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Bexarotene (Targretin)

Bexarotene (pronounced becks-a-roh-teen) is a cancer treatment drug and is also known by its brand name Targretin (pronounced tar-gree-tin).

It is a treatment for advanced skin lymphomas called cutaneous T cell lymphomas. These include mycosis fungoides and Sezary syndrome.

How it works

Bexarotene is a retinoid. Retinoids are drugs related to vitamin A. They work by slowing or stopping the growth of cells.

How you have it

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 take them with food or immediately after eating. 

Taking capsules

You must take your capsules according to the instructions your doctor or pharmacist gives you.

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.

When you have it

You usually continue taking bexarotene for as long as the treatment works. 

Tests

You have blood tests before 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.

Side effects

We haven't listed all the side effects. It is very unlikely that you will have all of these side effects, but you might have some of them at the same time.

How often and how severe the side effects are can vary from person to person. They also depend on what other treatment you are having. For example, your side effects could be worse if you are also having other drugs or radiotherapy.

When to contact your team

Your doctor or nurse will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:

  • you have severe side effects
  • your side effects aren’t getting any better
  • your side effects are getting worse

Early treatment can help manage side effects better. 

Contact your advice line or your doctor or nurse immediately if you have signs of infection, such as a temperature above 37.5C or below 36C, or if you develop a severe skin reaction. Signs of a severe skin reaction include peeling or blistering of the skin.

Common side effects

These side effects happen in more than 10 in 100 people (10%). You might have one or more of them. They include:

Increases risk of infection

Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, headaches, feeling cold and shivery and generally unwell. You might have other symptoms depending on where the infection is.

Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection. 

Low levels of thyroid hormones (hypothyroidism)

The level of your thyroid hormones may drop (hypothyroidism). You may feel tired or cold, gain weight, feel sad or depressed, or your voice may deepen. You will have regular blood tests to check your thyroid hormone levels.

Changes to the level of fats in the blood

This drug raises the amount of cholesterol and triglycerides in your blood. You will have regular blood tests to check this.

Skin reactions

This can include itching, redness, irritation and peeling. Contact your health advice line or tell your healthcare team. 

Increased skin sensitivity to sunlight

Don’t use sunbeds or sit in the sun. Cover up or use a sun block if you go out in the sun. Remember to put sun cream on your head or wear a hat if you have lost any hair there.

Pain in the muscles and joints

You might feel some pain from your muscles and joints. Speak to your doctor or nurse about what painkillers you can take to help with this.

Headache

Tell your doctor or nurse if you keep getting headaches. They can give you painkillers to help.

Tiredness and weakness (fatigue)

Tiredness and weakness (fatigue) can happen during and after treatment - doing gentle exercises each day can keep your energy up. Don't push yourself, rest when you start to feel tired and ask others for help.

Occasional side effects

These side effects happen in between 1 and 10 out of every 100 people (1 to 10%). You might have one or more of them. They include:

  • swelling of the lymph nodes or feeling like your lymphoma is getting worse
  • a drop in red blood cells causing paleness and tiredness
  • problems with your thyroid
  • weight gain
  • changes to how your liver and kidneys work
  • low levels of sodium in the blood
  • reduced sense of touch and numbness
  • dizziness
  • difficulty sleeping
  • eye problems including dry eyes, irritation and heaviness
  • hearing problems including deafness
  • swelling of the arms and legs
  • feeling or being sick
  • diarrhoea or constipation, wind (flatulence)
  • loss of appetite
  • dry mouth
  • skin problems such as ulcers, nodules, acne, dryness and abnormal skin growth
  • increased sweating
  • pain in the bones or tummy (abdomen)
  • chills
  • an allergic reaction

Rare side effects

These side effects happen in fewer than 1 in 100 people (1%). You might have one or more of them. They include:

  • problems with your blood clotting causing red or purple coloured areas on the skin (purpura)
  • an increase or decrease of platelets in the blood
  • an increase in the level of hormones your thyroid makes (hyperthyroidism)
  • gout
  • an increase of the amount of bilirubin in the blood
  • problems with coordination, balance and speech
  • nerve pain
  • depression
  • agitation
  • cataracts
  • inflammation of the eyes and eyelids, infection of the eyes (conjunctivitis)
  • changes to your eyesight (vision)
  • ear problems
  • a fast heart rate (tachycardia)
  • high blood pressure (hypertension)
  • swelling
  • varicose veins
  • inflammation of the pancreas
  • liver failure
  • problems with your stomach, gut and bowels (digestive system)
  • an excess amount of fluid draining from an opening in the body such as a wound
  • herpes simplex infection
  • skin and nail changes such as colour
  • skin infection such as cellulitis
  • back pain
  • protein in the urine
  • problems with the lining of your mouth, nose throat and gut
  • another cancer
  • high temperature (fever)

What else should I know?

Other medicines, food 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.

Grapefruit and grapefruit juice

You should not eat grapefruit or drink grapefruit juice when you are taking this drug because it can react with the drug.

Loss of fertility

It is not known whether this treatment affects fertility in people. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.

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 at least a month afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Breastfeeding

Don’t breastfeed during this treatment because the drug may come through into 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.

Immunisation

Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and the shingles vaccine (Zostavax).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine (as an injection)
  • be in contact with other people who have had live vaccines as injections

Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as oral polio or the typhoid vaccine.

This also includes the rotavirus vaccine given to babies. The virus is in the baby’s poo for up to 2 weeks and could 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 should also avoid close contact with children who have had the flu vaccine nasal spray if your immune system is severely weakened. 

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Information and help

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