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tretinoin

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Brand names: Retin-A

Retinoid (Topical) Rx

Tretinoin capsules help put acute promyelocytic leukemia (APL) into remission. You can use this medicine if other treatments have not worked or cannot be used.

Drug Pricing (NADAC)

Brand Price

$0.96/unit

Generic Price

$1.97/unit

Generic Available

Yes (21 manufacturers)

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

What it does

Tretinoin capsules treat acute promyelocytic leukemia (APL) in adults and children at least 1 year old.

Common side effects

Headache, Fever, Dry skin or mouth

Key warnings

Tretinoin capsules can cause serious harm to an unborn baby, including birth defects and miscarriage.

How It Works

Tretinoin is a retinoid, which is similar to vitamin A. It helps the leukemia cells mature properly. This can reduce the number of abnormal cells in your body.

How to Take It

Take tretinoin capsules exactly as your doctor tells you. The usual dose is 22.5 mg/m² twice a day. Always take the capsules with a meal. Swallow the capsules whole with water; do not chew, dissolve, or open them.

Pregnancy & Breastfeeding

Tretinoin capsules can cause birth defects or miscarriage. If you are pregnant or may become pregnant, do not take this medicine. Do not breastfeed while taking tretinoin capsules and for 1 week after the last dose.

Missed Dose

If you miss a dose, do not take it if your next dose is less than 10 hours away. Just take your next dose at the regular time.

Storage

Store tretinoin capsules at room temperature (68ºF to 77ºF) in a tightly closed container, away from light.

Side Effects (from patient reports)

Based on 5,050 FDA adverse event reports.

Using the medicine for a condition it's not approved for
897
The medicine is not working
788
Pain
536
Using the product for a condition it's not approved for
463
Throwing up
462
Feeling sick to your stomach
423
Skin rash
387
Headache
377
Diarrhea
361
Numbness or tingling
356

FDA Adverse Event Report Analysis

Detailed analysis of 7,629 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2004–2025.

Total Reports

7,629

Death-Related Reports

804

Hospitalization Reports

1,549

Top Indication

Product Used For Unknown Indication

Gender Distribution

Female 5,040 (76%)
Male 1,561 (23%)

Age Distribution

0–17 518
18–44 2,071
45–64 1,249
65–74 615
75+ 278

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 OFF LABEL USE 897
2 DRUG INEFFECTIVE 788
3 PAIN 536
4 PRODUCT USE IN UNAPPROVED INDICATION 463
5 VOMITING 463
6 NAUSEA 423
7 RASH 387
8 HEADACHE 377
9 DIARRHOEA 361
10 PARAESTHESIA 356
11 FATIGUE 336
12 ABDOMINAL PAIN UPPER 334
13 HYPOAESTHESIA 326
14 DRUG INTOLERANCE 318
15 GASTROOESOPHAGEAL REFLUX DISEASE 306

Reactions in Death Reports

MATERNAL EXPOSURE DURING PREGNANCY 212
OFF LABEL USE 179
DRUG INEFFECTIVE 172
PRODUCT USE IN UNAPPROVED INDICATION 153
PNEUMONIA 147
DRUG INTOLERANCE 145
CONTRAINDICATED PRODUCT ADMINISTERED 144
TASTE DISORDER 144
CONDITION AGGRAVATED 143
VOMITING 143

Reactions in Hospitalization Reports

OFF LABEL USE 241
PAIN 198
VOMITING 195
DRUG INEFFECTIVE 185
NAUSEA 174
DIARRHOEA 173
PNEUMONIA 150
ARTHRALGIA 144
DEPRESSION 138
HEADACHE 138

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

Tretinoin capsules can cause serious harm to an unborn baby, including birth defects and miscarriage. If you are a woman who can get pregnant, you must have a negative pregnancy test before starting this medicine and use two forms of birth control during treatment and for 1 month after your last dose. This medicine can also cause Differentiation Syndrome, a serious condition that can be life-threatening. Tell your doctor right away if you have fever, trouble breathing, weight gain, or swelling.

