{"id":6849,"date":"2020-04-23T10:50:39","date_gmt":"2020-04-23T13:50:39","guid":{"rendered":"https:\/\/doctorhoogstra.com\/es\/alitretinoina-2\/"},"modified":"2020-04-27T16:50:01","modified_gmt":"2020-04-27T19:50:01","slug":"alitretinoin-2","status":"publish","type":"wiki","link":"https:\/\/doctorhoogstra.com\/en\/wiki\/alitretinoina-2\/","title":{"rendered":"Alitretinoin"},"content":{"rendered":"<p><\/p><div id=\"ez-toc-container\" class=\"ez-toc-v2_0_88 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewbox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewbox=\"0 0 24 24\" version=\"1.2\" baseprofile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 eztoc-toggle-hide-by-default' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/alitretinoina-2\/#%C2%BFPara-que-se-usa-la-alitretinoina\" >What is alitretinoin used for?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/alitretinoina-2\/#%C2%BFComo-funciona-la-alitretinoina\" >How does alitretinoin work?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/alitretinoina-2\/#%C2%BFComo-se-administra-la-alitretinoina\" >How is alitretinoin administered?<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/alitretinoina-2\/#Gel-de-alitretinoina-01\" >Alitretinoin Gel 0.1%<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/alitretinoina-2\/#Capsulas-de-alitretinoina\" >Alitretinoin capsules<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/alitretinoina-2\/#Posibles-interacciones-farmacologicas-con-alitretinoina\" >Possible drug interactions with alitretinoin<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/alitretinoina-2\/#Que-eventos-adversos-%C2%BFPuede-causar-la-alitretinoina\" >What adverse events can alitretinoin cause?<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/alitretinoina-2\/#Gel-de-alitretinoina-01-2\" >Alitretinoin Gel 0.1%<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/alitretinoina-2\/#Capsulas-de-alitretinoina-2\" >Alitretinoin capsules<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/alitretinoina-2\/#Uso-en-embarazo\" >Use in pregnancy<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-11\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/alitretinoina-2\/#Uso-en-madres-lactantes\" >Use in nursing mothers<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-12\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/alitretinoina-2\/#Uso-en-ninos\" >Use in children<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-13\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/alitretinoina-2\/#Uso-en-ancianos\" >Use in the elderly<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-14\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/alitretinoina-2\/#Precauciones\" >Cautions<\/a><\/li><\/ul><\/nav><\/div>\n\n<section class=\"textBlock\">\n<p>Alitretinoin is a first-generation member of the <span class=\"term\" data-term-id=\"761\">retinoid<\/span> family, which also includes <span class=\"term\" data-term-id=\"763\">retinol<\/span>, retina, tretinoin, isotretinoin and acitretin. the <span class=\"term\" data-term-id=\"762\">retinoids<\/span> They are all related to vitamin A. Alitretinoin is not yet available in New Zealand.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFPara-que-se-usa-la-alitretinoina\"><\/span>What is alitretinoin used for?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<ul>\n<li>Alitretinoin <span class=\"term\" data-term-id=\"1123\">gel<\/span> 0.1% (Panretin\u00ae) is used to treat skin lesions resulting from Kaposi <span class=\"term\" data-term-id=\"1665\">sarcoma<\/span> (KS), a <span class=\"term\" data-term-id=\"30\">Cancer<\/span> of the cells that cover <span class=\"term\" data-term-id=\"953\">blood vessels<\/span> and is seen more frequently in patients with <span class=\"term\" data-term-id=\"127\">HIV<\/span>\/AIDS.<\/li>\n<li>Alitretinoin (Toctino\u00ae) capsules are used to treat severe <span class=\"term\" data-term-id=\"319\">chronic<\/span> hand <span class=\"term\" data-term-id=\"53\">dermatitis<\/span>\/ \/<span class=\"term\" data-term-id=\"491\">eczema<\/span> that does not respond to powerful <span class=\"term\" data-term-id=\"1330\">current<\/span> corticosteroid therapy.<\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFComo-funciona-la-alitretinoina\"><\/span>How does alitretinoin work?