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Drug(s) | Interaction |
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Antifibrinolytic agents (e.g., aminocaproic acid, aprotinin, and tranexamic acid) | May increase risk of thrombosis during tretinoin therapy. |
Drugs that induce cytochrome P-450 system (e.g., barbiturates, carbamazepine, phenytoin, primidone, rifabutin, and rifampin) | May decrease tretinoin concentrations and antineoplastic efficacy. |
Drugs that inhibit cytochrome P-450 (e.g., cimetidine, erythromycin, fluconazole, and ketoconazole) | May increase tretinoin concentrations and toxicity. Adjust tretinoin concentrations when necessary. |
Drugs that inhibit CYP-2C8 (e.g., atazanavir, gemfibrozil, and ritonavir) | May increase tretinoin concentrations and toxicity. Adjust tretinoin concentrations when necessary. |
Estrogen-progestin oral contraceptives | Tretinoin may decrease contraceptive efficacy. The use of at least 1 other effective form of contraception during tretinoin therapy is recommended. |
Progestin-only oral contraceptives | Tretinoin may decrease contraceptive efficacy. The use of at least 2 other effective forms of contraception during tretinoin therapy is recommended. |
Tetracycline antibiotics (e.g., doxycycline, minocycline, and tetracycline) | May increase risk of PC. |
Ethanol | May increase CNS depression. Avoid concomitant use. |
Hydroxyurea | Synergistic antineoplastic effects; may increase risk of cell lysis and potentially fatal bone marrow necrosis. |
St. John’s wort | May decrease tretinoin concentrations and antineoplastic efficacy. Avoid concomitant use. |
Vitamin A | Increased risk of vitamin A toxicity. Avoid combination. |
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