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May cause fetal harm
TARGRETIN may cause fetal harm and must not be given to a pregnant woman or a woman who intends to become pregnant.
If pregnant, discontinue use
TARGRETIN treatment must be stopped immediately if a patient becomes pregnant, and counseling is recommended.
Effective contraception
Effective contraception must be used for one month prior to initiation of therapy, during therapy, and for at least one month following discontinuation of therapy.
Male patients with sexual partners who are pregnant, possibly pregnant or who could become pregnant must use condoms during sexual intercourse while applying TARGRETIN Gel and for at least one month after last dose of drug.
Nursing
Due to the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Gel Safety
General Precautions1
Advise patients on the following precautions while treating with TARGRETIN Gel.
Because of the relationship of bexarotene to vitamin A, patients should be advised to limit vitamin A supplements to avoid potential additive toxic effects.
Retinoids as a class have been associated with photosensitivity. Patients should be advised to minimize exposure to sunlight and artificial ultraviolet light while using TARGRETIN.
Patients who are applying TARGRETIN Gel should not concurrently use products that contain DEET, a common component of insect repellent products.
Adverse reactions
The most common adverse events reported with TARGRETIN Gel in clinical trials with an incidence at the application site of at least 10% were1:
Rash
Pruritus
Skin disorder
Pain
Overdosage
Systemic toxicity following acute overdosage with topical application of TARGRETIN Gel is unlikely because of low systemic plasma levels observed with normal therapeutic doses1:
TARGRETIN Gel produces low systemic plasma levels within therapeutic doses.3
Capsule Safety
General Precautions2
Advise patients on the following precautions while treating with TARGRETIN Capsules.
Because of the relationship of bexarotene to vitamin A, patients should be advised to limit vitamin A supplements to avoid potential additive toxic effects.
Retinoids as a class have been associated with photosensitivity. Patients should be advised to minimize exposure to sunlight and artificial ultraviolet light while using TARGRETIN.
Adverse reactions
The most common adverse events reported with TARGRETIN Capsules in clinical trials with an incidence of at least 10% were2:
Hyperlipidemia
Hypercholesteremia
Headache
Hypothyroidism
Asthenia
Leukopenia
Rash
Nausea
Infection
Peripheral edema
Abdominal pain
Dry skin
Overdosage
Doses up to 1000 mg/m2/day of TARGRETIN Capsules have been administered in short-term trials in patients with advanced CTCL without acute toxic effects, 30 times the recommended dose.2
TARGRETIN Capsules produce no acute toxic effects at 30 times the recommended dose.
Important safety information
Indication and usage
TARGRETIN® (bexarotene) capsules and gel are indicated for the treatment of cutaneous manifestations of cutaneous T-cell lymphoma (only stages 1A and 1B for gel) in patients who are refractory to at least one prior systemic therapy.
Important Safety Information
Birth defects
Because of the risk of fetal harm, TARGRETIN capsules and gel must not be given to a woman who is pregnant or who intends to become pregnant. If a woman becomes pregnant during treatment with TARGRETIN, treatment must be stopped immediately, and the woman provided appropriate counseling about the risks.
To prevent pregnancy, effective contraception must be used for one month prior to the initiation of TARGRETIN therapy, during therapy and for at least one month following discontinuation of therapy; it is recommended that two reliable forms of contraception be used simultaneously unless abstinence is the chosen method. Male patients with sexual partners who are pregnant, possibly pregnant or who could become pregnant must use condoms during treatment and for at least one month after the last dose of drug.
No more than a one month supply of TARGRETIN should be given to the patient so that the results of pregnancy testing can be assessed and counseling regarding avoidance of pregnancy and birth defects can be reinforced.
Contraindication
TARGRETIN capsules and gel are contraindicated in patients with a known serious hypersensitivity to bexarotene or other components of the product.
Warnings and precautions
Capsules
Hyperlipidemia is present in most patients treated with TARGRETIN capsules. Obtain baseline values, monitor during treatment, and manage elevations during therapy.
Acute pancreatitis, including a fatal case, has been reported in patients treated with TARGRETIN capsules. Interrupt treatment and evaluate if suspected.
Hepatotoxicity, cholestasis, and hepatic failure TARGRETIN capsules had a dose-related effect on liver chemistry tests in clinical trials, including incidence of cholestasis and liver failure.
Hypothyroidism TARGRETIN capsules induce hypothyroidism in about half of all patients; obtain baseline thyroid function tests and monitor patients during treatment.
Neutropenia Leukopenia and neutropenia occurred in clinical trials with TARGRETIN capsules; obtain complete blood counts at baseline and periodically during treatment.
Cataracts Although a causal relationship has not been established, cataracts have been observed in animal and clinical studies with TARGRETIN capsules. Refer patients who experience visual difficulties for ophthalmologic evaluation.
Hypoglycemia in Diabetes TARGRETIN capsules may cause hypoglycemia in patients using insulin, agents enhancing insulin secretions, or insulin-sensitizers.
Nursing: Discontinue nursing during treatment with TARGRETIN.
Laboratory tests including CBC, fasting lipid profile, liver function tests, and thyroid profile should be obtained prior to treatment.
CA125 assay values in ovarian cancer patients may be elevated by treatment.
Capsules and Gel
Vitamin A Patients should be advised to limit Vitamin A intake to avoid potential additive toxicity.
Photosensitivity Advise patients to minimize exposure to sun and artificial sunlight during treatment.
Gel
Patients who are applying TARGRETIN gel should not concurrently use products that contain DEET, a common component of insect repellent products.
For nursing women, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Adverse reactions
Capsules
The most common adverse reactions (>10%) include hyperlipidemia, hypercholesteremia, headache, hypothyroidism, asthenia, leukopenia, rash, nausea, infection, peripheral edema, abdominal pain, and dry skin.
Gel
The most common adverse events reported in TARGRETIN gel clinical trials with an incidence at the application site of at least 10% were: rash, pruritus, skin disorder, and pain.
To report SUSPECTED ADVERSE REACTIONS contact customer service at 1-800-321-4576 or FDA at 1-800-FDA-1088 or visit fda.gov/medwatch.
Click here for full Prescribing Information, including Boxed Warning for TARGRETIN capsules.
Click here for full Prescribing information for TARGRETIN gel.
Indication and usage
TARGRETIN® (bexarotene) capsules and gel are indicated for the treatment of cutaneous manifestations of cutaneous T-cell lymphoma (only stages 1A and 1B for gel) in patients who are refractory to at least one prior systemic therapy.
Important Safety Information
Birth defects
Because of the risk of fetal harm, TARGRETIN capsules and gel must not be given to a woman who is pregnant or who intends to become pregnant. If a woman becomes pregnant during treatment with TARGRETIN, treatment must be stopped immediately, and the woman provided appropriate counseling about the risks.
References
- TARGRETIN gel 1% [prescribing information]. Bridgewater, NJ: Bausch Health US, LLC.
- TARGRETIN 75 mg capsules [prescribing information]. Bridgewater, NJ: Bausch Health US, LLC.
- Krejsgaard T, Lindahl LM, Mongan NP, et al. Malignant inflammation in cutaneous T-cell lymphoma—a hostile takeover. Semin Immunopathol. 2017;39(3):269-282.