TAZAROTENE

TAZAROTENE
(ta-zar'o-teen)
Avage, Tazorac
Classifications: antiacne; retinoid;
Therapeutic: antiacne

Prototype: Isotretinoin
Pregnancy Category: X

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

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.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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