Tretinoin cream

Tretonin cream, a topical retinoid, contains tretinoin 0.025% by weight in a hydrophilic cream vehicle of stearic acid, polyolprepolymer-2, isopropyl myristate, polyoxyl 40 stearate, propylene glycol, stearyl alcohol, xanthan gum, sorbic acid, butylated hydroxytoluene, and purified water. The tretinoin cream 0.02% contains the active ingredient tretinoin in a cream base. It is available at a concentration 

Separately prepare solution of items 1 and 2 and a mixture of items 3-7 by heating to about 75°C. 

Heat mixture of items 8-12 until a clear solution is formed. 

To the warm mixture of step 2 mix step 1 and cool by stirring. 

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Griffiths CE, Kang S, Ellis CN, Kim KJ, Finkel LJ, Ortiz-Ferrer LC, White GM, Hamilton TA,Voorhees JJ (1995) IVvo concentrations of topical tretinoin (retinoic acid) cause similar improvement of photoaging but different degrees of irritation. A double-blind, vehicle-controlled comparison of 0.1% and 0.025% tretinoin creams. Arch Dermatol 131 1037-1044... 

The concomitant use of various bleaching agents has also been shown to improve PIH. In 1975, tretinoin in combination with hydroqui-none and dexamethasone was reported as an effective treatment for PIH [14]. In a small study, the application of 2% hydroquinone and 10% glycolic acid gel twice daily and 0.05% tretinoin cream at night has been shown to provide benefit for darker-skinned patients with PIH [15]. Similarly, Yoshimura et al. [16] suggested efficacy of tretinoin combined with hydroquinone and lactic acid in reducing PIH. More re-... 

In vitro and in vivo pharmacokinetic studies with tretinoin cream and gel indicated that less than 0.3% of the topically applied dose is bioavailable. Circulating plasma levels of tretinoin are only slightly elevated above those found in healthy normal controls. Estimates of in vivo bioavailability ot Retin-A M/cro following single and multiple daily applications, for a period of 28 days with the 0.1 % gel, were... 

Tretinoin Cream weighed (1 mg drug), 20 ml tet-rahydrofuran (stabilized), shaken, 5 ml aliquot further diluted THF aqueous phosphoric acid, filtered 3 (p. 191)... 

Camera, G. and Pregliasco, P., Ear malformation in baby born to mother using tretinoin cream, Lancet, 339, 687, 1992. 

Tretinoin cream is used extensively for the treatment of acne and photodamaged skin, and local irritant dermatitis is common. With normal use, absorption is minimal and systemic adverse effects are therefore not expected. 

Breast discharge has been reported (105). Menstrual disturbances occur, and may be under-reported (SEDA-13, 121, 123). Vaginal bleeding in a 64-year-old woman was convincingly ascribed to the daily use of tretinoin cream 0.05% to her face, suggesting a systemic effect (SEDA-16, 159). 

Tretinoin cream should be kept out of direct sunlight and away from heat sources, to which it is sensitive. In spite of these precautions, it gradually loses its efficacy and it is recommended that the prescription be renewed every 3 months. Tretinoin is sensitive to oxidation, heat and ultraviolet light the refrigerator (4 C) seems to be the best place to store this cream. The by-products of degradation turn the cream a yellowish color, in which case it should no longer be used. 

If, on the other hand, a patient cannot tolerate a concentration of tretinoin at 0.05%, applying an 8-10% glycolic acid cream in the morning will make a tretinoin cream at 0.015% applied in the evening more effective, at the same time as reducing the irritation caused by the retinoid. These combinations must always be used under close medical supervision, however, as in dual therapy, skin reactions can be highly unpredictable and severe in some patients. More sensitive skins can be treated as follows ... 

In the evening, a 0.05% tretinoin cream should be applied (see Chapter 2). This cream reduces the thickness of the stratum corneum and provides a deeper peel with the same concentration. A 10% (non-photosensitizing) glycolic acid gel could be applied on younger women in the morning. 

Lucky A, Cullen S, Funicella T, et al. Double-bUnd, vehicle-controlled, 59. multicenter comparison of two 0.025% tretinoin creams in patients widi... 

A special group is formed by the radical scavengers butyUiydroxyanisole (see Fig. 23.22) and butylhydrox-ytoluene (see Fig. 23.23). They are used in non-aqueous environments. Concentrations usually start at 0.01-0.1 % of the complete formulation, if necessary increased to 1 %. Butyl hydroxytoluene is used in the lipid phase of a tretinoin cream 0.05 % (Table 23.25). 

Tretinoin cream 0.02% FNA Date dd/mm/yyyy Batch nr. Expiry date mm/yyyy Storage 2-8 °C copy of label used ... 

Pretreatment with 0.05% tretinoin cream for 2 weeks has been shown to significantiy acceierate heaiing, regardless of body region... 

Before performing CROSS, preconditioning the skin with agents such as tretinoin cream are not recommended due to the risk of unpredictable and excessive TCA penetration. 

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