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Tretinoin Prescription
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Generic Name: Tretinoin (Systemic) (TRET i noyn)
Easy-to-read patient leaflet for Tretinoin (Systemic). Includes indications, proper use, special instructions, precautions, and possible side effects. Average Savings for tretinoin (generic): 28.97%
Generic Name: Tretinoin (Systemic) (TRET i noyn)
Easy-to-read patient leaflet for Tretinoin (Systemic). Includes indications, proper use, special instructions, precautions, and possible side effects. Average Savings for tretinoin (generic): 28.97%
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30 tablets of Tretinoin 40 mg
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Tretinoin Drug Information:

This is not a list of all drugs or health problems that interact with tretinoin (systemic). Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take tretinoin (systemic) with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor. Use tretinoin (systemic) as ordered by your doctor. Read all information given to you. Follow all instructions closely. Learn more

Tretinoin Medicare Coverage

Tretinoin Medicare Overview

Does Medicare cover Tretinoin?


96% of Medicare Part D and Medicare Advantage plans cover this drug.
How much is my Tretinoin co-pay with Medicare?

It depends. Which coverage stage are you in? Click on a tab below…


$15 – $215

In the Deductible co-pay stage, you are responsible for the full cost of your prescriptions. Your Medicare deductible cannot exceed $360 in 2016.

Ways to Save on Tretinoin

Here are some ways that may lower the cost of your tretinoin prescription.

  • Instead of Medicare, Use a USA Rx Coupon

    If your Medicare co-pay is higher, you can save money by using a USARx coupon instead.

Tretinoin Side Effects

In Summary

Commonly reported side effects of tretinoin include: pleural effusion, dyspnea, edema, fever, hypotension, leukocytosis, weight gain, headache, hypercholesterolemia, hypertriglyceridemia, increased liver enzymes, nausea, visual disturbance, and vomiting. Other side effects include: pulmonary infiltrates. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to tretinoin: oral capsule liquid filled


Oral route (Capsule, Liquid Filled)

Patients with acute promyelocytic leukemia (APL) can have severe adverse reactions to tretinoin including retinoic acid-APL (RA-APL) syndrome characterized by fever, dyspnea, acute respiratory distress, weight gain, radiographic pulmonary infiltrates, pleural and pericardial effusions, edema, and hepatic, renal, and multi-organ failure. High-dose steroids given at the first suspicion of the RA-APL syndrome appear to reduce morbidity and mortality. Patients can also develop rapidly evolving leukocytosis during therapy which can lead to an increased risk of life-threatening complications. There is a high risk that a severely deformed infant will result if tretinoin is administered during pregnancy. Pregnancy testing is necessary prior to initiation of treatment in women of childbearing potential and the patient must be instructed in the need to use two reliable forms of contraception simultaneously during therapy and for 1 month following discontinuation of therapy. Pregnancy testing and contraception counseling should be repeated monthly throughout the period of tretinoin treatment.

Along with its needed effects, tretinoin may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking tretinoin:

More common

  • Black, tarry stools
  • bleeding
  • blistering
  • bloody stools
  • bone pain
  • burning
  • coldness
  • difficulty in moving
  • discomfort or pain in chest
  • enlarged heart
  • feeling of pressure
  • fever
  • hives
  • infection
  • inflammation
  • joint pain
  • lumps
  • numbness
  • paleness of skin
  • rash
  • redness
  • scaring
  • seizures
  • shortness of breath, troubled breathing, tightness in chest, or wheezing
  • soreness
  • stinging
  • sweating increased
  • swelling
  • swollen joints
  • tenderness
  • tingling
  • ulceration
  • unusual tiredness or weakness
  • vomiting of blood or material that looks like coffee grounds
  • warmness at site
  • weight gain (occurring together with any of the other symptoms listed before)

Less common

  • Blue lips and fingernails
  • convulsions (seizures)
  • difficulty in speaking, slow speech, or inability to speak
  • faintness
  • feeling of heaviness in chest
  • headache (severe)
  • inability to move arms, legs, or muscles of the face
  • nausea and vomiting (occurring together with a headache)
  • no blood pressure or pulse
  • pain in back or left arm
  • painful, red lumps under the skin, mostly on the legs
  • prominent superficial veins over affected area
  • stopping of heart
  • unconsciousness
  • vision problems (occurring together with a headache)
  • warmth

Check with your doctor as soon as possible if any of the following side effects occur while taking tretinoin:

More common

  • Any change in vision (not occurring with a headache)
  • coughing, sneezing, sore throat, and stuffy or runny nose
  • cracked lips
  • crusting, redness, pain, or sores in mouth or nose
  • decreased urination
  • earache or feeling of fullness in the ear
  • increase or decrease in blood pressure
  • irregular heartbeat
  • mental depression
  • pain in stomach, side, abdomen or back
  • pain and swelling in leg or foot
  • skin rash
  • swelling of abdomen (stomach area)
  • swelling of face, fingers, hands, feet, or lower legs

Less common

  • Bone swelling
  • cramping or pain in stomach (severe)
  • difficult or painful urination
  • drowsiness (very severe and continuing)
  • hallucinations (seeing, hearing, or feeling things that are not there)
  • hearing loss
  • heartburn, indigestion, or nausea (severe and continuing)
  • mood, mental, or personality changes
  • pain in lower back or side
  • swollen area that feels sore and tender
  • yellow eyes or skin

