Bexarotene: Uses, indications and cautions when using

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Bexarotene is used to treat skin problems caused by a type of cancer called cutaneous T-cell lymphoma - CTCL. Bexarotene belongs to a class of drugs called retinoids (vitamin A derivatives). Bexarotene works by slowing or stopping the growth of cancer cells.

1. What is Bexarotene?

Bexarotene is contraindicated in the following cases:
Skin T-cell lymphoma Bexarotene is contraindicated in the following cases:
People with low thyroid hormone levels. People with poorly controlled diabetes. High levels of triglycerides in the blood. Low white blood cell count. Alcoholics. People with cataracts Bile and gallbladder problems Acute pancreatitis Abnormal liver function Pregnancy Women who are breastfeeding People allergic to vitamin A analogues

2. Precautions when using Bexarotene

Read the leaflet provided by your doctor before you start using bexarotene and each time you get a refill. Bexarotene is to be taken by mouth during or immediately after a meal, usually once daily or as directed by your doctor. The dose of Bexarotene is calculated by your doctor based on your body size, medical condition, and response to therapy. Bexarotene should be swallowed whole, not crushed or chewed. Do not use Bexarotene capsule if it breaks or leaks. If the contents of the capsule touch your skin, immediately wash the area with soap and water and tell your doctor. Do not increase your dose or take Bexarotene more often than prescribed. Doing so will not help your condition improve faster, but it will also increase your risk of serious side effects. It may take up to several months of continuous use of Bexarotene to see a response to treatment. Your dose of Bexarotene may need to be adjusted by your doctor during this time. Because Bexarotene can be absorbed through the skin and lungs and may harm an unborn baby, women who are pregnant or may become pregnant should not use this medicine or breathe in the dust from the capsules. Learn the proper technique for the safe handling and disposal of Bexarotene and its container.

3. Bexarotene side effects

While using Bexarotene, you may experience headache, fatigue, nausea, vomiting, dry skin, diarrhea, or trouble sleeping. If any of these effects persist or worsen, notify your doctor.
Remember that your doctor has prescribed Bexarotene because they have judged that the benefit to you is greater than the risk of you experiencing side effects. Many people use Bexarotene without any serious side effects.
Using Bexarotene regularly may increase the level of "bad" fats (cholesterol/triglycerides) in your blood. Your doctor will order blood tests to check your levels of these fats. If your blood fats are too high, you may need to reduce your dose or stop bexarotene, or you may need to start taking cholesterol medication.
Bexarotene can cause an underactive thyroid (hypothyroidism). Tell your doctor right away if you have any symptoms of hypothyroidism, including: Unusual weight gain, feeling cold, constipation, slow heart rate, low energy. Your doctor will order blood tests and may start you on thyroid medication if needed.
Tell your doctor right away if you have any serious side effects while you are taking Bexarotene, including: Stomach pain, swelling of hands/feet, muscle pain, stiffness, cramps, fast or irregular heartbeat, mood swings such as depression, anxiety, suicidal thoughts.
Tell your doctor right away if any of these rare but very serious side effects occur while taking Bexarotene, including: Severe stomach/back/stomach pain, persistent nausea or vomiting, dark urine, changes in vision, yellowing of the eyes and skin.
Bexarotene may decrease the body's ability to fight infections. Notify your doctor right away if you have any signs of infection such as fever, chills, or persistent sore throat.
A very serious allergic reaction to Bexarotene is very rare. However, seek immediate medical attention if you notice the following symptoms of an allergic reaction while using Bexarotene: Rash, itching, or swelling on any end, especially in the face, tongue or throat, dizziness, trouble breathing.

Below are Bexarotene side effects by likelihood.
Common side effects of Bexarotene include:
Bacterial infections Low thyroid hormone levels Anemia Too much fat in the blood Fever Edema in the feet, legs, arms or hands. High cholesterol Low white blood cell levels Skin rash with peeling Skin rash Back pain Chills Decreased appetite Diarrhea Trouble sleeping Dry skin Flu-like symptoms Hair loss Headache High levels of triglycerides in the body Blood Nausea Stomach cramps Vomiting Uncommon side effects of Bexarotene include:
Abnormal liver function Pancreatitis High blood Bilirubin Pneumonia Rare side effects of Bexarotene include:
Obstruction Obstruction of normal bile flow This is not a complete list of the possible side effects of Bexarotene. If you notice other effects of Bexarotene medicine not listed above, contact your doctor.