Known Drug Interactions

moderate retinol

( 7.2 ) • Vitamin A : Avoid concomitant use with vitamin A. 7.3 Vitamin A The concomitant use of vitamin A with tretinoin capsules may lead to vitamin A related adverse reactions. Avoid concomitant use of tretinoin capsules with vitamin A.

Mechanism: Tretinoin is a type of Vitamin A, so taking it with other Vitamin A products can cause you to have dangerously high levels of the vitamin in your body.

What to do: Do not take Vitamin A supplements or other Vitamin A products while you are using this medication.

Tretinoin (CYP3A4 Inhibition) Although Not Studied, Voriconazole may Increase Tretinoin Concentrations and Increase the Risk of Adverse Reactions Frequent monitoring for signs and symptoms of pseudotumor cerebri or hypercalcemia.

Mechanism: Voriconazole stops the body from breaking down tretinoin, which can lead to high levels of the drug in your blood.

What to do: Your doctor should check you often for high calcium levels or signs of increased pressure in the brain.

Bortezomib Nintedanib Brentuximab- Panobinostat vedotin Ponatinib Busulfan a Ruxolitinib Erlotinib Sonidegib Gefitinib b Tretinoin (oral) Idelalisib Vandetanib a ImatinibIxabepilone Monitor for adverse reactions. Alitretinoin (oral) Cabergoline Cannabinoids Cinacalcet Galantamine Ivacaftor Monitor for adverse reactions.

Mechanism: Taking these together can cause tretinoin to build up in your body because itraconazole slows its removal. This increases the risk of having a bad reaction to the tretinoin.

What to do: Your healthcare provider should check you regularly for any signs of too much medication in your system.

Common Questions

What should I do if I vomit after taking a dose?
Do not take another dose. Continue with your next scheduled dose.
How long will I take tretinoin capsules?
You will usually take this medicine until your leukemia is in remission. Your doctor will tell you when to stop.
Can I take vitamin A while taking tretinoin capsules?
No, avoid taking vitamin A while taking this medicine.
What if I am a male and my partner can get pregnant?
Use effective birth control during treatment and for 1 week after your last dose.
What tests will I need while taking this medicine?
Your doctor will monitor your blood counts, liver function, and cholesterol levels.
Can I take other medicines with tretinoin capsules?
Tell your doctor about all the medicines you take, including over-the-counter drugs and supplements.
What are the symptoms of Differentiation Syndrome?
Symptoms include fever, trouble breathing, weight gain, and swelling.
What should I do if I experience side effects?
Tell your doctor about any side effects you experience.
How will I know if the medicine is working?
Your doctor will monitor your blood counts to see if your leukemia is responding to treatment.
Can I open the capsule and mix it with food?
No, swallow the capsule whole with water. Do not chew, dissolve, or open it.
What are the common side effects of tretinoin?
The most commonly reported side effects of tretinoin include Headache, Fever, Dry skin or mouth, Bone pain, Feeling unwell. Based on 5,050 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does tretinoin interact with other medications?
Yes, tretinoin has 3 known drug interactions. Notable interactions include retinol, voriconazole, itraconazole. Always inform your doctor about all medications you are taking.
What drug class is tretinoin?
tretinoin belongs to the Retinoid (Topical) drug class. It requires a prescription (Rx). Tretinoin capsules treat acute promyelocytic leukemia (APL) in adults and children at least 1 year old.
Is tretinoin safe during pregnancy?
Tretinoin capsules can cause birth defects or miscarriage. If you are pregnant or may become pregnant, do not take this medicine. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.

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What the FDA Data Shows for tretinoin

The FDA label for tretinoin (sold under brand names such as Retin-A) classifies it as a prescription-only medication in the Retinoid (Topical) class. Tretinoin capsules treat acute promyelocytic leukemia (APL) in adults and children at least 1 year old. Official labeling lists 13 commonly reported side effects, including Headache, Fever, Dry skin or mouth.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 5,050 voluntary reports. The database also lists 3 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. NADAC pricing from CMS shows a generic unit cost of $1.97 versus $0.96 for the brand.

Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: April 15, 2025

All federal data sources used on this page