Targretin

What is it?

A preparation used in chemotherapy and a retinoid, available as white, soft capsules containing a liquid with 75mg of bexarotene, all marked with name.

Medical Uses

Skin effects of advanced stage cutaneous T call lymphoma (CTCL - skin cancer) which has not responded to at least one course of systemic treatment. For specialist use.

Dosage

Adults, 300mg per metre2 of body surface area each day at first, capsules to be taken as single dose with a meal. Then, adjusted according to toxic effects to a daily maximum of 650mg per square metre. Treatment to be continued as long as patient is gaining benefit and must be started and supervised by specialist in this form of therapy.

Special Care

Impaired kidney function, diabetes, patients should avoid exposure to UV light. Risk of pancreatitis. Blood lipid levels must be rigorously monitored before treatment starts and weekly, then monthly, once it has begun. triglyceride levels should be normal and a lipis-lowering agent used, if necessary. Doses of targretin may need to be lowered or withdrawn if triglyceride levels stay raised. Haemoglobin, WBC count and liver function must Also, be carefully checked at weekly then monthly intervals once treatment has started and targretin may need to be stopped if results unsatisfactory. Thyroid gland function requires careful monitoring. Women of child-bearing age and men, must use non-hormonal contraception during treatment and for 1 month afterwards.

Avoid Use

Children, pregnancy, breast- feeding, impaired liver function, internal body infections, high blood cholesterol or triglyceride levels, previous pancreatitis.

Possible Drug and Food Interactions

Oral contraceptives, substrates or inhibitors of CYP3A4 (an enzyme), gemfibrozil, supplements of vitamin A, grapefruit juice, drugs causing high blood triglyceride levels.

Known Side Effects

Blood changes, increased levels of certain enzymes, low blood protein levels, leucopenia (low white blood cells), anaemia, loss of weight, lymphadenopathy (disorders of lymph system), lymphoma-like reaction, gastrointestinal upset, headache muscle, bone and joint pains, dizziness, weakness, dry eyes, disturbed vision, insomnia, chills, altered blood chemistry and hormones, high blood cholesterol and triglyceride levels, deafness, abnormalities in liver function. all adverse side effects must be reported to the Committee on the Safety of Medicines (CSM).