Bexarotene

How it works

It selectively binds and activates retinoid X receptors, modulating gene transcription to influence cellular differentiation and apoptosis of malignant lymphocytes.

Prescribing in practice

• It commonly causes marked hyperlipidaemia and central hypothyroidism, which require baseline and ongoing monitoring and management.
• It is a specialist oral retinoid used only under supervision of clinicians experienced in cutaneous T-cell lymphoma.
• It is teratogenic and strictly contraindicated in pregnancy; concurrent vitamin A supplements and photosensitivity also warrant caution.

Monitoring

Monitor fasting lipids, thyroid function, full blood count and liver function before and regularly during treatment.

Counselling the patient

• Pregnancy must be avoided; use reliable contraception during and for a period after treatment.
• Avoid additional vitamin A supplements and limit sun exposure.
• Attend regular blood tests to check cholesterol and thyroid function.

Evidence & guidelines

Its activity in cutaneous T-cell lymphoma is supported by registration studies and reflected in its licensed indication and the SPC.