Pharmacological information Optimal® (Tretinoin) is a retinoic acid which is effective in the treatment of acne vulgaris. The exact mode of action is not known, however it is suggested that tretinoin has the ability to modify abnormal follicular keratinization, increase mitotic activity of follicular epithelia which enhances shedding of corneocytes from follicle and this in turn will promote detachment of cornified cells. Also, tretinoin modifies abnormal cellular processes by modulating the proliferation and differentiation of skin cells through interaction with a family of nuclear proteins, retinoic acid receptors. However, the exact mechanism whereby these actions take place is not understood. Indications Topical treatment of acne vulgaris. Dosage and administration Adults: - Before applying Optimal®: areas to be treated should be cleaned with water
and mild non-medicated soap and allowed to dry without rubbing for at least 20-30 minutes.
- Using gauze swab, cotton wool or the tips of clean fingers, apply lightly to
the affected area once daily in the evening.
- Avoid oversaturation, since excess medication could run into areas where
Usually it takes 2-3 weeks for a therapeutic effect to be noticed and more than 6 weeks for beneficial effects to appear. Children: Safety and effectiveness have not been documented. Use in pregnancy and lactation During pregnancy topical tretinoin should be used only if potential benefits justify potential risk to the fetus. Caution should be exercised when tretinoin is administered to a nursing mother, since it might be excreted in breast milk. Side effects The most encountered side effects are some degree of local irritation, dry skin, burning, slight stinging, warmth, erythema, pruritus, rash, peeling, and temporary hypo-and hyper-pigmentation. Other adverse reactions such as blistering of the skin, eye irritation and edema were rarely reported. True contact allergy to topical tretinoin is rarely encountered. Precautions - It is not recommended to initiate treatment with tretinoin or continue its use
in the presence of skin irritation until these symptoms subside.
- During early weeks of the treatment, an exacerbation of inflammation may
be noticed, this is due to the action of medication on the deep unseen lesions, and medication should not be ceased because of that.
- Care should be taken to prevent contact of medication with eyes, eyelids,
angles of nose, mouth and mucous membranes.
- Exposure to sunlight should be avoided or minimized during the use of
tretinion, or at least use of sunscreen products and protective clothing over treated area is recommended.
Drug interactions - Concomitant use tertinoin with medicated or abrasive sops and cleansers,
cosmetics that have strong drying effect, and products with high concentration of alcohol, astringents, spices or lime, may increase irritation of treated area.
- Particular caution should be exercised when using preparations containing
sulfur resorcinol, or salicylic acid, concomitantly with tretinoin.
Contraindications Hypersensitivity to the active ingredient or any component of the product. Overdosage Since little systemic absorption occurs when topically used, the over dosage is unlikely to happen. In case of accidental ingestion, gastric lavage or induction of emesis should take place. Presentation Optimal®cream: 0.05% Tretinoin. (Tube containing 30 g). Optimal®gel: 0.025% Tretinoin. (Tube containing 30g).
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