TAZAROTENE (ta-zar'o-teen)
Avage, Tazorac Classifications: antiacne; retinoid; Therapeutic: antiacne Prototype: Isotretinoin Pregnancy Category: X
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Availability
0.05%, 0.1% gel, cream
Action
Retinoid prodrug that blocks epidermal cell proliferation and hyperplasia.
Therapeutic Effect
Suppresses inflammation present in the epidermis of psoriasis patients. Effectiveness indicated by improvement in acne or
psoriasis.
Uses
Topical treatment of plaque psoriasis on up to 20% of the body, mild to moderate acne, facial fine wrinkling, mottled
hypo- and hyperpigmentation (blotchy skin discoloration), and benign facial lentigines.
Contraindications
Hypersensitivity to tazarotene; pregnancy (category X), women who are or may become pregnant; lactation.
Cautious Use
Concurrent administration with drugs that are photosensitizers (e.g., thiazide diuretics, tetracyclines); retinoid hypersensitivity.
Safety and efficacy in children <12 y are not established.
Route & Dosage
Plaque Psoriasis Adult: Topical Apply thin film to affected area once daily in evening
Acne Adult: Topical After cleansing and drying face, apply thin film to acne lesions once daily in evening
Fine Wrinkles Adult: Topical Apply thin film of cream to affected area once daily
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Administration
Topical
- Dry skin completely before application of a thin film of medication.
- Apply medication to no more than 20% of body surface in those with psoriasis.
- Apply only to affected areas; avoid contact with eyes and mucous membranes.
Adverse Effects (≥1%)
Skin: Pruritus, burning/stinging, erythema, worsening of psoriasis, irritation, skin pain, rash, desquamation of skin, irritant contact dermatitis, inflammation, fissuring, bleeding, dry skin, sunburn.
Interactions
Drug: Increased risk of photosensitivity reactions with
quinolones (especially
sparfloxacin),
phenothiazines,
sulfonamides,
sulfonylureas,
tetracyclines,
thiazide diuretics.
Pharmacokinetics
Absorption: Rapidly absorbed through skin.
Distribution: Active
metabolite >99% protein bound; crosses placenta, distributed into breast milk.
Metabolism: Undergoes esterase hydrolysis to active
metabolite AGN 190299.
Elimination: In both urine and feces.
Half-Life: 18 h.
Nursing Implications
Assessment & Drug Effects
- Monitor for photosensitivity in those concurrently using any of the following: thiazides, tetracyclines, fluoroquinolones,
phenothiazines, sulfonamides.
Patient & Family Education
- Understand fully the risk of serious fetal harm. Use reliable forms of effective contraception. Discontinue treatment and
notify physician if pregnancy occurs.
- Alert: Immediately rinse thoroughly with water if contact with eyes occurs.
- Avoid all unnecessary exposure to sunlight or artificial UV light. If brief exposure is necessary, cover as much skin surface
as possible and use sunscreens (minimum SPF 15).
- Do not apply to sunburned skin.
- Discontinue medication and notify physician if any of the following occur: pruritus, burning, skin redness, excessive peeling,
worsening of psoriasis.
- Limit application of topicals with strong skin-drying effects to skin areas being treated with tazarotene.