Bexarotene - Oral

Bexarotene is used to treat a certain type of skin cancer in individuals who have failed at least one previous therapy.

Take Bexarotene exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.

Take this medicine together with food or immediately after a meal. Try to take it at the same time each day.

The dose of this medicine will be decided by your doctor. Your doctor will advise you on the course of treatment depending on the severity of your condition and response to the medication.

Bexarotene must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.

DO NOT double a dose under any circumstances.

If you often forget to take your medicine, let your doctor and pharmacist know.

Do not take this medicine if you are pregnant or planning to have a baby soon. If you become pregnant while on Bexarotene therapy, alert your doctor immediately. This medicine may cause harm to your unborn child.

It is important that you do not get pregnant while taking this medicine. You must use proven birth control methods for 1 month before starting, during Bexarotene therapy and for at least 1 month after stopping the treatment. Birth control medicines containing hormones may not be effective. You may wish to discuss other reliable methods of birth control with your doctor.

Men with female partners of childbearing potential must also use proven birth control methods during treatment and for at least 1 month after the last dose of Bexarotene. You may wish to discuss reliable methods of birth control with your doctor.

Inform your doctor if you have the following conditions:

• history of pancreatitis (inflammation of pancreas)
• thyroid disorders e.g. underactive thyroid gland
• gallbladder problems
• high cholesterol levels in the blood
• known allergic reaction to a similar type of medicine known as retinoids
• high levels of vitamin A in the blood
• diabetes
• history of depression
• liver disease

Let your doctor know if you are breastfeeding.

Why is it important to keep my appointments with the doctor?

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.

• Pregnancy tests must be done before starting and during treatment to know if this medicine is suited for you to take.
• Routine tests (e.g. cholesterol and blood sugar levels, complete blood count, liver and thyroid function) may be done before and while you are being treated with Bexarotene. Your doctor will advise you about how often you need to have these tests.
• Regular monitoring for signs of depression and pancreatitis may also be needed.

Bexarotene may cause any of the following side effects: headache, dizziness, nausea, vomiting, diarrhoea, constipation, stomach pain or wind, loss of appetite, weight gain, weakness, lip swelling, dry mouth, dry eyes, rash, itching, dry skin, and excessive sweating.

This medicine may also make your skin more sensitive to sunlight. Apply sunscreen when going outdoors and avoid prolonged exposure to sunlight and UV lamps.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:

• yellowing of the skin or eyes, abdominal pain, dark coloured urine, tiredness, swelling in the legs and ankles
• severe nausea, vomiting, stomach pain that radiates to the back
• feeling cold, constipation, memory problems
• unusual changes in mood or behaviour (being too depressed, agitated, or having compulsive and impulsive behaviour)
• changes in eyesight, clouding of the lens of the eye

This medicine may cause the level of your red blood cells and white blood cells to drop.

Red blood cells carry oxygen around your body. A fall in the level of red blood cells may make you feel tired and worn out.

White blood cells help your body to fight infections. A fall in the level of your white blood cells may put you at higher risk for infections, such as coughs, colds and flu, which may lead to more serious infections. Avoid crowded places and people who are sick. Inform your doctor if you have a fever, cough, or flu that does not go away.

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Inform your doctor and pharmacist if you are taking any of these medicines:

• medicines or supplements containing vitamin A
• certain antibiotics e.g. erythromycin, clarithromycin
• medicines for epilepsy (fits or seizures) e.g. phenytoin, phenobarbital
• medicines to treat fungal infection e.g. ketoconazole, itraconazole
• other medicines for cancer e.g. tamoxifen, paclitaxel
• cholesterol-lowering medicines e.g. gemfibrozil, atorvastatin
• medicines for diabetes e.g. insulin
• dexamethasone (anti-inflammatory medicine)
• rifampicin (medicine to treat TB, a lung infection known as tuberculosis)

This list does not include all medicines that may interact with Bexarotene.

Alert your doctor if you are taking birth control pills or other types of hormonal birth control. You may need to add on another type of birth control.

Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.

Avoid alcohol.

Avoid excessive consumption of grapefruit or grapefruit juice (more than 1 litre a day).

Store in a cool, dry place away from the reach of children.

Keep the capsules in their original bottle to protect from light. Avoid exposing the capsules to humidity or high temperatures after opening the bottle.

Medicines must not be used past the expiry date.

As this is a cancer medicine, always return any unused or expired capsules to the clinic, hospital or pharmacy for disposal. Do not throw it away in the household waste.