joint, bone and muscle aches
- Hair thinning
- Kidney changes that are mild and unlikely to cause symptoms – this will almost certainly go back to normal when treatment is finished. You will have regular blood tests to check how well your kidneys are working
- A dry mouth
- Liver changes that are mild and unlikely to cause symptoms – they usually go back to normal when the treatment ends. You will have regular blood tests to check your liver function
- Difficulty hearing
- Stomach pains
Fewer than 1 in 100 people have these side effects
- Bruising more easily from a drop in platelets – you may have nosebleeds, bleeding gums after brushing your teeth, or lots of tiny red spots or bruises on your arms or legs (known as petechia)
- Mood changes, including feeling sad or depressed, or agitated
- Back pain
- Sensitivity to touch
- Sharp pains in the upper area of the tummy (abdomen) due to inflammation of the pancreas (pancreatitis) – let your doctor or nurse know straight away if you have this
- An over active thyroid gland, producing high levels of thyroid hormones. Let your doctor or nurse know if you have any of the following effects – restlessness, nervousness, shaky hands, weight loss, increased appetite, palpitations, sweating, and feeling hot
You will not get all these side effects and they may be mild. A side effect may get worse through your course of treatment. Or you may have more side effects as the course goes on. This depends on
- How many times you've had a drug before
- Your general health
- How much of the drug you have (the dose)
- Other drugs you are having
Coping with side effects
Talk to your doctor, pharmacist or nurse about all your side effects so that they can help you manage them. They can give you advice or reassure you. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.
Other medicines and foods
Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies. Some drugs can react together.
Don’t eat grapefruit or drink grapefruit juice while having treatment with bexarotene. It can alter the amount of bexarotene you absorb and make the side effects worse.
Pregnancy and contraception
This drug may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment with this drug and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.
Do not breastfeed during this treatment because the drug may come through in the breast milk.
You should not have immunisations with live vaccines while you are having treatment or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG, yellow fever and Zostavax (shingles vaccine).
You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your treatment. It is safe to have the flu vaccine.
It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with vaccines you take by mouth (oral vaccines), but not many people in the UK have these now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.
We don’t list all the very rare side effects of this treatment that are very unlikely to affect you. For further information look at the Electronic Medicines Compendium website at www.medicines.org.uk/emc.
If you have a side effect we don’t mention here and you think it may be due to this treatment, you can report it to the Medicines Health and Regulatory Authority (MHRA) at www.mhra.gov.uk.
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