Some side effects of tretinoin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Acid or sour stomach
  • agitation
  • anxiety
  • belching
  • blurred vision
  • bloating
  • burning, crawling, or tingling feeling in the skin
  • chills
  • confusion
  • constipation
  • darkened urine
  • diarrhea
  • dizziness
  • dryness of skin, mouth, or nose
  • fast heartbeat
  • flushing
  • general feeling of discomfort or illness
  • hair loss
  • headache (mild and not occurring together with other side effects)
  • indigestion
  • irritability
  • itching of skin
  • loss of appetite
  • mood or mental changes
  • muscle pain
  • nausea and vomiting (not occurring together with a headache)
  • shivering
  • trouble sleeping
  • weakness
  • weight loss

Less common

  • Anxiety and restlessness (occurring together)
  • clumsiness or unsteadiness when walking
  • difficulty sleeping
  • disorientation
  • forgetfulness
  • frequent urination
  • lethargy
  • lightheadedness
  • low body temperature
  • redness, soreness or itching skin
  • sores, welting or blisters
  • sores on genitals
  • swelling of feet or lower legs
  • thirst
  • trembling, sometimes with a flapping movement
  • weak or feeble pulse
  • weakness in legs

For Healthcare Professionals

Applies to tretinoin: compounding powder, oral capsule


-The most frequent undesirable effects of this drug are consistent with signs of hypervitaminosis A syndrome (as for other retinoids).

-APL patients treated with this drug may experience a potentially fatal syndrome characterized by fever, dyspnea, acute respiratory distress, weight gain, radiographic pulmonary infiltrates, pleural and pericardial effusions, edema, and hepatic, renal, and multi-organ failure. This syndrome is sometimes accompanied by impaired myocardial contractility and episodic hypotension with or without concomitant leukocytosis.


Very common (10% or more): Fever (83%), malaise (66%), peripheral edema (52%), earache/feeling of fullness in the ears (23%), edema (29%), shivering (63%), hearing impaired, chills, weakness, fatigue, chest pain

Common (1% to 10%): Face edema, hypothermia, hearing loss and other unspecified auricular disorders

Uncommon (0.1% to 1%): Irreversible hearing loss

Frequency not reported: Histamine level increased, teratogenicity


Very common (10% or more): Hemorrhage (60%), disseminated intravascular coagulation (26%)

Frequency not reported: Thrombocytosis, leukocytosis, basophilia


Very common (10% or more): Transaminases increased

Common (1% to 10%): Hepatosplenomegaly, hepatitis, unspecified liver disorder


Very common (10% or more): Skin/mucous membrane dryness (77%), rash (54%), pruritus (20%), increased sweating (20%), alopecia (14%), skin changes (14%), erythema, hyperhidrosis

Frequency not reported: Erythema nodosum, acute febrile neutrophilic dermatosis (Sweet's syndrome)


Very common (10% or more): Bone pain (77%), myalgia (14%)

Common (1% to 10%): Bone inflammation, flank pain

Frequency not reported: Myositis


Very common (10% or more): Nausea/vomiting (57%), GI hemorrhage (34%), abdominal pain (31%), mucositis (26%), diarrhea (23%), constipation (17%), dyspepsia (14%), abdominal distension (11%)

Common (1% to 10%): Ascites, ulcer

Frequency not reported: Organomegaly, pancreatitis


Very common (10% or more): Visual disturbances/ocular disorders (17%), conjunctival disorders

Common (1% to 10%): Changed visual acuity, visual field defects


Very common (10% or more): Injection site reactions (17%)


Very common (10% or more): Upper respiratory tract disorders (63%), dyspnea (60%), respiratory insufficiency (26%), pleural effusion (20%), pneumonia (14%), rales (14%), expiratory wheezing (14%), respiratory failure, nasal dryness, asthma

Common (1% to 10%): Lower respiratory tract disorders, pulmonary infiltration, pulmonary edema, larynx edema, unspecified pulmonary disease


Very common (10% or more): Arrhythmia (23%), flushing (23%), hypotension (14%), hypertension (11%), phlebitis (11%)

Common (1% to 10%): Pallor, lymph disorders, cardiac failure, cardiac arrest, myocardial infarction, enlarged heart, heart murmur, ischemia, stroke, myocarditis, pericarditis, pulmonary hypertension, secondary cardiomyopathy

Frequency not reported: Arterial thrombosis, venous thrombosis involving various sites (e.g., cerebrovascular accident, renal infarct), vasculitis

Nervous system

Very common (10% or more): Headache (86%), dizziness (20%), paresthesias (17%), intracranial pressure increased, pseudotumor cerebri

Common (1% to 10%): Cerebral hemorrhage, intracranial hypertension, abnormal gait, agnosia, aphasia, asterixis, cerebellar edema, cerebellar disorders, convulsions, coma, CNS depression, dysarthria, encephalopathy, facial paralysis, hemiplegia, hyporeflexia, hypotaxia, no light reflex, neurologic reaction, spinal cord disorder, tremor, leg weakness, unconsciousness, slow speech

Frequency not reported: Cerebrovascular accident


Common (1% to 10%): Dysuria, micturition frequency, enlarged prostate

Frequency not reported: Genital ulceration


Very common (10% or more): Anorexia (17%), weight loss (17%), decreased appetite, weight gain (23%), blood triglyceride increased, blood creatinine increased, blood cholesterol increased

Common (1% to 10%): Fluid imbalance, acidosis

Frequency not reported: Hypercalcemia


Very common (10% or more): Anxiety (17%), insomnia (14%), depression (14%), confusion (11%)

Common (1% to 10%): Agitation, hallucination, dementia, forgetfulness, somnolence


Very common (10% or more): Renal insufficiency (11%)

Frequency not reported: Renal infarct

Editorial References and Review

Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/3/2022.

Source: Drugs.com Tretinoin (www.drugs.com/tretinoin.html).