Alitretinoin

INTRODUCTION

Indications

Topical treatment of cutaneous lesions from AIDS-related Kaposi's sarcoma (KS).

Action

Binds to and activates retinoid receptors, resulting in inhibition of KS cells. Therapeutic Effects: Decreased cutaneous lesions of KS.

Adverse Reactions/Side Effects Local: pain, pruritus, rash, edema, exfoliative, dermatitis, paresthesia.

PHYSICAL THERAPY IMPLICATIONS

Examination and Evaluation

• Assess the area being treated to help document whether drug therapy is successful in reducing skin lesions.

• Monitor any new or increased reactions at the site of application, including inflammation, irritation, burning, swelling, numbness, tingling, exfoliation, and rash. Report severe or prolonged skin reactions to the physician.

Interventions

• Protect skin from breakdown, especially over bony prominences.

Patient/client-Related Instruction

• Check that the patient and family or caregivers understand topical application procedures, and adhere to the recommended dosing schedule.

Pharmacokinetics

Absorption: Small amounts are absorbed.

Distribution: Unknown.

Metabolism and Excretion: Some metabolism occurs.

Half-life: Unknown.

Contraindications/Precautions

Contraindicated in: Hypersensitivity to retinoids; OB: Potential for birth defects; Lactation: Use breast milk alternative.

Use Cautiously in: Patients with childbearing potential; Pedi: Safety not established.

Interactions

Drug-Drug: Do not use concurrently with insect-repellent products containing N,N-diethyl-m-toluamide (DEET). Alitretinoin increases DEET absorption.

Route/Dosage

Topical (Adults): Apply generous coating twice daily to KS lesions initially; application may be increased to 3–4 times daily.

Availability

Topical gel: 0.1% in 60-g tubes.