Brand Name

Panretin

Generic Name
Alitretinoin
View Brand Information
FDA approval date: September 10, 2019
Classification: Retinoid
Form: Gel

What is Panretin (Alitretinoin)?

Panretin ® gel is indicated for topical treatment of cutaneous lesions in patients with AIDS-related Kaposi’s sarcoma. Panretin ® gel is not indicated when systemic anti-KS therapy is required . There is no experience to date using Panretin ® gel with systemic anti-KS treatment.

Brand Information

PANRETIN (alitretinoin)
1INDICATIONS AND USAGE
1.1 Kaposi’s Sarcoma
PANRETIN GEL is indicated for topical treatment of cutaneous lesions in adults with AIDS related Kaposi’s sarcoma (KS).
Limitations of Use: PANRETIN GEL is not indicated when systemic anti-KS therapy is required (including more than 10 new KS lesions in the prior month, symptomatic lymphedema, symptomatic pulmonary KS, or symptomatic visceral involvement) [see Clinical Studies (.
2DOSAGE AND ADMINISTRATION
PANRETIN GEL is for topical use only.
  • Apply PANRETIN GEL twice daily to coat the entire cutaneous Kaposi sarcoma lesions.
  • Gradually increase the application frequency up to four (4) times a day as tolerated.
  • Continue PANRETIN GEL as long as patient is deriving benefit.
  • Reduce application frequency for application site toxicity. Interrupt treatment for severe irritation; may resume at a reduced application frequency once symptoms improve.
  • Avoid application of gel to normal skin and do not apply on or near mucosal surfaces.
  • Wash hands after application unless gel is applied to Kaposi sarcoma lesions on the hands.
  • Allow gel to dry for three to five minutes before covering with clothing.
3DOSAGE FORMS AND STRENGTHS
Topical Gel: 0.1% alitretinoin (clear yellow gel) in a 60-gram tube.
4CONTRAINDICATIONS
PANRETIN GEL is contraindicated in patients with a known hypersensitivity to retinoids or to any of the ingredients of the product.
5ADVERSE REACTIONS
The following clinically significant adverse reactions are described elsewhere in the labeling:
5.1Clinical Trials Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.
The safety of PANRETIN GEL was assessed in two multicenter, prospective, randomized, double-blind, vehicle-controlled trials (Trial 1 and Trial 2) in patients with cutaneous lesions of AIDS-related KS
In Trial 1, severe local skin adverse reactions (erythema and edema with or without vesiculation) occurred in 10% of patients during the first 12 weeks of treatment (versus 0% in the vehicle control). Adverse reactions led to withdrawal from the study in 7% of patients.
In Trial 2, severe local skin adverse reactions (erythema and edema with or without vesiculation) occurred in 6% of patients during the first 12 weeks of treatment (versus 0% in the vehicle control) and 1 patient withdrew due to severe skin irritation.
Table 1 lists the most common application site adverse reactions that occurred in a least 5% of patients during the double-blind phase who received PANRETIN GEL in either of the two controlled studies.
TABLE 1: Adverse Reactions at Application Site in Trial 1 and 2 in ≥ 5% of Patients Treated with PANRETIN GEL
6DESCRIPTION
PANRETIN GEL is a retinoid. PANRETIN GEL 0.1% contains alitretinoin and is intended for topical application only. The chemical name is (2E,4E,6Z,8E)-3,7-Dimethyl-9-(2,6,6-trimethyl-1-cyclohexen-1-yl)-2,4,6,8-nonatetraenoic acid, also known as 9-cis-retinoic acid. Chemically, alitretinoin is related to vitamin A. It is a yellow powder with a molecular weight of 300.44 and a molecular formula of C
PANRETIN GEL is a clear, yellow gel containing 0.1% (w/w) alitretinoin. Each gram of PANRETIN GEL contains 1 mg alitretinoin. PANRETIN GEL contains the following inactive ingredients: butylated hydroxytoluene NF, dehydrated alcohol USP 92%, hydroxypropyl cellulose NF, and polyethylene glycol 400 NF.
7CLINICAL STUDIES
14.1 Kaposi’s Sarcoma
