Tazarotene

A to Z Drug Facts

 Action Undefined; however, inhibits cornified envelope formation, which is an element of psoriatic scales.

 Indications Treatment of acne (Tazorac cream and gel), psoriasis (Tazorac gel); as an adjunctive agent in mitigation of facial fine wrinkling, facial mottled hyper- and hypopigmentation, and benign facial lentigines in patients who use comprehensive skin care and sunlight avoidance programs (Avage).

 Contraindications Pregnancy; hypersensitivity to any component of the product.

 Route/Dosage

Acne

Adults and Children (12 yr and older): Topical After gently cleansing and drying the face, apply a thin film (2 mg/cm²) once daily in the evening where acne lesions appear.

Psoriasis

Adults (18 yr and older): Topical Apply once a day in the evening to psoriatic lesions, using enough (2 mg/cm²) to cover only the lesion with a thin film.

Wrinkling, Hyper- and Hypopigmentation, Lentigines

Adults (18 yr and older): Topical Apply pea-sized amount once daily at bedtime to lightly cover the entire face including the eyelids if desired.

 Interactions None well documented.

 Lab Test Interferences None well documented.

 Adverse Reactions

DERMATOLOGIC: Skin pain (Tazorac); skin inflammation, worsening of psoriasis, rash (Tazorac for psoriasis); desquamation; stinging; dry skin; erythema; pruritus; skin irritation; burning sensation; fissuring localized edema, skin discoloration (Tazorac gel for acne); irritant contact dermatitis; fissuring; bleeding (Tazorac gel for psoriasis); contact dermatitis; dermatitis; eczema; peripheral edema (Tazorac cream for psoriasis); irritant contact dermatitis; acne; rash; cheilitis (Avage). METABOLIC: Hypertriglyceridemia (Tazorac cream for psoriasis)

 Precautions

Pregnancy: Category X. Lactation: Undetermined. Children: Safety and efficacy not established in patients with psoriasis under 18 yr or under 12 yr with acne (cream). Safety and efficacy not established in children under 12 yr (gel). Safety and efficacy not established in patients under 17 yr with facial fine wrinkling, facial mottled hypo- and hyperpigmentation and benign facial lentigines (Avage). Photosensitivity: Use with caution if patient is known to be taking a photosensitizing drug because of increased risk of photosensitivity. Special risk patients: Avoid use on eczematous skin and avoid concurrent use of medications and cosmetics that have a strong drying effect; assess facial pigmented lesions before use.

 Administration/Storage

• For topical use only. Not for ophthalmic, oral, or intravaginal use.
• Avoid contact with eyes, eyelids, lips, and mucus membranes.
• Cream or gel is usually applied to affected areas once daily at nighttime.
• For treatment of acne, cleanse area with a mild or soapless cleanser before applying cream or gel. Skin should be dry before application.
• For treatment of wrinkling, hyper- or hypopigmentation, or lentigines, cleanse area with a mild soap before applying cream. Skin should be dry before application.
• Apply a thin film of cream or gel to cover the affected area(s). Avoid application to unaffected areas of the skin.
• Store gel at controlled room temperature (59° to 86°F). Cream may be stored in refrigerator or at room temperature (23° to 86°F). Keep tube tightly capped.

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies. Note sensitivity to sunlight, concurrent use of medications which increase sensitivity to sunlight, or concurrent use of vitamin A supplements.
• Ensure that women of childbearing potential are not pregnant before starting therapy and that effective birth control measures are being used.
• Initiate therapy in women of childbearing potential during a normal menstrual period.
• Assess the skin and identify areas where medication is to be applied and areas that should be avoided (eg, eczema, sunburned skin).
• Assess and document skin condition before initial application and periodically throughout treatment.
• Monitor for side effects, including redness, scaling, dryness, or persistent itching or burning. Inform health care provider if noted and significant.

 Patient/Family Education

• Advise patient to carefully read the “Information For Patients” leaflet before using the first time and with each refill.
• Explain name, dose, action, and potential side effects of drug.
• Advise patient that medication is applied topically to skin lesions once daily at nighttime.
• Teach patient with psoriasis proper technique for applying medication: ensure that skin is dry if shower or bath were taken; wash hands; apply a thin film of cream or gel to cover skin areas with psoriasis plaques or scales; wash medication off unaffected areas that may have had medication applied. Wash hands after applying medication unless medication is being used to treat psoriasis on hands.
• Teach patient with acne proper technique for applying medication: wash hands; cleanse area with mild or soapless cleanser first then apply a thin film of cream or gel to cover skin areas with acne lesions. Wash hands after applying medication.
• Teach patient with winkling, hypo- or hyperpigmentation or lentigines proper technique for applying medication: wash hands; cleanse area with mild soap first, allow to dry and then apply a “pea-sized” amount of cream and lightly spread to cover the entire face, including the eyelids if desired. Wash hands after applying medication. Remind patient that facial moisturizers may be used as frequently as desired and to always apply a moisturizing sunscreen, SPF 15 or greater, each morning.
• Advise patient using creams or lotions to soften or lubricate skin to apply medication only after ensuring that the cream or lotion has been absorbed and the skin is dry.
• Caution patient not to cover treated areas with bandages or dressings.
• Inform patient that a mild sensation of warmth or slight stinging or burning may be felt shortly after application and that this is expected and should be of no concern.
• Warn patient that applying medication more often than prescribed or in excessive quantities will not produce more rapid improvement or better results but will result in greater side effects such as redness, scaling, and discomfort.
• Advise patient that if they miss an application to not try to make it up but to return to normal application schedule as soon as possible.
• Warn patient to avoid contact with the eyes, eyelids, lips, and mucous membranes.
• Advise patient that if cream or gel comes in contact with the eyes to wash eyes with large amounts of cool water and to contact health care provider if eye irritation persists.
• Advise patient to not apply to skin areas with eczema or that are sunburned.
• Advise patient with psoriasis that plaques and scales will begin to improve in 1 to 4 wk but that the redness may take longer to improve and to continue using the medication.
• Advise patient with acne that improvement may not be seen for at least 4 wk and to continue using the medication.
• Advise patient that local redness, drying, scaling, burning, or itching are the most common side effects and to notify health care provider if becoming bothersome.
• Advise patient that if severe dermal reactions occur to stop using the medication and contact health care provider.
• Advise patient to talk to health care provider before using any other topical agents (eg, medicated soaps, astringents, cosmetics, other acne products) on treated skin.
• Warn patient to avoid unnecessary exposure to sun and sun lamps while using this medication. Advise patient to use sunscreens, with minimum SPF of 15, and protective clothing over treated areas when exposure cannot be avoided.
• Caution patient that while using the medication, exposure to extreme weather conditions (eg, wind, cold air) may be irritating to the treated areas.
• Advise women to inform health care provider if pregnant, planning to become pregnant, or breastfeeding.
• Warn patient not to take any prescription or OTC drugs or dietary supplements without consulting health care provider.
• Advise patient that follow-up visits to examine the skin lesions may be necessary and to keep appointments.

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Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts