Retinoid X receptor agonist (specialist)
Bexarotene
Brand names: Targretin
Adult dose
Dose: 300mg/m² PO OD with food
Route: Oral
Frequency: OD
Clinical pearls
- NICE TA177: cutaneous T-cell lymphoma
- BAD CTCL guidance; ESMO
- Pregnancy Prevention Programme — contraception 1 month before, throughout, 1 month after
Contraindications
- Pregnancy (highly teratogenic — Pregnancy Prevention Programme)
- Severe hepatic impairment
- Pancreatitis history
- Hypersensitivity
Side effects
- Hyperlipidaemia (very common)
- Hypothyroidism
- Hepatotoxicity
- Photosensitivity
- Pancreatitis
- Cataracts
- Cytopenias
- Teratogenicity
Interactions
- Strong CYP3A4 inhibitors
- Vitamin A
- Gemfibrozil (avoid)
- Grapefruit juice
Monitoring
- Lipids weekly initially
- TFTs
- LFTs
- FBC
- Pregnancy testing (PPP)
Reference: BNF; NICE TA177; BAD CTCL; ESMO; SmPC; https://bnf.nice.org.uk/drugs/bexarotene-specialist-drug/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways
- Acute Myeloid Leukaemia Presentation · BSH; NICE — NG146
- Tumour Lysis Syndrome · Cairo-Bishop; BSH; NICE — Best Practice
- Suspicious Pigmented Lesion — Melanoma Pathway · NICE NG14 2015 / BAD
- Cellulitis and Erysipelas · NICE NG141 2019 / CREST
- Psoriasis — Severity Assessment and Step-Up Therapy · NICE NG153 2019 / BAD
- Atopic Eczema — Assessment and Step-Up Therapy · NICE NG95 2023