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Author: Dr Tim Aung, Primary Care Practitioner, Brisbane & Logan, Queensland, Australia. DermNet NZ Editor in Chief: Adjunct A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand. June 2020.
Retinoids are classified into four generations [1,2,3]:
Oral retinoids include:
The effects of retinoids are mediated through binding to and activation of the retinoic acid receptor (RAR) and the retinoid X receptor (RXR), which regulate cell proliferation, differentiation and apoptosis [4,5]. They also have a role in immune modulation, are anti-inflammatory, and activate tumour suppressor genes.
The therapeutic use of retinoids depends on the individual product [6,7]. Their specific usage varies at the approval of individual country and on the results of off-label trials [1,4,8,9,10].
Indications for an oral retinoid
The most serious adverse effect of oral retinoids is teratogenicity (category X) if a retinoid is taken during pregnancy. The most frequent birth malformations caused by oral retinoids are craniofacial, central nervous system, cardiovascular, and thymic .
Systemic treatment may also cause:
Follow the instructions carefully.
Drug interactions with oral retinoids are uncommon and generally mild.
The effects of the oral retinoid and progress of the disease should be monitored at regular follow-up appointments.
If you are not based in New Zealand, we suggest you refer to your national drug approval agency for further information about medicines (eg, the Australian Therapeutic Goods Administration and the US Food and Drug Administration) or a national or state-approved formulary (eg, the New Zealand Formulary and New Zealand Formulary for Children and the British National Formulary and British National Formulary for Children).
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