Chemotherapy Patient Resource Area

Bexarotene/Targreti^®

Drug
Bexarotene (generic name) is manufactured as Targretin^® (trade name) (Ligand Pharmaceuticals, San Diego, CA)

Action
Bexarotene interferes with the growth of cancerous cells. It is a type of drug called a retinoid and is used to treat a type of cancer called cutaneous T-cell lymphoma.

What does the drug look like?
Bexarotene is supplied in 75-mg, off-white-colored, oblong gelatin capsules.

How long will I take the drug?
Although some patients see improvement within the first several weeks of treatment with bexarotene, most patients require several months of treatment.

How do I take the drug?
Bexarotene is taken by mouth once a day with a meal. The duration of therapy with bexarotene varies but is usually several months. The dose of bexarotene is based on your body size and is determined by your doctor. Your doctor and pharmacist will tell you how many capsules to take each day. Take your daily dose of bexarotene all at once. Swallow each capsule whole; do not chew or open them. Your dose may be adjusted during therapy, and the number of capsules you need to take may change, so follow all directions and medicine labels carefully. If you miss a dose of bexarotene, take it as soon as possible with food. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. Let your doctor know if you miss a dose. If you accidentally take too many capsules or someone else accidentally takes your medicine, contact your doctor or the nearest emergency room immediately.

Storage
Store this medicine at room temperature. Do not store it in the bathroom, near the kitchen sink, or in other damp places, because moisture may cause this medication to break down. Keep this medicine in its original container, out of the reach of children or pets. Do not keep outdated medication that you no longer need. Ask your nurse or pharmacist how you should dispose of any medicine you do not use.

• Bexarotene temporarily lowers the number of white blood cells in your blood, increasing your chance of getting an infection. Avoid crowds and people who have infections. Call your doctor immediately if you develop a temperature higher than 100.5^oF or have chills, a cough, or painful urination.
• Bexarotene also lowers the number of platelets in your blood, which are necessary for proper blood clotting. Call your doctor immediately if you notice unusual bleeding or bruising, have black or tar-like stools, see blood in your urine, or develop pinpoint red spots on your skin. Use a soft toothbrush, and use care when flossing. Your healthcare providers may give you suggestions on how to care for your mouth, and these directions should be followed carefully.
• Bexarotene may cause your skin to be more sensitive to sunlight than it normally is. Exposure to sunlight, even for short periods of time, may cause skin rash, itching, redness, and, possibly, severe sunburn. Stay out of direct sunlight, wear protective clothing and sunglasses, and apply a sunblock product that has a skin protection factor (SPF) of at least 15 to your skin and lips. Do not use a tanning bed or sunlamp while taking bexarotene.
• While you are being treated with bexarotene, do not receive any immunizations (vaccinations) without your doctor's approval. Bexarotene may lower your resistance, and you may get the infection that the immunization is intended to prevent. Other people living with you should not receive the oral polio vaccine, because there is a chance they could pass the polio virus on to you.
• Bexarotene can cause the thyroid gland in the neck to become underactive, and periodic blood tests may be needed to detect this. Let your doctor know if you have had thyroid problems in the past or take thyroid medicine. Symptoms of an underactive thyroid may be difficult to detect because they may develop gradually and may be mild. Symptoms include fatigue, low energy level, or feeling unusually cold all the time. Notify your doctor if you experience these symptoms.
• The presence of other medical problems may affect the use of bexarotene. Make sure to tell your doctor if you have cataracts, because bexarotene may cause new cataracts or worsen previous cataracts. People with diabetes who take bexarotene may be more likely to experience low blood sugar (hypoglycemia). Bexarotene can increase lipid levels (cholesterol and triglyceride levels) in the blood. If you have elevated lipid levels, these will be monitored closely and possibly treated. People with pancreatitis (inflammation of the pancreas) or risk factors for pancreatitis (such as people who consume large amounts of alcohol, those with gallbladder or biliary tract problems, or people with diabetes) may be at risk for increased symptoms of pancreatitis when taking bexarotene.
• Bexarotene must not be taken during pregnancy because of the possible risks to the fetus. It must not be taken if there is a chance that you may become pregnant one month before treatment, during treatment, or within a month after treatment has ended. Women who are able to have children must have a pregnancy test done within one week before starting bexarotene to make sure they are not pregnant. The pregnancy test is repeated once a month during treatment. For one month before treatment, during treatment, and for one month afterward, you must use two effective forms of birth control at the same time. Bexarotene may interfere with the effectiveness of hormonal birth control (such as the birth control pill), so one form of birth control should be nonhormonal, such as condoms. Male patients with sexual partners who are pregnant, possibly pregnant, or could become pregnant must use condoms during sexual intercourse while taking bexarotene and for at least one month after taking the last dose. If you are of childbearing potential, be sure to discuss birth control with your doctor.

Drug and food interactions
When you are taking bexarotene, it is important that you let your doctor know if you are taking acyclovir, tamoxifen, seizure medicines, diabetes medicines, medicines for infection, heart medicines, or antidepressants. These medications may interact or interfere with bexarotene. DO NOT take aspirin or aspirin-containing products while taking bexarotene. If you are taking vitamins (especially vitamin A supplements), herbs, or nutritional supplements, be sure to let your doctor know. You should not take more than the recommended daily dietary allowance of vitamin A (4,000-5,000 International Units). Avoid drinking grapefruit juice or eating a lot of grapefruit while taking bexarotene, because this can affect the breakdown of the medicine.

• Temperature (fever) higher than 100.5^oF
• Any signs of infection, such as chills, cough, or burning or pain on urination
• Any bleeding, such as from your nose or gums or in your urine
• Dark-colored (black or tar-like) stool
• Unusual bruising
• Pinpoint red spots on your skin
• Moderate to severe sunburn
• Yellow eyes or skin