Drug reference
Bexarotene is an agonist at the retinoid X receptor, which is involved in the regulation of cell Immune system and malignant disease differentiation and proliferation. Bexarotene can cause regression of cutaneous T-cell lymphoma.
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Skin manifestations of cutaneous T-cell lymphoma refractory to previous systemic treatment ▶BY MOUTH ▶Adult: Initially 300 mg/m2 once daily, adjusted according to response, to be taken with a meal
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History of pancreatitis. hypervitaminosis A. uncontrolled hyperlipidaemia. uncontrolled hypothyroidism
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Avoid in Acute porphyrias p. 1120. history of depression (risk of neuropsychiatric reactions). hyperlipidaemia. hypothyroidism
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Caution— hypersensitivity to retinoids.
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Scottish Medicines Consortium (SMC) decisions SMC No. 14/02 The Scottish Medicines Consortium has advised (November 2002) that bexarotene (Targretin ®) is recommended for restricted use as a second-line treatment for patients with advanced (stages IIb or III) cutaneous T-cell lymphoma who have proved refractory both to local skin directed therapy and to at least one systemic therapy.
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RISKS OF INCORRECT DOSING OF ORAL ANTI-CANCER MEDICINES See Cytotoxic drugs p. 938. MHRA/CHM ADVICE: ORAL RETINOID MEDICINES: REVISED AND SIMPLIFIED PREGNANCY PREVENTION EDUCATIONAL MATERIALS FOR HEALTHCARE PROFESSIONALS AND WOMEN (JUNE 2019) Materials to support the Pregnancy Prevention Programme in women and girls of childbearing potential taking oral acitretin, alitretinoin, or isotretinoin have been updated. Oral tretinoin and bexarotene do not have a Pregnancy Prevention Programme in light of their oncology indication and specialist care setting. However, healthcare professionals are advised that these medicines are extremely teratogenic and product information should be consulted for contraceptive and pregnancy testing requirements when used in females of childbearing potential. Neuropsychiatric reactions have been reported in patients taking oral retinoids. Healthcare professionals are advised to monitor patients for signs of depression or suicidal ideation and refer for appropriate treatment, if necessary; particular care is needed in those with a history of depression. Patients should be advised to speak to their doctor if they experience any changes in mood or behaviour, and encouraged to ask family and friends to look out for any change in mood.
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→Appendix 1: retinoids
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▶Common or very common Alopecia. anaemia. appetite decreased. arthralgia. asthenia. chills. constipation. deafness. diarrhoea. dizziness. dry eye. dry mouth. dyslipidaemia. eye disorders. gastrointestinal discomfort. gastrointestinal disorders. headaches. hyperhidrosis. hypersensitivity. hypoproteinaemia. hypothyroidism. increased risk of infection. insomnia. leucopenia. lymphadenopathy. muscle complaints. nausea. oedema. oral disorders. pain. pseudolymphoma. sensation abnormal. skin nodule. skin reactions. skin ulcer. thyroid disorder. vomiting. weight changes ▶Uncommon Albuminuria. anxiety. arrhythmias. ataxia. blood disorder. cataract. coagulation disorder. depression . ear disorder. eosinophilia. eye inflammation. fever. gout . haemorrhage. hair disorder. hepatic failure. hyperbilirubinaemia. hypertension. hyperthyroidism. increased leucocytes. mucous membrane disorder. muscle weakness. nail disorder. neoplasms. nerve disorders. pancreatitis. renal impairment. serous drainage. thrombocytopenia. thrombocytosis. varicose veins. vasodilation. vertigo. vision disorders ▶Frequency not known Burping. chest pain. confusion. cough aggravated. dehydration. drowsiness. dysphagia. dyspnoea. emotional lability. hypercalcaemia. hyperuricaemia. libido decreased. muscle tone increased. pelvic pain. peripheral vascular disease. red blood cell abnormality. taste altered. thirst. tinnitus. white blood cell abnormalities
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Manufacturer advises effective contraception during and for at least 1 month after treatment in men and women.
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Avoid. See also Pregnancy and reproductive function in Cytotoxic drugs p. 938.
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Discontinue breast-feeding.
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Manufacturer advises avoid in hepatic insufficiency.
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There can be variation in the licensing of different medicines containing the same drug. Capsule ▶Targretin (Eisai Ltd) Bexarotene 75 mg Targretin 75mg capsules | 100 capsule P £937.50
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Risk of neuropsychiatric reactions The MHRA advises patients and carers to seek medical attention if changes in mood or behaviour occur.
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Initially 300 mg/m2 once daily, adjusted
First-line fragment. Read the complete Indications and Dose section above.
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