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<ul>\n<li>Retinoids play a role in regulating normal cell growth and cell death.<\/li>\n<li>Alitretinoin binds to retinoid receptors on the cell. <span class=\"term\" data-term-id=\"728\">core<\/span> and activates the receptors.<\/li>\n<li>Activated receptors regulate the expression of <span class=\"term\" data-term-id=\"775\">genes<\/span> that <span class=\"term\" data-term-id=\"1854\">control<\/span> cell <span class=\"term\" data-term-id=\"1307\">differentiation<\/span> and growth in both normal and abnormal cells.<\/li>\n<li>In this way, alitretinoin is capable of <span class=\"term\" data-term-id=\"1022\">inhibit<\/span> The growth of Kaposi sarcoma cells.<\/li>\n<li>The mechanism of action of alitretinoin in chronic hand eczema is unknown.<\/li>\n<li>Alitretinoin has been shown <span class=\"term\" data-term-id=\"680\">immunomodulator<\/span> and anti<span class=\"term\" data-term-id=\"490\">inflammatory<\/span> effects that are relevant to the skin <span class=\"term\" data-term-id=\"148\">inflammation<\/span>.<\/li>\n<\/ul>\n<div id=\"square-placement-country-holder\" class=\"country-dependent advert\">\n<div class=\"box-placement square-placement\">\n<div class=\"advert__frame\">\n<div id=\"dermnet-dermnet-mobbox\">\n<\/div><\/div><\/div><\/div>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFComo-se-administra-la-alitretinoina\"><\/span>How is alitretinoin administered?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<h3><span class=\"ez-toc-section\" id=\"Gel-de-alitretinoina-01\"><\/span>Alitretinoin Gel 0.1%<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<ul>\n<li>Alitretinoin gel is usually applied directly to AIDS-related KS lesions twice a day.<\/li>\n<li>It can be applied three or four times a day if tolerated.<\/li>\n<li>If side effects occur, the frequency of application should be decreased.<\/li>\n<li>The affected skin is thoroughly cleaned with mild soap or cleanser and water. Avoid medicated or abrasive soap, or soap that dries the skin.<\/li>\n<li>Clean fingertips, gauze, or a cotton swab can be used to apply the medication.<\/li>\n<li>The gel should not be applied to skin outside of KS lesions.<\/li>\n<li>The gel is allowed to dry for at least 3 to 5 minutes before putting on clothing.<\/li>\n<li>Dressings, bandages, cosmetics, lotions or other skin medications should not be applied to the area to be treated.<\/li>\n<li>Response to treatment has been seen within two weeks in some patients, however longer treatment periods (8-14 weeks) may be required in other patients.<\/li>\n<li>It is best to avoid applying the gel near <span class=\"term\" data-term-id=\"1018\">mucous membrane<\/span> Surfaces such as eyes, nostrils, mouth, lips, vagina, tip of the penis, rectum or anus.<\/li>\n<li>\n<p>Insect repellents containing diethyltoluamide (DEET) should be avoided due to potential interaction and increased <span class=\"term\" data-term-id=\"1160\">toxicity<\/span>.<\/li>\n<\/ul>\n<h3><span class=\"ez-toc-section\" id=\"Capsulas-de-alitretinoina\"><\/span>Alitretinoin capsules<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<ul>\n<li>Alitretinoin capsules should only be prescribed by dermatologists or doctors experienced in using <span class=\"term\" data-term-id=\"380\">systemic<\/span> retinoids, and have a complete understanding of the risks of systemic retinoid therapy and the requirements for regular monitoring.<\/li>\n<li>The medication is usually taken with a meal.<\/li>\n<li>Alitretinoin is <span class=\"term\" data-term-id=\"1399\">teratogenic<\/span> (causes birth deformities). A negative pregnancy test must be confirmed before starting treatment.<\/li>\n<li>The recommended starting dose is 30 mg once a day.<\/li>\n<li>A dose reduction to 10 mg once daily may be considered in patients with unacceptable side effects at the higher dose.<\/li>\n<li>A course of alitretinoin treatment is usually 12 to 24 weeks, depending on response.<\/li>\n<li>Treatment should be discontinued in patients who continue to have severe disease after the initial 12 weeks of treatment.<\/li>\n<li>If dermatitis recurs, patients may benefit from additional treatment with alitretinoin.