Drug/Small Molecule:
tretinoin

2D structure

Overview

Generic Names: ATRA; All Trans Retinoic Acid; All Trans-Retinoic Acid; Retionic Acid; beta-Retinoic Acid; tretinoin
Trade Names: Aberel; Accutane; Airol; Aknefug; Aknoten; Amnesteem; Atra-IV; Claravis; Dermairol; Eudyna; Lsotretinoin; Retisol-A; Solage; Sotret; Stieva-A; Stieva-a Forte; Tri-Luma; Vitinoin
PharmGKB Accession Id: PA451746

Description

Tretinoin, also known as all-trans-retinoic acid (ATRA), is a naturally occurring derivative of vitamin A (retinol). Retinoids such as tretinoin are important regulators of cell reproduction, proliferation, and differentiation and are used to treat acne and photodamaged skin and to manage keratinization disorders such as ichthyosis and keratosis follicularis. Tretinoin also represents the class of anticancer drugs called differentiating agents and is used in the treatment of acute promyelocytic leukemia (APL). (source: Drug Bank)

Indication

For the the induction of remission in patients with acute promyelocytic leukemia (APL), French-American-British (FAB) classification M3 (including the M3 variant); For the topical treatment of acne vulgaris, flat warts and other skin conditions (psoriasis, ichthyosis congenita, icthyosis vulgaris, lamellar icthyosis, keratosis palmaris et plantaris, epidermolytic hyperkeratosis, senile comedones, senile keratosis, keratosis follicularis (Darier's disease), and basal cell carcinomas.); For palliative therapy to improve fine wrinkling, mottled hyperpigmentation, roughness associated with photodamage. (source: Drug Bank)

ATC Therapeutic Categories

  • D10AD:Retinoids for topical use in acne
  • D10BA:Retinoids for treatment of acne
  • L01XX:Other antineoplastic agents

Pharmacology, Interactions, and Contraindications

Mechanism Of Action

Tretinoin binds to alpha, beta, and gamma retinoic acid receptors (RARs). RAR-alpha and RAR-beta have been associated with the development of acute promyelocytic leukemia and squamous cell cancers, respectively. RAR-gamma is associated with retinoid effects on mucocutaneous tissues and bone. Although the exact mechanism of action of tretinoin is unknown, current evidence suggests that the effectiveness of tretinoin in acne is due primarily to its ability to modify abnormal follicular keratinization. Comedones form in follicles with an excess of keratinized epithelial cells. Tretinoin promotes detachment of cornified cells and the enhanced shedding of corneocytes from the follicle. By increasing the mitotic activity of follicular epithelia, tretinoin also increases the turnover rate of thin, loosely-adherent corneocytes. Through these actions, the comedo contents are extruded and the formation of the microcomedo, the precursor lesion of acne vulgaris, is reduced. Tretinoin is not a cytolytic agent but instead induces cytodifferentiation and decreased proliferation of APL cells in culture and in vivo. When Tretinoin is given systemically to APL patients, tretinoin treatment produces an initial maturation of the primitive promyelocytes derived from the leukemic clone, followed by a repopulation of the bone marrow and peripheral blood by normal, polyclonal hematopoietic cells in patients achieving complete remission (CR). The exact mechanism of action of tretinoin in APL is unknown. (source: Drug Bank)

Pharmacology

Tretinoin, also known as all-<i>trans</i>-retinoic acid (ATRA), is a naturally occurring derivative of vitamin A (retinol). Retinoids such as tretinoin are important regulators of cell reproduction, proliferation, and differentiation and are used to treat acne and photodamaged skin and to manage keratinization disorders such as ichthyosis and keratosis follicularis. Tretinoin also represents the class of anticancer drugs called differentiating agents and is used in the treatment of acute promyelocytic leukemia (APL). (source: Drug Bank)

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Hepatic (source: Drug Bank)

Protein Binding

> 95% (source: Drug Bank)

Absorption

1-31% (topical) (source: Drug Bank)

Isomeric SMILES Code:

CC1=C(C(CCC1)(C)C)/C=C/C(=C/C=C/C(=C/C(=O)O)/C)/C (source: Drug Bank)

The following genes are in curated knowledge about this drug.

  Gene Relationship Evidence
Phenotype data available Genotype Data Available Literature annotations available Has annotations
ABCB1
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  • FA
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Publications
Phenotype data available Genotype Data Available Literature annotations available Not annotated
CYP2C8
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  • PK
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Publications
Phenotype data available Genotype Data Available Literature annotations available Has annotations
CYP2C9
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  • PK
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Publications
Phenotype data available Genotype Data Available Literature annotations available Not annotated
CYP3A
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  • PK
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Publications
Phenotype data available Genotype Data Available Literature annotations available Has annotations
CYP3A4
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  • PK
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Publications
Phenotype data available Genotype Data Available Literature annotations available Has annotations
CYP3A5
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  • PK
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Publications
No phenotype data No genotype data Literature annotations available Not annotated
RARA
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  • FA
  • GN
Publications

A list of non-curated publications that mention this drug along with other genes is available.

Drug Targets

Gene Description
GPRC5A Uncurated Annotation (source: Drug Bank)
ALDH1A1 Uncurated Annotation (source: Drug Bank)
ALDH1A2 Uncurated Annotation (source: Drug Bank)
NR0B1 Uncurated Annotation (source: Drug Bank)
RARRES1 Uncurated Annotation (source: Drug Bank)
RARG Uncurated Annotation (source: Drug Bank)
RXRB Uncurated Annotation (source: Drug Bank)
RXRG Uncurated Annotation (source: Drug Bank)

The following drugs are in curated knowledge about this drug.

  Drug Relationship Evidence
No phenotype data No genotype data Literature annotations available Not annotated
atorvastatin
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  • FA
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Publications

A list of non-curated publications that mention this drug along with other drugs is available.

Curated Information

The following diseases are in curated knowledge about this drug.

  Disease Relationship Evidence
No phenotype data No genotype data Literature annotations available Not annotated
Leukemia, Promyelocytic, Acute
  • CO
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Publications

Non-Curated Information

A list of non-curated publications that mention this drug along with other diseases is available.

Additional Datasets

These datasets are minimally curated and are sorted alphabetically by title.

  1. The Connectivity Map: using gene-expression signatures to connect small molecules, genes, and disease

LinkOuts

Web Resource:
Wikipedia
DrugBank:
DB00755
ChEBI ID:
15367
KEGG Compound ID:
C00777
KEGG Drug ID:
D00094
PubChem Compound ID:
5538
PubChem Substance ID:
7847162

Common Searches

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Non-Curated Publications

A list of non-curated publications that mention this drug is available.

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