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Pronunciation
(taz AR oh teen)
Generic Available (U.S.)
No
Brand Names: U.S.
Brand Names: Canada
Pharmacologic Category
Pharmacologic Category Synonyms
Use: Labeled Indications
Topical treatment of facial acne vulgaris; topical treatment of stable plaque psoriasis; mitigation (palliation) of facial skin wrinkling, facial mottled hyper-/hypopigmentation, and benign facial lentigines
Pregnancy Risk Factor
X
Pregnancy Considerations
May cause fetal harm if administered to a pregnant woman. A negative pregnancy test should be obtained within 2 weeks prior to treatment; treatment should begin during a normal menstrual period.
Lactation
Excretion in breast milk unknown/use caution
Contraindications
Hypersensitivity to tazarotene, other retinoids or vitamin A derivatives (isotretinoin, tretinoin, etretinate), or any component of the formulation; use in women of childbearing potential who are unable to comply with birth control requirements; pregnancy (negative pregnancy test required)
Warnings/Precautions
Concerns related to adverse effects:
• Photosensitivity: May cause photosensitivity; exposure to sunlight should be avoided unless deemed medically necessary, and in such cases, exposure should be minimized (including use of sunscreens/protective clothing). Risk may be increased by concurrent therapy with known photosensitizers (thiazides, tetracyclines, fluoroquinolones, phenothiazines, sulfonamides).
•Skin irritation: Treatment can increase skin sensitivity to weather extremes of wind or cold. Also, concomitant topical medications (eg, medicated or abrasive soaps, cleansers, or cosmetics with a strong drying effect) should be used with caution due to increased skin irritation.
Special populations:
• Women of childbearing potential: Must use adequate contraceptive measures because of potential teratogenicity.
Dosage form specific issues:
• Gel: Safety and efficacy of gel applied over >20% of BSA have not been established.
Other warnings/precautions:
• Appropriate use: For external use only; avoid contact with eyes, eyelids, and mouth. Not for use on eczematous, broken, or sunburned skin; not for treatment of lentigo maligna. Avoid application over extensive areas.
Adverse Reactions
Percentage of incidence varies with formulation and/or strength:
>10%: Dermatologic: Burning/stinging, desquamation, dry skin, erythema, irritation, pruritus, skin pain, worsening of psoriasis
1% to 10%:
Cardiovascular: Peripheral edema
Dermatologic: Cheilitis, contact dermatitis, discoloration, eczema, fissuring, inflammation, localized bleeding, rash
Endocrine & metabolic: Hypertriglyceridemia
Frequency not defined: Dermatologic: Photosensitization
Postmarketing and/or case reports: Blistering
Metabolism/Transport Effects
None known.
Drug Interactions
There are no known significant interactions.
Storage
Store at 25°C (77°F).
Mechanism of Action
Synthetic, acetylenic retinoid which modulates differentiation and proliferation of epithelial tissue and exerts some degree of anti-inflammatory and immunological activity
Pharmacodynamics/Kinetics
Duration: Therapeutic: Psoriasis: Effects have been observed for up to 3 months after a 3-month course of topical treatment
Absorption: Minimal following cutaneous application (≤6% of dose)
Distribution: Retained in skin for prolonged periods after topical application.
Protein binding: >99%
Metabolism: Prodrug, rapidly metabolized via esterases to an active metabolite (tazarotenic acid) following topical application and systemic absorption; tazarotenic acid undergoes further hepatic metabolism
Half-life elimination: 18 hours
Excretion: Urine and feces (as metabolites)
Dosage
Topical: Note: In patients experiencing excessive pruritus, burning, skin redness, or peeling, discontinue until integrity of the skin is restored, or reduce dosing to an interval the patient is able to tolerate.
Children ≥12 years and Adults:
Acne: Tazorac® cream/gel 0.1%: Apply a thin film (2 mg/cm2) to affected area once daily
Psoriasis: Tazorac® gel: Initial: 0.05%: Apply once daily to psoriatic lesions using enough (2 mg/cm2) to cover only the lesion with a thin film to no more than 20% of body surface area. May increase strength to 0.1% if tolerated and necessary.
Children ≥17 years and Adults: Palliation of fine facial wrinkles, facial mottled hyper-/hypopigmentation, benign facial lentigines: Avage™: Apply a pea-sized amount once daily
Adults: Psoriasis: Tazorac® cream: Initial: 0.05%: Apply once daily to psoriatic lesions using enough (2 mg/cm2) to cover only the lesion with a thin film. May increase strength to 0.1% if tolerated and necessary.
Administration: Topical
Do not apply to eczematous or sunburned skin; avoid eyes and mouth
Acne: Apply in evening after gently cleansing and drying face; apply enough to cover entire affected area.
Palliation of fine facial wrinkles, facial mottled hyper-/hypopigmentation, benign facial lentigines: Apply to clean dry face at bedtime; lightly cover entire face including eyelids if desired. Emollients or moisturizers may be applied before or after; if applied before tazarotene, ensure cream or lotion has absorbed into the skin and has dried completely.
Psoriasis: Apply in evening. If a bath or shower is taken prior to application, dry the skin before applying. If emollients are used, apply them at least 1 hour prior to application. Unaffected skin may be more susceptible to irritation, avoid application to these areas.
Monitoring Parameters
Disease severity in plaque psoriasis during therapy (reduction in erythema, scaling, induration); pregnancy test prior to treatment of female patients
Patient Education
This medication is for external use only; avoid using near eyes or mouth. Severe skin reactions may occur. Avoid any other skin products (including cosmetics or personal products that may contain medications, alcohols, or irritants) that are not approved by your prescriber. May cause photosensitivity, which will cause severe rash or burning (use sunblock SPF 15 or higher, wear protective clothing and eyewear, and avoid direct sunlight, sunlamps, or tanning beds). Report redness or discoloration, irritation, burning, stinging, excessive dryness, or worsening of condition.
Application: Wash affected area gently and completely dry before applying medication. Apply a thin layer to cover affected area. Wash off any medication that gets on unaffected skin areas and wash hands thoroughly after application.
Geriatric Considerations
No differences in safety or efficacy were seen when the cream formulation was administered to patients >65 years of age; may experience increased sensitivity. Increased incidence of adverse effects and lower treatment success rates were observed with the gel formulation in the treatment of psoriasis.
Dental Health: Effects on Dental Treatment
No significant effects or complications reported
Dental Health: Vasoconstrictor/Local Anesthetic Precautions
No information available to require special precautions
Mental Health: Effects on Mental Status
None reported
Mental Health: Effects on Psychiatric Treatment
Use caution with drugs known to cause photosensitivity (psychotropics), effects may be augmented
Nursing: Physical Assessment/Monitoring
Assess for accumulated photosensitivity.
Dosage Forms
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Cream, topical:
Avage®: 0.1% (30 g) [contains benzyl alcohol]
Tazorac®: 0.05% (30 g, 60 g); 0.1% (30 g, 60 g) [contains benzyl alcohol]
Gel, topical:
Tazorac®: 0.05% (30 g, 100 g); 0.1% (30 g, 100 g) [contains benzyl alcohol]
Pricing: U.S. (www.drugstore.com)
Cream (Avage)
0.1% (30): $245.98
Cream (Tazorac)
0.05% (30): $209.98
0.05% (60): $445.00
0.1% (30): $245.98
0.1% (60): $480.01
Gel (Tazorac)
0.05% (30): $209.98
0.05% (100): $750.95
0.1% (30): $250.98
0.1% (100): $818.00
International Brand Names
Lexi-Comp.com
Last full review/revision December 2011
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