<\/li>\n<li>Alitretinoin should not be prescribed if the patient&#039;s dermatitis can be adequately controlled by standard measures, including skin protection, avoidance <span class=\"term\" data-term-id=\"409\">Allergens<\/span> and <span class=\"term\" data-term-id=\"1443\">irritants<\/span>and treatment with potent topical corticosteroids.<\/li>\n<li>The use of alitretinoin is not recommended in patients under 18 years of age.<\/li>\n<li>Licensing requirements may mean that alitretinoin prescriptions for women of childbearing potential are limited to 30 days and continued treatment requires a new prescription.<\/li>\n<\/ul>\n<p>Link to key evidence from clinical trials on alitretinoin<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Posibles-interacciones-farmacologicas-con-alitretinoina\"><\/span>Possible drug interactions with alitretinoin<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<ul>\n<li>Alitretinoin is metabolized by cytochrome P450 3A4 (CYP3A4; a liver <span class=\"term\" data-term-id=\"1525\">enzyme<\/span> involved in drugs <span class=\"term\" data-term-id=\"934\">metabolism<\/span>)<\/li>\n<li>CYP3A4 inhibitors such as ketoconazole increase the <span class=\"term\" data-term-id=\"1513\">plasma<\/span> oral alitretinoin level and dose reduction may be necessary.<\/li>\n<li>A 16% reduction in simvastatin plasma levels has been observed when taken with oral alitretinoin.<\/li>\n<li>It is not known if there is any interaction between topical alitretinoin and systemically administered medications for KS.<\/li>\n<li>To date, topical alitretinoin has not been reported to interact with systemic antiretroviral medications, azole antifungals, and macrolide antibiotics.<\/li>\n<li>Not <span class=\"term\" data-term-id=\"1734\">pharmacokinetics<\/span> Interactions have been observed when taking oral alitretinoin with cyclosporine or the oral contraceptive ethinyl estradiol and norgestimate.<\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"Que-eventos-adversos-%C2%BFPuede-causar-la-alitretinoina\"><\/span>Than <span class=\"term\" data-term-id=\"909\">adverse events<\/span> Can alitretinoin cause?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<h3><span class=\"ez-toc-section\" id=\"Gel-de-alitretinoina-01-2\"><\/span>Alitretinoin Gel 0.1%<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Adverse events related to the use of alitretinoin gel in patients with AIDS-related KS occur almost exclusively at the application site. These include:<\/p>\n<ul>\n<li>mild heat or itching of the skin<\/li>\n<li>lightening or darkening of the skin<\/li>\n<li>red, <span class=\"term\" data-term-id=\"384\">climbing<\/span> skin<\/li>\n<li><span class=\"term\" data-term-id=\"255\">eruption<\/span><\/li>\n<li>swelling, blisters or <span class=\"term\" data-term-id=\"966\">crust<\/span> of the skin<\/li>\n<li>pain at application site<\/li>\n<li>Itch<\/li>\n<li>sensitivity to the sun on the treated site.<\/li>\n<\/ul>\n<h3><span class=\"ez-toc-section\" id=\"Capsulas-de-alitretinoina-2\"><\/span>Alitretinoin capsules<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<ul>\n<li>Headache<\/li>\n<li>Increased levels of <span class=\"term\" data-term-id=\"1509\">triglycerides<\/span> and blood <span class=\"term\" data-term-id=\"1507\">cholesterol<\/span>\n<\/li>\n<li>Blood cell disorders: decreased coagulation, decreased number of red and white blood cells.<\/li>\n<li>Thyroid problems: decreased levels of thyroid hormones<\/li>\n<li>Eye problems: inflammation of the eye (<span class=\"term\" data-term-id=\"1898\">conjunctivitis<\/span>) and eyelid area; eyes feel dry and irritated<\/li>\n<li>Muscle and joint pain<\/li>\n<li>Skin and <span class=\"term\" data-term-id=\"122\">hair<\/span> problems: dry skin, especially on the lips and face, inflamed skin, hair loss<\/li>\n<li>Increased risk of sunburn.<\/li>\n<li>Increased liver levels. <span class=\"term\" data-term-id=\"1526\">enzymes<\/span> have been seen in blood tests<\/li>\n<li>Depression, anxiety, aggressive tendencies, mood disturbances, and very rarely, suicidal ideation have been reported in patients treated with systemic retinoids, including oral alitretinoin.<\/li>\n<li>\n<span class=\"term\" data-term-id=\"1336\">Allergic reactions<\/span> affecting the skin, including <span class=\"term\" data-term-id=\"440\">anaphylaxis<\/span> and <span class=\"term\" data-term-id=\"1091\">vasculitis<\/span> have been rarely reported.