All Trans-Retinoic Acid (Generic Name)

Other Names: Vasanoid®

About This Drug

All trans-retinoic acid is used to treat cancer. This drug is given orally (by mouth).

Possible Side Effects (More Common)

  • Headache. Dizziness, nausea, and vomiting may occur if the headache is severe.
  • Serious syndrome may occur with use of this drug which is known as Differentiation Syndrome. You may develop a fever, weight gain, and respiratory distress. You will be monitored for signs of this syndrome.
  • Effects on the heart. High doses of this drug can weaken the heart and decrease heart function. Your heart function will be checked as needed. Symptoms may include:
      • Chest pain or symptoms of a heart attack. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes. Or the discomfort may go away and come back. It can feel like uncomfortable pressure, squeezing, fullness, or pain. Sometimes discomfort is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
      • Rapid or irregular heartbeat (palpitations)
      • Difficulty catching your breath
      • Foot, ankle, or leg swelling
      • Difficulty breathing when lying flat
  • Eye problems may include:
      • Excessive tearing
      • Sensitivity to bright light
      • Eye pain or discomfort
      • Blurred or decreased vision
      • Decreased vision
      • Dryness of the eyes
      • Inflamed eyelids or lining of the eyelids.
  • Rash or skin and tissue irritation. You may have redness, peeling, dryness, or itching.
  • Soreness of the mouth and throat. You may have red areas, white patches, or sores that are painful.
  • Dry mouth
  • Flushing of your face, neck and/or chest
  • Some people have diarrhea and some people have constipation
  • Abdominal pain
  • Gastrointestinal bleeding
  • Drowsiness
  • Weakness
  • Dizziness
  • Trouble sleeping
  • Changes in your emotions (depression, anxiety)
  • Changes in blood pressure. In some people, the blood pressure is increase and in others it is decreased.
  • Fever
  • Shivering
  • Sweating
  • Changes in liver enzymes. Liver enzymes will be monitored as needed.
  • Increase in triglyceride and cholesterol in your blood. These will be monitored as needed.
  • Hair loss in some people. It is usually temporary and your hair will grow back after you finish taking this drug.
  • Ear pain or fullness
  • Blood clots. A blood clot in your leg may cause your leg to swell, appear red and warm, and/or cause pain. A blood clot in your lungs may cause shortness of breath, pain when breathing, and/or chest pain.

Possible Side Effects (Less Common)

  • Sensitivity to light (photosensitivity). Photosensitivity means that you may become more sensitive to the effects of the sun, sun lamps, and tanning beds. Your eyes may water more, especially in bright light.
  • Hearing loss

Sexual Problems and Reproductive Concerns

  • Pregnancy warning: This drug is known to have harmful effects on the unborn child, so two effective methods of birth control should be used during your cancer treatment. and for one month after treatment.
  • Genetic counseling is available to you to discuss the effects of this drug therapy on future pregnancies. In addition, a genetic counselor can review the potential risks of problems in the fetus due to this medication if an exposure during pregnancy has occurred.
  • Breast feeding warning : Women are advised not to breast feed during treatment because this drug could enter the breast milk and seriously harm a breast feeding infant.

Treating Side Effects

  • Ask your doctor or nurse about medication to help prevent or lessen headache, nausea, vomiting, constipation, dry eyes, dry mouth, abdominal pain, or diarrhea.
  • Do not put anything on your skin unless your doctor or nurse says you may. Keep the area around the irritated skin clean and dry.
  • Mouth care is very important. Your mouth care should consist of regular, gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of 1/2 teaspoon of salt in 8 ounces of water or 1/2 teaspoon of sodium bicarbonate (baking soda) in 8 ounces of water. This should be done at least after every meal and at bedtime.
  • Avoid mouthwash that contains alcohol. Avoid alcohol and smoking because they can irritate your mouth and throat.
  • Cover up when you are out in the sun. Wear wide-brimmed hats, long-sleeved shirts, and pants. Keep your neck, chest, and back covered.
  • Use sunscreen with SPF 30 or higher when you are out in the sun even for a short time.
  • Avoid sun lamps, tanning booths, and tanning beds.
  • Keep lips moist; apply lip salve as needed.
  • Talk with your doctor or nurse about feelings of anxiety, depression and trouble sleeping.

Food and Drug Interactions

Take All Trans Retinoic Acid with food. Swallow the capsule whole.  Do not chew, break or crush the capsule.

There are no known interactions of All-Trans Retinoic Acid with specific foods. This drug may interact with other medication. Tell your doctor and pharmacist about all the medication and dietary supplements (vitamins, minerals, herbs and others) that you are currently taking.

The safety and effectiveness of dietary supplements and alternative diets are often unknown. Using these might unexpectedly affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's advice.

Allergic Reactions

Serious allergic reactions including anaphylaxis are rare. While you are taking this drug, call 911 immediately if you have any of the following symptoms of an allergic reaction:

  • Difficulty catching your breath
  • Feeling like your tongue or throat are swelling
  • Feeling your heart beat rapidly (palpitations)
  • Dizziness or lightheadedness
  • Flushing/itching/rash/hives

When to Call the Doctor

Call your doctor or nurse immediately if you have any of the following symptoms:

  • Temperature of 100.5 F (38 C) or above
  • Chills
  • Unusual bleeding or bruising
  • Uncontrolled nausea that prevents you from eating or drinking
  • Chest pain or symptoms of a heart attack. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes. Or the discomfort may go away and come back. It can feel like uncomfortable pressure, squeezing, fullness, or pain. Sometimes discomfort is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
  • Rapid or irregular heartbeat
  • Difficulty breathing, new cough
  • Dizziness
  • Severe headache unrelieved by prescribed medication; headache with nausea and vomiting

Call your doctor or nurse as soon as possible if you have any of the following symptoms:

  • Sudden weight gain or weight gain of five pounds or more in one week
  • Foot, ankle or leg swelling
  • Painful mouth or throat that makes it difficult to eat or drink
  • Nausea, vomiting, bone pain or headache unrelieved by prescribed medication
  • Diarrhea of five stools in one day or diarrhea with weakness or lightheadedness
  • Extreme drowsiness that interferes with normal activities
  • Hearing loss
  • Yellowing of the skin or eyes
  • Eye or vision problems
  • Inflamed or dry eyes
  • Hearing loss
  • Rash, redness, peeling, dryness, or itchy skin 
  • Shivering and/or sweating episodes
  • Ear pain or fullness
  • Symptoms of a blood clot in your leg: pain, swelling, redness, and/or warmth
  • Extreme weakness or drowsiness that keeps you from doing your daily activities

Revised March 2011

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