General

Pronunciation:
taz-ar-oh-teen

Trade Name(s)

• Arazlo
• Fabior
• Tazorac

Ther. Class.

antiacne agents

antipsoriatics

cosmetic agents

Pharm. Class.

retinoids

Indications

• 0.1% foam, cream, and gel, and 0.045% lotion: Mild to moderate acne vulgaris.
• 0.05% and 0.1% cream and gel: Stable plaque psoriasis.

Action

Has antihyperproliferative and anti-inflammatory effects; also normalizes differentiation.

Therapeutic Effect(s):

Decreased severity of acne vulgaris or plaque psoriasis.

Pharmacokinetics

Absorption: A prodrug that is rapidly converted to its active form, tazarotenic acid. Minimal systemic absorption.

Distribution: Unknown.

Protein Binding: >99%.

Metabolism and Excretion: Highly metabolized and excreted via urine and feces.

Half-life: 8.1 hr.

TIME/ACTION PROFILE (improvement in lesions)

Contraindication/Precautions

Contraindicated in:

• OB:  Pregnancy;
• Lactation: Lactation.

Use Cautiously in:

• History of local irritation/sensitivity;
• Personal/family history of skin cancer;
• History of eczema;
• Weather extremes;
• Concurrent use of photosensitizers;
• Rep:  Women of reproductive potential;
• Pedi:  Safety and effectiveness not established in children <12 yr (cream, foam, and gel) and <9 yr (lotion).

Adverse Reactions/Side Effects

Local: burning/stinging, dry skin, itching, peeling, photosensitivity, red skin, skin pain (psoriasis), worsening of psoriasis

* CAPITALS indicate life-threatening.
Underline indicate most frequent.

Interactions

Drug-Drug

• Concurrent use of other irritant/drying topical medications  may risk of irritant/drying reactions.
• Concurrent use of  oxidizing agents  including  benzoyl peroxide, may decrease effectiveness by inactivating tazarotene.
• ↑ risk of photosensitivity reactions with other  photosensitizing drugs, including  fluoroquinolones,  phenothiazines,  sulfonamides,  tetracyclines, and  thiazides.

Route/Dosage

Topical (Adults and Children ≥12 yr): Apply once daily (not recommended for use longer than 12 wk for acne or 12 mo for plaque psoriasis).

Topical (Adults and Children ≥9 yr): Lotion: Apply once daily.

Availability (generic available)

Cream (Tazorac): 0.05%, 0.1%

Foam (Fabior): 0.1%

Gel (Tazorac): 0.05%, 0.1%

Lotion (Arazlo): 0.045%

In Combination with: halobetasol (Duobrii). See combination drugs.

Assessment

• Assess skin lesions before and periodically during therapy.

Lab Test Considerations:

Obtain a negative serum or urine pregnancy test having a sensitivity down to at least 25 mIU/mL for human chorionic gonadotropin within 2 wk prior to tazarotene therapy. Begin therapy during a normal menstrual period for females of reproductive potential.

Implementation

• Topical 

  Acne:  Wash with a mild cleanser and fully dry affected area in the evening; then apply once daily. Shake can before use. Dispense a small amount of foam, cream, gel, or lotion into palm of hand. Use fingertips to apply only enough product to lightly cover the entire affected areas of the face and/or upper trunk with a thin layer. Massage product gently into skin until the foam disappears. Avoid the eyes, lips, and mucous membranes. Wash hands after application. Store can upright; do not freeze.

  • May use moisturizer as needed.
  • If undue irritation (redness, peeling, or discomfort) occurs, reduce frequency of application or temporarily interrupt treatment. Treatment may be resumed once irritation subsides. Discontinue treatment if irritation persists.
• Topical Psoriasis:  Apply a thin film of cream or gel once per day in the evening, to cover only lesions. If a bath or shower is taken prior to application, dry skin before applying cream or gel. If emollients used, apply at least 1 hr before application of cream or gel. Unaffected skin may be more susceptible to irritation; avoid application to unaffected areas.

Patient/Family Teaching

• Instruct patient on correct technique for application.
• Caution patient to wear sunscreen and protective clothing to prevent photosensitivity reactions. Avoid tanning beds and sunlamps. Wind and cold weather may also irritate skin.
• Inform patient foam is flammable. Avoid fire, flame, or smoking during and immediately following application.
• Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications.
• Rep:  May cause fetal harm. Advise females of reproductive potential to use an effective form of contraception during therapy and notify health care professional if pregnancy is planned or suspected or if breastfeeding.

Evaluation/Desired Outcomes

Decreased severity of acne vulgaris or plaque psoriasis.