Last update Feb. 9, 2023

Tretinoin (topical use)

Compatible

Safe substance and/or breastfeeding is the best option.

Retinoic acid form of vitamin A. Indicated in the treatment of acne and other skin diseases (psoriasis). Topical administration on damaged skin in the form of gel, cream or 0.01-01% alcoholic solution.

At the date of the last update, there was no available published data on its excretion in breast milk.

Its pharmacokinetic data (large volume of distribution, high percentage of protein binding, low pKa and short half-life) make it unlikely that it will pass into breast milk in a clinically significant quantity.

The small dose and poor plasma absorption of most topical dermatological preparations make it unlikely that a significant amount will pass into breast milk. Percutaneous absorption of tretinoin is less than 2% (AEMPS 2020, Valeant 2012, Akhavan 2003, van Hoogdalem 1998) and plasma levels are undetectable. (Lucek 1985)

It can cause gynecomastia. (Atzenhoffer 2018)

Various medical societies, expert authors and expert consensus consider the use of this medication safe or probably safe during breastfeeding. (Hale, Briggs 2015, Butler 2014, Kong 2013, Leachman 2006).

Do not apply to the breast area or clean well before breastfeeding.

Systemic, oral use (as an antineoplastic) is absolutely contraindicated during lactation.


See below the information of these related products:

  • Acne (Safe substance and/or breastfeeding is the best option.)
  • Tretinoin (systemic use) (Unsafe. Moderate/severe adverse effects. Compatible under certain circumstances. Follow-up recommended. Use safer alternative or discontinue breastfeeding from 5 to 7 T ½ . Read Commentary.)

Alternatives

  • Adalimumab (Safe substance and/or breastfeeding is the best option.)
  • Adapalene (Safe substance and/or breastfeeding is the best option.)
  • Azelaic Acid (Safe substance and/or breastfeeding is the best option.)
  • Benzoyl Peroxide (Safe substance and/or breastfeeding is the best option.)
  • Clindamycin (Safe substance and/or breastfeeding is the best option.)
  • Erythromycin (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
  • Etanercept (Safe substance and/or breastfeeding is the best option.)
  • Infliximab (Safe substance and/or breastfeeding is the best option.)
  • Melitracen Hydrochloride (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
  • Netupitant (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

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Other names

Tretinoin (topical use) is also known as


Tretinoin (topical use) in other languages or writings:

Group

Tretinoin (topical use) belongs to this group or family:

Tradenames

Main tradenames from several countries containing Tretinoin (topical use) in its composition:

List of 16 tradenames

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 50 (Percutan: 0.8 - 1.4) %
Molecular weight 300 daltons
Protein Binding > 95 %
VD 0.4 l/Kg
pKa 4.76 -
Tmax 1 - 2 hours
T½ 0.7 (0.5 - 2) hours

References

  1. LactMed. Drugs and Lactation Database (LactMed). Internet. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/ 2006 - Consulted on April 16, 2024 Full text (link to original source)
  2. Hale TW. Medications & Mothers' Milk. 1991- . Springer Publishing Company. Available from https://www.halesmeds.com Consulted on April 10, 2024 Full text (link to original source)
  3. AEMPS. Tretinoina crema. Ficha técnica. 2020 Full text (in our servers)
  4. Atzenhoffer M, Pierre S, Bellet F, Pinel S, Javot L, Vial T, Kassai B, Auffret M.1 Gynecomastia and galactorrhea: Unlabeled adverse drug reactions of retinoids used in dermatology. Drug Safety. 2018;41:1198–9. Poster 1274. Abstract Full text (link to original source) Full text (in our servers)
  5. Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Wolters Kluwer Health. Tenth edition (acces on line) 2015
  6. Butler DC, Heller MM, Murase JE. Safety of dermatologic medications in pregnancy and lactation: Part II. Lactation. J Am Acad Dermatol. 2014 Mar;70(3):417.e1-10; quiz 427. Abstract
  7. Kong YL, Tey HL. Treatment of acne vulgaris during pregnancy and lactation. Drugs. 2013 Jun;73(8):779-87. Abstract
  8. Valeant. Tretinoin gel. Drug Summary. 2012 Full text (in our servers)
  9. Leachman SA, Reed BR. The use of dermatologic drugs in pregnancy and lactation. Dermatol Clin. 2006 Abstract
  10. Akhavan A, Bershad S. Topical acne drugs: review of clinical properties, systemic exposure, and safety. Am J Clin Dermatol. 2003 Abstract
  11. van Hoogdalem EJ. Transdermal absorption of topical anti-acne agents in man; review of clinical pharmacokinetic data. J Eur Acad Dermatol Venereol. 1998 Abstract
  12. Lucek RW, Colburn WA. Clinical pharmacokinetics of the retinoids. Clin Pharmacokinet. 1985 Jan-Feb;10(1):38-62. Review. Abstract

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