Bexarotene (Targretin)

Bexarotene is a type of cancer drug called a retinoid. It is also known as Targretin. 

It is a treatment for advanced skin lymphomas called cutaneous T cell lymphomas. These include mycosis fungoides and Sezary syndrome.

You pronounced bexarotene as becks-a-roh-teen. 

How does bexarotene work?

Bexarotene is a retinoid. Retinoids are drugs related to vitamin A. They work by slowing or stopping the overgrowth of normal cells.

How do you take bexarotene?

Bexarotene is a capsule. You take the capsules once a day. The number of capsules you take each day depends on your individual needs.

Swallow the capsules whole (do not chew) with plenty of water. You take them with food or immediately after eating. Don't take bexarotene on an empty stomach.

Taking capsules

Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.

You should take the right dose, not more or less.

Talk to your healthcare team before you stop taking or miss a dose of a cancer drug.

How often do you have bexarotene?

You usually continue taking bexarotene for as long as the treatment works. 

Tests

You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

What are the side effects of bexarotene?

Side effects can vary from person to person. They also depend on what other treatment you are having. 

When to contact your team

Your doctor, pharmacist or nurse will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:

• you have severe side effects

• your side effects aren’t getting any better

• your side effects are getting worse

• the side effects are affecting your daily life

Early treatment can help manage side effects better. 

We haven't listed all the side effects here. Remember it is very unlikely that you will have all of these side effects, but you might have some of them at the same time.

Common side effects

These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:

Increases risk of infection

Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, headaches, feeling cold and shivery and generally unwell. You might have other symptoms depending on where the infection is.

Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection. 

Low levels of thyroid hormones (hypothyroidism)

The level of your thyroid hormones may drop (hypothyroidism). You may feel tired or cold, gain weight, feel sad or depressed, or your voice may deepen. You will have regular blood tests to check your thyroid hormone levels.

Changes to the level of fats in the blood

This drug raises the amount of cholesterol and triglycerides in your blood. You will have regular blood tests to check this.

Skin reactions

This can include itching, rash, redness, irritation and peeling. Contact your health advice line or tell your healthcare team. 

Increased skin sensitivity to sunlight

Don’t use sunbeds or sit in the sun. Cover up or use a sun block if you go out in the sun. Remember to put sun cream on your head or wear a hat if you have lost any hair there.

Pain in the muscles and joints

You might feel some pain from your muscles and joints. Speak to your doctor or nurse about what painkillers you can take to help with this.

Headache

Tell your healthcare team if you keep getting headaches. They can give you painkillers to help.

Tiredness and weakness (fatigue)

Tiredness and weakness (fatigue) can happen during and after treatment. Doing gentle exercises each day can keep your energy up. Don't push yourself, rest when you start to feel tired and ask others for help.

Occasional side effects

These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:

• swelling of the lymph nodes or feeling like your lymphoma is getting worse
• a drop in red blood cells causing paleness and tiredness
• weight gain
• changes to how your liver and kidneys work
• low levels of sodium in the blood
• reduced sense of touch and numbness
• dizziness
• difficulty sleeping
• eye problems including dry eyes, irritation and heaviness
• swelling of the arms and legs
• feeling or being sick
• diarrhoea or constipation, wind (flatulence)
• loss of appetite and weight loss
• dry mouth
• skin problems such as ulcers, nodules, acne, dryness and abnormal skin growth
• swollen lips
• increased sweating
• pain in the bones or tummy (abdomen)
• chills
• an allergic reaction
• changes to your hormone levels
• hair loss

Rare side effects

These side effects happen in fewer than 1 in 100 people (fewer than 1%). You might have one or more of them. They include:

• problems with your blood clotting causing red or purple coloured areas on the skin (purpura)
• an increase or decrease of platelets in the blood
• changes to the number of white cells in your blood (cells that fight infection)
• gout
• problems with coordination, balance and speech
• nerve pain
• depression
• agitation
• cataracts
• inflammation of the eyes and eyelids, infection of the eyes (conjunctivitis) or lazy eye
• changes to your eyesight (vision)
• ear problems
• a fast heart rate (tachycardia)
• high blood pressure (hypertension)
• swelling
• varicose veins
• inflammation of the pancreas
• liver failure
• problems with your stomach, gut and bowels (digestive system)
• an excess amount of fluid draining from an opening in the body such as a wound
• herpes simplex infection
• skin and nail changes (which can include colour)
• skin infection such as cellulitis
• back pain
• protein in the urine
• problems with the lining of your mouth, nose throat and gut (ulcers)
• another cancer
• high temperature (fever)
• weakness in the muscles in the eyes, face and other muscles
• mental health changes and mood disturbances

Coping with side effects

We have more information about side effects and tips on how to cope with them.

What else should I know?

Other medicines, food and drink

Cancer drugs can interact with medicines, herbal products, and some food and drinks. We are unable to list all the possible interactions that may happen. An example is grapefruit or grapefruit juice which can increase the side effects of certain drugs.

Tell your healthcare team about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies. Also let them know about any other medical conditions or allergies you may have.

Loss of fertility

It is not known whether this treatment affects fertility in people. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.

Pregnancy and contraception

This drug may harm a baby developing in the womb. It is important not to become pregnant or get someone pregnant while you are having treatment with this drug and for at least a month afterwards.

Talk to your doctor or nurse about effective contraception before starting treatment. Let them know straight away if you or your partner become pregnant while having treatment.

Breastfeeding

Don’t breastfeed during this treatment because the drug may come through into your breast milk.

Treatment for other conditions

If you are having tests or treatment for anything else, always mention your cancer treatment. For example, if you are visiting your dentist.

Immunisation

Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and one of the shingles vaccines called Zostavax.

You can have:

• other vaccines, but they might not give you as much protection as usual
• the flu vaccine (as an injection)
• the coronavirus (COVID-19) vaccine - talk to your doctor or pharmacist about the best time to have it in relation to your cancer treatment

Members of your household who are aged 5 years or over are also able to have the COVID-19 vaccine. This is to help lower your risk of getting COVID-19 while having cancer treatment and until your immune system recovers from treatment.

Contact with others who have had immunisations - You can be in contact with other people who have had live vaccines as injections. Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine. Sometimes people who have had the live shingles vaccine can get a shingles type rash. If this happens they should keep the area covered.

If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray as this is a live vaccine. This is for 2 weeks following their vaccination.

Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to change their nappies during this time if you can. If this isn't possible, wash your hands well after changing their nappy.

More information about this treatment

For further information about this treatment and possible side effects go to the electronic Medicines Compendium (eMC) website. You can find the patient information leaflet on this website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.