<\/li>\n<\/ul>\n<div id=\"square-placement-country-holder\" class=\"country-dependent advert\">\n<div class=\"box-placement square-placement\">\n<div class=\"advert__frame\">\n<div id=\"dermnet-dermnet-mobbox\">\n<\/div><\/div><\/div><\/div>\n<h2><span class=\"ez-toc-section\" id=\"Uso-en-embarazo\"><\/span>Use in pregnancy<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<ul>\n<li>Alitretinoin gel can harm the fetus if it is absorbed through the skin.<\/li>\n<li>Women of childbearing potential should avoid becoming pregnant when using the gel or taking the capsules.<\/li>\n<li>It is not known whether the risk increases with the application of alitretinoin gel to ulcerated lesions.<\/li>\n<li>Women of childbearing age should not take alitretinoin capsules for hand eczema unless strict contraceptive precautions are followed.<\/li>\n<li>To exclude the possibility of pregnancy, a pregnancy test should be performed and its date and result recorded before prescribing alitretinoin capsules.<\/li>\n<li>The need to repeat pregnancy tests every month depends on the patient&#039;s sexual activity and recent menstrual history.<\/li>\n<li>Five weeks after stopping treatment, women should undergo a final pregnancy test to exclude pregnancy.<\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"Uso-en-madres-lactantes\"><\/span>Use in nursing mothers<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<ul>\n<li>It is not known whether alitretinoin is excreted in human milk.<\/li>\n<li>Because many drugs are excreted in human milk, mothers should stop breastfeeding before using alitrethionin.<\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"Uso-en-ninos\"><\/span>Use in children<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>The safety and effectiveness of alitretinoin have not been established in children.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Uso-en-ancianos\"><\/span>Use in the elderly<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Safety and <span class=\"term\" data-term-id=\"914\">effectiveness<\/span> of alitretinoin in patients 65 years and older have not been evaluated.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Precauciones\"><\/span>Cautions<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<ul>\n<li>Exposure of skin treated with alitretinoin gel to sunlight and sunlamps should be minimized to avoid <span class=\"term\" data-term-id=\"706\">photosensitivity<\/span>.<\/li>\n<li>Patients treated with oral alitretinoin should be observed for signs of depression and referred for appropriate treatment if necessary.<\/li>\n<li>In case of adverse effects, the medication may be discontinued or the dose may be reduced.<\/li>\n<\/ul>\n<div class=\"grey-box\"><em><span style=\"font-size: 0.9em;\">New Zealand approved data sheets are the official source of information for these prescription drugs, including approved uses and risk information. See the New Zealand individual data sheet on the Medsafe website.<\/span><\/em><\/div>\n<\/section>","protected":false},"excerpt":{"rendered":"<p>La alitretino\u00edna es un miembro de primera generaci\u00f3n del retinoide familia, que tambi\u00e9n incluye retinol, retina, tretino\u00edna, isotretino\u00edna y acitretina. los retinoides est\u00e1n todos relacionados con la vitamina A. La&#8230;<\/p>","protected":false},"author":8,"featured_media":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","format":"standard","meta":{"footnotes":""},"categories":[204],"tags":[],"class_list":["post-6849","wiki","type-wiki","status-publish","format-standard","category-glosario-definiciones"],"_links":{"self":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/6849","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki"}],"about":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/types\/wiki"}],"author":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/comments?post=6849"}],"version-history":[{"count":0,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/6849\/revisions"}],"wp:attachment":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/media?parent=6849"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/categories?post=6849"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/tags?post=6849"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}