Introduction
Vesanoid is a form of vitamin A that is used to treat acne which appears as spots or pimples on your face, chest or back. It also helps to smooth rough facial skin and to reduce fine wrinkles on the skin.
Vesanoid reduces excessive oil production of the skin. Ideally, a pinpoint application at nighttime is recommended for the duration prescribed by your doctor. The amount you need and for how long you need to take it will depend on what you are being treated for. You should normally wash and dry the affected area before applying a thin layer of this medicine. Follow your doctor's instructions. You should not apply it to damaged or broken skin and avoid contact with your mouth, eyes and nose. It may take several weeks for your symptoms to improve but keep using it regularly to get the most benefit. Consult your doctor again if you do not notice any improvement after a few weeks. Using more medicine or applying it more often than prescribed will not make it work any faster and may increase the side effects.
The most common side effects include irritation, dryness and redness of the skin. They are usually mild and improve as your body gets used to the medicine. Drink plenty of water and use moisturizer as it may lead to dryness of the mouth, lips and eyes. Let your doctor know if these side effects bother you or do not go away. Serious side effects with this medicine are rare.
This medicine may make you more sensitive to sunlight so you should limit exposure to the sun if possible. It may make your skin more fragile. It is advised, not to have any waxing (hair removal), or laser treatments during treatment. Pregnant women or women who are planning to get pregnant should not use this medicine as it can lead to birth defects.
Side effects of Vesanoid
Common
- Erythema (skin redness)
- Skin irritation
- Dry skin
- Dry lips
- Pale red skin
- Increased sensitivity to light
How to use Vesanoid
This medicine is for external use only. Use it in the dose and duration as advised by your doctor. Check the label for directions before use. Clean and dry the affected area and apply the cream. Wash your hands after applying, unless hands are the affected area.
How Vesanoid works
Vesanoid is a form of vitamin A. When applied on skin, it reduces oil production in the skin, replenishes acne-prone skin and helps keep your pores open.
What if you forget to take Vesanoid?
If you miss a dose of Vesanoid, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Indication
Acute promyelocytic leukaemia
Administration
Should be taken with food.
Adult Dose
Oral
Acute promyelocytic leukaemia
Adult: Remission induction: 45 mg/m2 daily in 2 divided doses. Treatment is continued until 30 days after complete remission or up to 90 days, whichever occurs first.
Hepatic impairment: Reduce dose to 25 mg/m2 daily.
Child Dose
Oral
Acute promyelocytic leukaemia
Child: Remission induction: 1-16 yr 45 mg/m2 daily in 2 divided doses. Treatment is continued until 30 days after complete remission or up to 90 days, whichever occurs first.
Hepatic impairment: Reduce dose to 25 mg/m2 daily.
Renal Dose
Renal impairment: Reduce dose to 25 mg/m2 daily.
Contraindication
Hypersensitivity to retinoids. Application to eczematous, sunburnt or abraded skin. Pregnancy, lactation.
Mode of Action
Tretinoin is a trans-retinoic acid form of vitimin A. It stimulates mitosis and turnover of follicular epithelial cells and reduce their cohesiveness. This facilitates extrusion of existing comedones and prevents formation of new comedone. It also exhibits thinning effect on the stratum corneum. In acute promyelocytic leukaemia, it induces cellular differentiation and decreases proliferations.
Precaution
Children, hepatic or renal impairment. Reduce dose if intractable headache occurs. Discontinue temporarily if LFT exceed 5 times upper limit of normal. Monitor closely for leukocytosis or respiratory compromise. Monitor haematologic profile, coagulation parameters, LFT, serum triglyceride and cholesterol concentrations regularly.
Lactation: Unknown if excreted in breast milk; do not breast-feed, because of potential for serious adverse reactions in infant
Side Effect
>10%
Headache (86%),Fever (83%),Bone pain (77%),Dry mucous membranes (77%),Malaise (67%),URI (63%),Shivering (60%),Dyspnea (60%),Hemorrhage (60%),Elevated liver function tests (50-60%),Hyperlipidemia (60%).Infections (58%),Nausea and vomiting (57%),Rash (54%),Peripheral edema (52%),Leukocytosis (40%),Pain (37%),Abdominal pain (31%),DIC (26%),Respiratory insufficiency (26%),Mucositis (26%),GI disorder (26%),Retinoic acid-APL syndrome (25%),Ear ache (23%),Diarrhea (23%),Pleural effusion (20%),Dizziness (20%),Pruritus (20%),Sweating (20%),Anxiety (17%),Paresthesia (17%),Constipation (17%),Vision changes (17%),Dyspepsia (14%),Depression(14%),Insomnia (14%),Alopecia (14%),Skin changes (14%),Confusion (11%),Abdominal distention (11%),Renal insufficiency (11%)
1-10% (selected)
Cardiac failure,Pseudotumor cerebri,Ulcer
Potentially Fatal: Retinoic acid syndrome, cardiac arrthythmia, disseminated intravascular coagulation, blood dyscrasias, cardiac arrest, cerebral haemorrhage.
Interaction
Enhances percutaneous absorption of minoxidil. Increased risk of fatal thrombotic complications with antifibrinolytic. Increased tretinoin concentrations with azole antifungals. Enhances peeling action of sulphur, resorcinol, benzoyl peroxide, salicylic acid. Increased photosensitivity with photosensitising medications eg, thiazides, tetracyclines, fluoroquinolones, phenothiazines and sulfonamides.
Potentially Fatal: Increased risk of intracranial pressure with tetracyclines.