4. Measures to prevent side effects of the drug Bexarotene

Before taking bexarotene, tell your doctor if you are allergic to this medicine; or vitamin A-related drugs (other retinoids such as isotretinoin); and any other allergies. Bexarotene may contain inactive ingredients that can cause allergic reactions or other problems.
Before taking Bexarotene, consult your doctor if you have pancreatitis. Before using Bexarotene, tell your doctor your medical history, especially of:
Regular alcohol use Cataracts High blood fats (high cholesterol/triglycerides) Diabetes Gallbladder problems liver problems Psychiatric problems such as depression Thyroid problems such as hypothyroidism. Bexarotene may make you more sensitive to the sun. Limit the time you spend in the sun, and use sun protection when going outside, during treatment with Bexarotene.
Because Bexarotene can decrease the body's ability to fight infection, wash your hands often to prevent the infection from spreading.
Bexarotene can cause serious birth defects if used during pregnancy. Pregnant women should not take bexarotene. If you become pregnant while using Bexarotene, tell your doctor right away.
You should have a pregnancy test and contraception advice from your doctor before starting treatment with bexarotene and monthly while you are taking it. Use 2 effective forms of birth control together (or avoid sex altogether) for 1 month before starting treatment, during treatment, and for 1 month after stopping treatment.
One of your forms of birth control should not be hormonal such as: a barrier method such as a condom/cap/diaphragm, an IUD, or spermicide.
Men taking Bexarotene should use condoms during sexual activity with women who are pregnant or may become pregnant, continuing for up to 1 month after the last dose of treatment.
Because Bexarotene can be absorbed through the skin and lungs and may harm an unborn baby, women who are pregnant or may become pregnant should not use this medicine or breathe dust from the capsules.
Because Bexarotene may harm a nursing infant, breastfeeding while using this medicine is not recommended. Consult your doctor before breast-feeding during treatment with Bexarotene.

5. Bexarotene drug interactions

Your doctor may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dose of any medicine while using Bexarotene, before checking with your doctor.
Bexarotene should not be used with gemfibrozil because a very serious interaction can occur. If you are currently using the medicines listed above, tell your doctor or pharmacist before you start using bexarotene.
Before using gemfibrozil, tell your doctor about all prescription and nonprescription/herbal medicines you are taking, especially: tamoxifen, vitamins or vitamin supplements. A, drugs that affect liver enzymes that remove bexarotene from your body (e.g., azole antifungals such as itraconazole/ketoconazole, macrolide antibiotics such as clarithromycin/erythromycin, cimetidine, rifamycins including rifabutin, St. John's wort, certain anticonvulsants such as phenytoin/phenobarbital).
Bexarotene may decrease the effectiveness of hormonal birth control such as the pill, patch, or ring. This can lead to an unwanted pregnancy. You should use an extra reliable form of birth control while using Bexarotene.
Bexarotene may interfere with certain tests (including CA-125 levels), possibly causing false test results. Make sure laboratory staff and all your doctors know you are using Bexarotene. T
Before using Bexarotene, tell your doctor about all the products you use.

6. What to do when using an overdose of Bexarotene?

If you or someone else has overdosed on Bexarotene and has severe symptoms such as passing out or having trouble breathing, call 911.

7. What to do if you forget to use Bexarotene?

If you miss a dose of Bexarotene, take it with a meal as soon as you remember. If you find that it is almost time for your next dose of Bexarotene, skip the missed dose and take your next dose at the usual time. Do not take a double dose of Bexarotene to make up for a previously missed dose.

8. How to store Bexarotene

Store Bexarotene in an airtight container at room temperature between 36-77 degrees F (2-25 degrees C), away from light and moisture. Do not store Bexarotene in the bathroom. Keep Bexarotene out of reach of children and pets.
Do not flush Bexarotene down the toilet or down the drain unless instructed to do so. Dispose of medication properly when it has expired or is no longer needed.

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Reference source: webmd.com