Spotex

Introduction
Spotex is a form of vitamin A that is used to treat acne which appears as spots or pimples on your face, chest or back. It also helps to smooth rough facial skin and to reduce fine wrinkles on the skin. Spotex reduces excessive oil production of the skin. Ideally, a pinpoint application at nighttime is recommended for the duration prescribed by your doctor. The amount you need and for how long you need to take it will depend on what you are being treated for. You should normally wash and dry the affected area before applying a thin layer of this medicine. Follow your doctor’s instructions. You should not apply it to damaged or broken skin and avoid contact with your mouth, eyes and nose. It may take several weeks for your symptoms to improve but keep using it regularly to get the most benefit. Consult your doctor again if you do not notice any improvement after a few weeks. Using more medicine or applying it more often than prescribed will not make it work any faster and may increase the side effects. The most common side effects include irritation, dryness and redness of the skin. They are usually mild and improve as your body gets used to the medicine. Drink plenty of water and use moisturizer as it may lead to dryness of the mouth, lips and eyes. Let your doctor know if these side effects bother you or do not go away. Serious side effects with this medicine are rare. This medicine may make you more sensitive to sunlight so you should limit exposure to the sun if possible. It may make your skin more fragile. It is advised, not to have any waxing (hair removal), or laser treatments during treatment. Pregnant women or women who are planning to get pregnant should not use this medicine as it can lead to birth defects.

_
Uses of Spotex
Acne
Side effects of Spotex
Common
Erythema (skin redness)
Skin irritation
Dry skin
Dry lips
Pale red skin
Increased sensitivity to light
How to use Spotex
This medicine is for external use only. Use it in the dose and duration as advised by your doctor. Check the label for directions before use. Clean and dry the affected area and apply the cream. Wash your hands after applying, unless hands are the affected area.
How Spotex works
Spotex is a form of vitamin A. When applied on skin, it reduces oil production in the skin, replenishes acne-prone skin and helps keep your pores open.
What if you forget to take Spotex?
If you miss a dose of Spotex, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Quick Tips
You have been prescribed Spotex for the treatment of acne.
Clean the affected area with water and a non-medicated soap. Let it dry for 20-30 minutes before applying Spotex.
It may increase the severity of the spots or pimples in the first few weeks of use. Continue using it as prescribed by your doctor.
It may cause a stinging sensation or a feeling of warmth when you first start using it. Inform your doctor if this persists.
Avoid exposure to sunlight while using Spotex as it increases the sensitivity of your skin. Use protective measures such as sunscreen or protective clothing.
Avoid face waxing and laser treatment while using this medicine as it makes your skin more fragile.
Avoid taking tetracycline (e.g. doxycycline) as it may reduce the Spotex activity.
Do not use Spotex if you are pregnant.
Inform your doctor if excessive skin dryness or skin sensitivity take place.
Brief Description
Indication
Acute promyelocytic leukaemia
Administration
Should be taken with food.
Adult Dose
Oral Acute promyelocytic leukaemia Adult: Remission induction: 45 mg/m2 daily in 2 divided doses. Treatment is continued until 30 days after complete remission or up to 90 days, whichever occurs first. Hepatic impairment: Reduce dose to 25 mg/m2 daily.

_
Child Dose
Oral Acute promyelocytic leukaemia Child: Remission induction: 1-16 yr 45 mg/m2 daily in 2 divided doses. Treatment is continued until 30 days after complete remission or up to 90 days, whichever occurs first. Hepatic impairment: Reduce dose to 25 mg/m2 daily.

_
Renal Dose
Renal impairment: Reduce dose to 25 mg/m2 daily.
Contraindication
Hypersensitivity to retinoids. Application to eczematous, sunburnt or abraded skin. Pregnancy, lactation.
Mode of Action
Tretinoin is a trans-retinoic acid form of vitimin A. It stimulates mitosis and turnover of follicular epithelial cells and reduce their cohesiveness. This facilitates extrusion of existing comedones and prevents formation of new comedone. It also exhibits thinning effect on the stratum corneum. In acute promyelocytic leukaemia, it induces cellular differentiation and decreases proliferations.
Precaution
Children, hepatic or renal impairment. Reduce dose if intractable headache occurs. Discontinue temporarily if LFT exceed 5 times upper limit of normal. Monitor closely for leukocytosis or respiratory compromise. Monitor haematologic profile, coagulation parameters, LFT, serum triglyceride and cholesterol concentrations regularly. Lactation: Unknown if excreted in breast milk; do not breast-feed, because of potential for serious adverse reactions in infant

_
Side Effect
>10% Headache (86%),Fever (83%),Bone pain (77%),Dry mucous membranes (77%),Malaise (67%),URI (63%),Shivering (60%),Dyspnea (60%),Hemorrhage (60%),Elevated liver function tests (50-60%),Hyperlipidemia (60%).Infections (58%),Nausea and vomiting (57%),Rash (54%),Peripheral edema (52%),Leukocytosis (40%),Pain (37%),Abdominal pain (31%),DIC (26%),Respiratory insufficiency (26%),Mucositis (26%),GI disorder (26%),Retinoic acid-APL syndrome (25%),Ear ache (23%),Diarrhea (23%),Pleural effusion (20%),Dizziness (20%),Pruritus (20%),Sweating (20%),Anxiety (17%),Paresthesia (17%),Constipation (17%),Vision changes (17%),Dyspepsia (14%),Depression(14%),Insomnia (14%),Alopecia (14%),Skin changes (14%),Confusion (11%),Abdominal distention (11%),Renal insufficiency (11%) 1-10% (selected) Cardiac failure,Pseudotumor cerebri,Ulcer Potentially Fatal: Retinoic acid syndrome, cardiac arrthythmia, disseminated intravascular coagulation, blood dyscrasias, cardiac arrest, cerebral haemorrhage.

_
Interaction
Enhances percutaneous absorption of minoxidil. Increased risk of fatal thrombotic complications with antifibrinolytic. Increased tretinoin concentrations with azole antifungals. Enhances peeling action of sulphur, resorcinol, benzoyl peroxide, salicylic acid. Increased photosensitivity with photosensitising medications eg, thiazides, tetracyclines, fluoroquinolones, phenothiazines and sulfonamides. Potentially Fatal: Increased risk of intracranial pressure with tetracyclines.

_