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warnings
WARNINGS RENOVA ® (tretinoin cream) 0.02% is a dermal irritant, and the results of continued irritation of the skin for greater than 52 weeks in chronic use with RENOVA ® (tretinoin cream) 0.02% are not known. There is evidence of atypical changes in melanocytes and keratinocytes and of increased dermal elastosis in some patients treated with RENOVA ® (tretinoin cream) 0.05% for longer than 48 weeks. The significance of these findings and their relevance for RENOVA ® (tretinoin cream) 0.02% are unknown. RENOVA ® (tretinoin cream) 0.02% should not be administered if the patient is also taking drugs known to be photosensitizers (e.g., thiazides, tetracyclines, fluoroquinolones, phenothiazines, sulfonamides) because of the possibility of augmented phototoxicity. Exposure to sunlight (including sunlamps) should be avoided or minimized during use of RENOVA ® (tretinoin cream) 0.02% because of heightened sunburn susceptibility. Patients should be warned to use sunscreens (minimum SPF of 15) and protective clothing when using RENOVA ® (tretinoin cream) 0.02%. Patients with sunburn should be advised not to use RENOVA ® (tretinoin cream) 0.02% until fully recovered. Patients who may have considerable sun exposure, e.g., due to their occupation, and those patients with inherent sensitivity to sunlight should exercise caution when using RENOVA ® (tretinoin cream) 0.02% and follow the precautions outlined in the Patient Package Insert. RENOVA ® (tretinoin cream) 0.02% should be kept out of the eyes, mouth, angles of the nose, and mucous membranes. Topical use may cause severe local erythema, pruritus, burning, stinging, and peeling at the site of application. If the degree of local irritation warrants, patients should be directed to use less medication, decrease the frequency of application, discontinue use temporarily, or discontinue use altogether and consider additional appropriate therapy. Tretinoin has been reported to cause severe irritation on eczematous skin and should be used only with caution in patients with this condition. Application of larger amounts of medication than recommended has not been shown to lead to more rapid or better results, and marked redness, peeling, or discomfort may occur.
ADVERSE REACTIONS (See WARNINGS and PRECAUTIONS sections.) In double-blind, vehicle-controlled studies involving 339 patients who applied RENOVA ® (tretinoin cream) 0.02% to their faces, adverse reactions associated with the use of RENOVA ® (tretinoin cream) 0.02% were limited primarily to the skin. Almost all patients reported one or more local reactions such as peeling, dry skin, burning, stinging, erythema, and pruritus. In 32% of all study patients, skin irritation was reported that was severe, let to temporary discontinuation of RENOVA ® (tretinoin cream) 0.02%, or led to the use of a mild topical corticosteroid. About 7% of patients using RENOVA ® (tretinoin cream) 0.02%, compared to less than 1% of the control patients, had sufficiently severe local irritation to warrant short-term use of mild topical corticosteroids to alleviate local irritation. About 4% of patients had to discontinue use of RENOVA ® (tretinoin cream) 0.02% because of adverse reactions. Approximately 2% of spontaneous post-marketing adverse even reporting for RENOVA ® (tretinoin cream) 0.05% were for skin hypo- or hyperpigmentation. Other spontaneously reported adverse events for RENOVA ® (tretinoin cream) 0.05% predominantly appear to be local reactions similar to those seen in clinical trials.