Bexarotene (Systemic)

Brand Names : Targretin

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For bexarotene, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to bexarotene or other retinoid (vitamin A) preparations. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy - Bexarotene must not be taken during pregnancy because of the possible risks to the infant. In addition, bexarotene must not be taken if there is a chance that you may become pregnant 1 month before treatment, during treatment, and within 1 month after treatment is ended. Women who are able to have children must have a pregnancy test done within 1 week before starting bexarotene, to make sure they are not pregnant. The pregnancy test must be repeated once a month during treatment. For 1 month before treatment with bexarotene, during treatment, and for 1 month after treatment is over, you must use two effective forms of birth control at the same time. Bexarotene may interfere with the effectiveness of hormonal birth control (such as the pills), so one form of birth control should be non-hormonal, such as condoms. Male patients with sexual partners who are pregnant, possibly pregnant, or who could become pregnant must use condoms during sexual intercourse while taking bexarotene and for at least 1 month after taking the last dose. Be sure you have discussed this information with your doctor.

Breast-feeding - It is not known whether this medicine passes into breast milk. However, bexarotene is not recommended during breast-feeding, because it may cause unwanted effects in nursing babies.

Children - Studies of this medicine have been done only in adult patients, and there is no specific information comparing the use of bexarotene in children with use in other age groups.

Older adults - This medicine has been tested in patients 60 years of age or older and has not been shown to cause different side effects or problems in older people than it does in younger adults. However, elderly patients may be more sensitive to the effects of bexarotene.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose or other precautions may be necessary. When you are taking bexarotene, it is especially important that your health care professional know if you are using any of the following:

• Acyclovir (e.g., Zovirax) or
• Anticonvulsants (seizure medicine) or
• Antidiabetics, oral (diabetes medicine taken by mouth) or
• Anti-infectives by mouth or by injection (medicine for infection) or
• Antipsychotics (medicine for mental illness) or
• Captopril (e.g., Capoten) or
• Enalapril (e.g., Vasotec) or
• Flecainide (e.g., Tambocor) or
• Gold salts (medicine for arthritis) or
• Imipenem or
• Inflammation or pain medicine, except narcotics or
• Lisinopril (e.g., Prinivil, Zestril) or
• Maprotiline (e.g., Ludiomil) or
• Penicillamine (e.g., Cuprimine) or
• Pimozide (e.g., Orap) or
• Procainamide (e.g., Pronestyl) or
• Promethazine (e.g., Phenergan) or
• Ramipril (e.g., Altace) or
• Sulfasalazine (e.g., Azulfidine) or
• Tiopronin (e.g., Thiola) or
• Tocainide (e.g., Tonocard) or
• Tricyclic antidepressants (medicine for depression) or
• Trimeprazine (e.g., Temaril) - Concurrent use of these agents with bexarotene may cause blood disorders

• Alpha interferons (e.g., Intron A, Roferon-A) or
• Amphotericin B by injection (e.g., Fungizone) or
• Antineoplastics, other (cancer medicine) or
• Antithyroid agents (medicine for overactive thyroid) or
• Azathioprine (e.g., Imuran) or
• Chloramphenicol (e.g., Chloromycetin) or
• Colchicine or
• Cyclophosphamide (e.g., Cytoxan) or
• Flucytosine (e.g., Ancobon) or
• Ganciclovir (e.g., Cytovene) or
• Zidovudine (e.g., AZT, Retrovir) - Concurrent use of these agents with bexarotene increases the risk of infection

• If you have ever been treated with radiation or cancer medicines - Bexarotene may increase the effects that these medicines or radiation therapy may have on the blood

• Phenobarbital or
• Phenytoin (e.g., Dilantin) or
• Rifampin (e.g., Rifadin, Rimactane) or
• Erythromycin (e.g., E-Mycin, Ery-Tab, Ilotycin) or
• Grapefruit juice or
• Itraconazole (e.g., Sporanox) or
• Ketoconazole (e.g., Nizoral) - These medicines may increase or decrease the metabolism (breakdown) of bexarotene, leading to higher-than-usual or lower-than-usual amounts of bexarotene in the body

• Gemfibrozil (e.g., Lopid) - This medicine may lead to higher-than-usual amounts of bexarotene in the body

• Insulin (e.g., Humulin, Novolin) or
• Medications that make your body more sensitive to insulin, such as:
  • Pioglitazone (e.g., Actos) or
  • Rosiglitazone (e.g., Avandia)
• Medications that help your body to secrete more insulin, such as:
  • Acetohexamide (e.g., Dymelor) or
  • Chlorpropamide (e.g., Diabinese) or
  • Glimepiride (e.g., Amaryl) or
  • Glipizide (e.g., Glucotrol) or
  • Glyburide (e.g., DiaBeta) or
  • Tolazamide (e.g., Tolinase) or
  • Tolbutamide (e.g., Orinase) - Use of bexarotene may increase the effects of these medicines, which may cause low blood sugar (hypoglycemia)

• Tamoxifen (e.g., Nolvadex) - Bexarotene may lead to lower-than-usual amounts of tamoxifen in the body

• Vitamin A supplements (e.g., Aquasol A) - May increase the chance of side effects

Other medical problems - The presence of other medical problems may affect the use of bexarotene. Make sure to tell your doctor if you have any other medical problems, especially

• Bone marrow depression, existing or
• Infection - There may be an increased risk of infections or worsening of infections because of the body's reduced ability to fight them
• Cataracts - May cause new cataracts or worsen previous cataracts
• Chickenpox (including recent exposure) or
• Herpes zoster (shingles) - Risk of severe disease affecting other parts of the body
• Diabetes mellitus - May be more likely to experience low blood sugar (hypoglycemia).
• High cholesterol - Bexarotene can cause an increase in cholesterol levels.
• Kidney disease - May increase the chance of side effects

• Liver disease - Effects of bexarotene may be increased because of slower removal from the body.

• Pancreatitis or
• Risk factors for pancreatitis, such as:
  • Drinking large quantities of alcohol or
  • Problems with your gallbladder or biliary tract or
  • Diabetes mellitus (sugar diabetes) that is not well-controlled or
  • High cholesterol that is not well-controlled or
  • Taking medicines that cause high levels of triglycerides (fat-like substances) or
  • Taking medicines that are toxic to the pancreas or
  • Prior pancreatitis - Bexarotene can cause an increase in triglyceride levels which can cause inflammation of the pancreas.
• Photosensitivity - Bexarotene may cause increased sensitivity of the skin to sunlight