ACRETIN 0.025% CREAM 30G

Indications

Approved Uses

Acne vulgaris

Off-Label Uses

Off-label: melasma and post-inflammatory hyperpigmentation (often in combination regimens), keratosis pilaris, flat warts, and other hyperkeratotic disorders; (less consistently supported) striae distensae.

Dosage & Administration

Dosing by Condition

Acne vulgaris: apply a thin layer to affected area(s) once daily at bedtime. Photoaging/palliation: apply a pea-sized amount as a thin layer to the entire face once daily at bedtime (with sun avoidance/sunscreen).

Initial Dose

Apply a thin layer to the affected area once daily at bedtime. For sensitive skin, application may be started every other night.

Maintenance Dose

Once daily application at bedtime; frequency may be reduced to every other day if irritation occurs

Maximum Dose

Apply a thin layer once daily (typically at night); more frequent application does not improve efficacy and increases irritation.

Dose Adjustment Notes

If significant irritation occurs, reduce frequency (e.g., every other night/2-3 times weekly) and/or temporarily stop until tolerated, then restart and titrate as tolerated; consider strength escalation only after tolerability is established.

How to Take

Cleanse with a mild, non-medicated cleanser and pat dry; wait ~20-30 minutes until skin is completely dry; apply a pea-sized amount as a thin film to the affected area(s) once daily at bedtime; avoid eyes, lips, nostrils, and mucous membranes; wash hands after application; use moisturizer as needed and apply broad-spectrum sunscreen daily (and minimize sun exposure).

Side Effects

Common Side Effects

Application-site irritation (erythema, dryness, peeling/scaling), burning/stinging, pruritus, and increased photosensitivity; acne may appear to worsen transiently early in therapy.

Side Effect Frequency

Very common (>10%): local irritation/erythema, dryness, peeling (desquamation), burning/stinging. Common (1-10%): pruritus, photosensitivity, discomfort, transient acne flare. Uncommon (<1%): pigment changes (hyper/hypopigmentation), blistering/crusting, allergic contact dermatitis.

Safety & Warnings

Contraindications

Contraindications: hypersensitivity to tretinoin or any component; pregnancy (avoid use).

Warnings & Precautions

Avoid eyes/mucosa and broken, sunburned, or eczematous skin; minimize UV exposure and use sunscreen/protective clothing; expect early irritation/possible initial acne flare; avoid concurrent irritating topicals/other retinoids on same area and avoid abrasive cleansers/waxing on treated skin.

Age Restriction

Safety/efficacy not established in children <12 years; use only if prescribed with clinician supervision.

Driving Warning

Safe

Drug Interactions

Drug Interactions

Main interactions are additive local irritation with other topical peeling/drying agents (e.g., benzoyl peroxide, salicylic acid, sulfur, resorcinol, astringents/abrasives); photosensitizing drugs may increase sunburn risk; topical antibiotics are generally compatible but may add irritation.

Interaction Severity

MODERATE: Concurrent irritating/peeling topical agents (e.g., benzoyl peroxide, salicylic acid, sulfur/resorcinol, astringents, abrasive cleansers) due to additive irritation; MODERATE: Photosensitizing medications (e.g., tetracyclines, thiazides, fluoroquinolones, sulfonamides) due to additive sunburn risk; MINOR/management: benzoyl peroxide may oxidize tretinoin-separate application times (e.g., BPO AM, tretinoin PM) if used together.

Food Interaction

No clinically relevant food interactions (not applicable for topical use).

Alcohol Interaction

Safe

Special Populations

Pregnancy

Contraindicated

Breastfeeding

Caution

Elderly

Standard adult dosing; elderly patients may have more sensitive skin - start with less frequent application and monitor for irritation

Kidney Impairment

No dose adjustment needed (not applicable for topical use).

Liver Impairment

No dose adjustment needed (not applicable for topical use).

Storage & Patient Advice

Missed Dose

If a dose is missed, apply it as soon as remembered. If it is almost time for the next dose, skip the missed dose and resume the regular schedule. Do not apply a double dose.

Stopping the Medicine

Can be stopped at any time; acne often relapses after stopping (timing varies), and photoaging benefits diminish after discontinuation.

Overdose

Topical overuse causes excessive erythema/peeling/burning; manage by washing off and holding/reducing frequency until resolved; if ingested, contact poison control/seek medical care (supportive management).

Patient Counseling

Use once nightly on clean, completely dry skin (wait ~20-30 minutes after washing); apply a pea-sized thin layer and avoid eyes/lips/nasal creases; expect dryness/peeling and possible early acne flare-use moisturizer and reduce frequency if needed; avoid harsh scrubs/astringents and separate from other irritating products; use broad-spectrum SPF ≥30 daily and minimize sun exposure; do not use in pregnancy and discuss use if breastfeeding; store below 30°C and keep tube tightly closed.

Monitoring Requirements

No routine laboratory monitoring; monitor clinically for local irritation/dermatitis, photosensitivity, and treatment response/adherence.

Pharmacology

Mechanism of Action

Binds nuclear retinoic acid receptors (RARs) to alter gene transcription, normalizing follicular keratinization, reducing cohesiveness of keratinocytes, promoting comedolysis and preventing microcomedone formation, and increasing epidermal turnover.

Onset of Action

Acne: initial improvement often in ~2-4 weeks, with more meaningful benefit typically by 8-12 weeks; photoaging changes generally require several months of continuous use.

Duration of Effect

Benefits require ongoing use; acne control and photoaging improvements gradually diminish after discontinuation.

Half-Life

Approximately 0.5-2 hours (systemic tretinoin); topical use has minimal systemic exposure so a clinically meaningful topical half-life is not typically applicable.

Bioavailability

Minimal systemic absorption with topical application; absorption may increase if applied to inflamed, abraded, or occluded skin.

Metabolism

Hepatic metabolism, primarily via CYP26-mediated oxidation to metabolites (e.g., 4-hydroxy- and 4-oxo-retinoic acid) for any systemically absorbed fraction.

Protein Binding

>95% plasma protein binding (primarily albumin) for systemically absorbed tretinoin.

Product Information

Available Dosage Forms

Cream, Gel, Solution

Composition per Dose

Each gram of cream: 0.25 mg tretinoin (0.025%) in a cream base

Generic Availability

Yes

OTC Alternatives

OTC options for acne include adapalene 0.1% gel (where available OTC), benzoyl peroxide, and salicylic acid; there is no true OTC equivalent to prescription tretinoin for photoaging.

Skin Condition

Acne

Legal Disclaimer - Al Mujtama Pharmacy

The product information provided is derived from verified pharmaceutical references and is intended for general health education only. It is not a substitute for professional medical advice, diagnosis, or treatment.

Al Mujtama Pharmacy assumes no legal or medical liability for:

• Any therapeutic decision made based on the information displayed without consulting a licensed physician or pharmacist
• Any discrepancy between the information provided and the product's package insert or SFDA guidelines
• Any misuse of medication resulting from personal interpretation of the content displayed

Important notice: Drug formulations and instructions may vary between production batches. Always rely on the leaflet included inside the product packaging you have, and consult your pharmacist or physician before starting, adjusting, or discontinuing any medication.

By using this content, you acknowledge that you have read this disclaimer and agree that Al Mujtama Pharmacy bears no liability arising from reliance on this information as a substitute for direct medical consultation.

Your health is a trust - always consult your doctor first.