Targretin (Bexarotene)

(bex er' oh teen)

Topical bexarotene is used to treat cutaneous T-cell lymphoma (CTCL, a type of skin cancer) that could not be treated with other medications. Bexarotene is in a class of medications called retinoids. It works by stopping the growth of cancer cells.

Topical bexarotene comes as a gel to apply to the skin. It is usually applied once every other day at first and gradually applied more frequently up to two to four times a day. Use topical bexarotene at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use bexarotene exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor. Your doctor will probably start you on a low dose of topical bexarotene and gradually increase your dose, not more often than once a week. Your doctor may decrease your dose if you experience side effects. Your condition may improve as soon as 4 weeks after you begin to use topical bexarotene, or it may take several months before you notice any improvement. Continue to use topical bexarotene after you notice improvement; your condition may continue to improve. Do not stop using topical bexarotene without talking to your doctor. Bexarotene gel may catch fire. Do not use this medication near a source of heat or near an open flame such as a cigarette. Bexarotene gel is for external use only. Do not swallow the medication and keep the medication away from your eyes, nostrils, mouth, lips, vagina, tip of penis, rectum, and anus. You may bathe, shower, or swim during your treatment with topical bexarotene, but you should use only a mild, non-deodorant soap. You should wait at least 20 minutes after bathing or showering before applying topical bexarotene. After you apply the medication, do not bathe, swim, or shower for at least 3 hours. Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient. To use the gel, follow these steps:

• Wash your hands.
• If you are using a new tube of bexarotene gel, remove the cap and check that the opening of the tube is covered with a metal safety seal. Do not use the tube if you do not see the safety seal or if the seal has been punctured. If you do see the safety seal, turn the cap upside down and use the sharp point to puncture the seal.
• Use a clean finger to apply a generous layer of gel to the area to be treated only. Be careful not to get any gel on the healthy skin around the affected area. Do not rub the gel into the skin. You should be able to see some gel on the affected area after you are finished applying it.
• Do not cover the treated area with a tight bandage or dressing unless you were told to do so by your doctor.
• Wipe the finger that you used to apply the gel with a tissue and throw the tissue away. Wash your hands with soap and water.
• Allow the gel to dry for 5-10 minutes before covering with loose clothing. Do not wear tight clothing over the affected area.

Before using topical bexarotene,
• tell your doctor and pharmacist if you are allergic to bexarotene; any other retinoid such as acitretin (Soriatane), etretinate (Tegison), isotretinoin (Accutane), or tretinoin (Vesanoid); or any other medications.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: certain antifungals such as ketoconazole (Nizoral) and itraconazole (Sporanox);erythromycin (E.E.S., E-Mycin, Erythrocin); gemfibrozil (Lopid); other medications or products that are applied to the skin; and vitamin A (in multivitamins). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with topical bexarotene, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
• tell your doctor if you have or have ever had kidney or liver disease.
• tell your doctor if you are pregnant or plan to become pregnant. Topical bexarotene may cause severe birth defects, so you will need to take precautions to prevent pregnancy during and shortly after your treatment. You will begin your treatment on the second or third day of your menstrual period, and you will need to have negative pregnancy tests within one week of the start of your treatment and once a month after your treatment. You must use 2 acceptable forms of birth control during your treatment and for one month after your treatment. If you become pregnant during your treatment with topical bexarotene, call your doctor immediately.
• tell your doctor if you are breast-feeding.
• if you are male and have a partner who is pregnant or can become pregnant, talk to your doctor about precautions you should take during your treatment. Call your doctor immediately if your partner becomes pregnant while you are using topical bexarotene.
• plan to avoid unnecessary or prolonged exposure to sunlight and sunlamps and to wear protective clothing, sunglasses, and sunscreen. Topical bexarotene may make your skin sensitive to sunlight.
• do not use insect repellants or other products containing DEET during your treatment with topical bexarotene.
• do not scratch the affected areas during your treatment with topical bexarotene.

Talk to your doctor about eating grapefruit and drinking grapefruit juice while using this medicine.

Apply the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not apply extra gel to make up for a missed dose.

Topical bexarotene may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• itching
• redness, burning, irritation, or scaling of the skin
• rash
• pain
• sweating
• weakness
• headache
• swelling of the arms, hands, feet, ankles, or lower legs

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:

• sore throat, fever, chills, or other signs of infection
• swollen glands

Bexarotene may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

Keep this medication in the container it came in, tightly closed, and out of reach and sight of children. Store it at room temperature and away from light, excess heat, open flames, and moisture (not in the bathroom). Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program. It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Keep all appointments with your doctor. Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.