Joseph D. Diaz, MD Araceli Elizalde, MD Erika Gonzalez, MD W. Ted Kniker, MD Melissa E. Garcia, PA-C M. Celeste Loera, FNP-BC Revised 6/05/2013 Date: ________________ Patient’s Name: _______________________________________ Age: _________ Patient’s Primary MD: _______________________________________ Practice Type: GP FP Internist Peds Other: __
Optimal® (Tretinoin) is a retinoic acid which is effective in the treatment of
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.
Topical treatment of acne vulgaris.
Dosage and administration
- 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.
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.
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.
- 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.
- 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.
Hypersensitivity to the active ingredient or any component of the product.
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.
Optimal® cream: 0.05% Tretinoin. (Tube containing 30 g).
Optimal® gel: 0.025% Tretinoin. (Tube containing 30g).
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