Oral retinoids (acitretin, alitretinoin, bexarotene, isotretinoin, and tretinoin) are highly teratogenic. Biologically active members of this class are used clinically in the treatment of severe cystic ACNE; PSORIASIS; and other disorders of keratinization. We’ll send you a link to a feedback form. Toxicologist. Longitudinal study of infants exposed to isotretinoin (13-cis-retinoic acid) in utero. 3 0 obj *The need for repeated medically supervised pregnancy tests every month should be determined according to local practice including consideration of the patient’s sexual activity, recent menstrual history (abnormal menses, missed periods or amenorrhea), and Systemic exposure is thought to be negligible following application of topical retinoids (topical adapalene, alitretinoin, isotretinoin, tazarotene, and tretinoin) during pregnancy. However, since risk cannot be excluded, use of topical retinoids is contraindicated during pregnancy as a precaution. Treatment can last for up to 16 weeks and if there is a relapse, a second course of treatment may be prescribed by your dermatologist. The limitations of the available data did not allow the review to establish a clear causal association between risk of neuropsychiatric disorders and use of oral retinoids. Lammer EJ. <> Toxicity represents the main limitation to the prolonged use of retinoids. Advice about monitoring for neuropsychiatric disorders Retinoids Accession Number DBCAT000355 (DBCAT003007) Description. <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 595.38 841.92] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. Retinoids currently play a limited role in cancer treatment and prevention despite potential in physiological pathways. Symptoms of a serious allergic reaction may include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. endobj Ideally pregnancy testing should be done on the same day as the issuing and dispensing of the prescription. Women and girls should be advised not to use topical retinoids if they are planning a pregnancy and to use effective contraception to minimise the risk of accidental exposure in pregnancy if they are of childbearing potential.Evidence for a possible link between isotretinoin and psychiatric disorders (for example, depression, suicidal behaviour) has been under review for many years. %���� <> Oral tretinoin is authorised for promyelocytic leukaemia. Oral retinoids indicated for haematological malignancies. Oral bexarotene is authorised for T-cell lymphoma. x��][o�F~7��0�R��\���Ȯ��b�>��H"L�Z�����{�3�#k��B�@eG3�~���M��,��?\�t]���\|���7^�=m��m�,��+�������Sd6�͏?�w?�����93��$�'f"LC�OD�N�F^^����./��]^\��ؙy�nqy�қg�^;}����ݚ���X,[����=�!_4K~9�y��_//>O��Oq�������������g��ꮫ�������S7���N#���N�>gb�^�k�9I����8I҃t���+o"�&+����VWL�IU�V�[]�Ч��u�o����BV�+"EV�E�L�׮�a]VW�y��zg�祎۷������r�7�J?�F�UN��K���g��-�^> ���5U��oX!k/�ߐ�U"u��J�df��eW\��}q�����څ��;�r��j�Zgd�@��l���^w�������;������s�Y��N%�)�rgN����������[�����I�Ns*>�|�BՒ� ��S�H�y�h�A+3bw٭rb7YqK�l�z!۶�鷊-%)Z endobj It will take only 2 minutes to fill in. Drugs. Side Effects of Oral Retinoids: Side effects in some cases can be very severe. All patients treated with an oral retinoid should be monitored for signs of depression or suicidal ideation and refer for appropriate treatment, if necessary. <>/Metadata 221 0 R/ViewerPreferences 222 0 R>> Healthcare professionals should discuss with patients taking an oral retinoid that they may experience changes in their mood or behaviour and to talk to their doctor if their mood is affected. Don’t worry we won’t send you spam or share your email address with anyone. The MHRA has monitored reports closely and since 2015 advice has been present in the Patient Information Leaflet for isotretinoin that patients should discuss any history of mental illness with their doctor before taking isotretinoin.Cases of newly diagnosed depression, worsening of existing depression, and anxiety have been reported with oral retinoids.