PANRETIN GEL was evaluated in two multicenter, randomized, double-blind, vehicle-controlled studies in adult patients with cutaneous lesions of AIDS-related KS. In both studies the primary efficacy objective was the patients’ cutaneous KS tumor response rate through 12 weeks of study drug treatment which was assessed by evaluating from 3 to 8 KS index lesions according to the modified AIDS Clinical Trials Group (ACTG) response criteria as applied to topical therapy (i.e., evaluation of height and area reductions of the index lesions only; progressive disease in non-index lesions and new lesions were not considered progressive disease; progressive disease was scored only in the treated index lesions). A global evaluation by physicians was also carried out. It considered all the patient’s treated lesions (index and other) compared to baseline. In this evaluation, patients with at least a 50% improvement in the KS lesions were considered responders. In addition, photographs of lesions in patients considered responders by the modified ACTG criteria were examined by the FDA for a cosmetically beneficial response, defined as at least a 50% improvement in appearance compared to baseline, considering both the KS lesions and dermal toxicity at the lesion site, in at least 50% of the index lesions and maintained for at least 3 weeks. Visceral disease was not monitored in these trials and the appearance of new KS lesions was not considered part of the response assessment.
In Trial 1, a total of 268 patients were entered from centers in the U.S. and Canada. Patients were treated topically three to four times a day with either PANRETIN GEL or a matching vehicle gel for a minimum of 12 weeks, followed by an open-label phase in patients who had not yet progressed on PANRETIN GEL. Median age of patients was 39 years, 99% were men, 75% were White, 16% Hispanic, and 7% Black. Fifty-seven percent of patients had a CD4+ lymphocyte count <200/mm3 and 36% had CD4+ lymphocyte count less than 100/mm3; 12% had visceral KS. Responses during the double-blind phase are shown in 
Trial 2 was an international study with a planned enrollment of 270 patients. Patients were treated topically twice a day with PANRETIN GEL or a matching vehicle for 12 weeks. The study was stopped early because of positive-interim results in the initial 82 patients. Median age of patients was 36 years for PANRETIN-GEL and 39 years for matching vehicle; all patients were men; 89% White; 5% Hispanic, and 4% Black; 67% had a CD4+ lymphocyte count ≤200/mm3 and 39% had CD4+ lymphocyte count ≤100/mm3; and 16% had visceral KS.
Results of the study are shown in 
Table 2:  Response Rates
*All responses were partial responses except 1% complete response for modified ACTG response in Trial 1. 
In the clinical trials, the cumulative percentage of patients who experienced a response was less than 1% at 2 weeks, 10% at 4 weeks, and 28% at 8 weeks. Photographs of some patients revealed an erythematous and edematous response, leading to a cosmetically mixed outcome.
8HOW SUPPLIED/STORAGE AND HANDLING
PANRETIN GEL is a clear yellow gel and is supplied in a 60-gram tubes containing 0.1% alitretinoin.
9PATIENT COUNSELING INFORMATION
Advise the patient to read the FDA-approved patient labeling (Patient Information).
Embryo-Fetal Toxicity
Advise females to inform their healthcare provider if they are pregnant or become pregnant. Inform females of the risk to a fetus and potential loss of pregnancy
Advise females of reproductive potential to use effective contraception during treatment and for 1 week after the last dose of PANRETIN GEL
Advise males with female partners of reproductive potential to use effective contraception during treatment and for 1 week following the last dose of PANRETIN GEL
Lactation
Advise patients not to breastfeed during treatment with PANRETIN GEL and for 1 week after the last dose of PANRETIN GEL [see Use in Specific Populations (
Photosensitivity
Advice patients that PANRETIN GEL can cause photosensitivity and to avoid sunlight and sunlamps and use measures such as protective clothing in PANRETIN-applied areas [see Warnings and Precautions (
Toxicity with DEET-Containing Products
Advise patients to avoid DEET-containing products such as insect repellant while using PANRETIN GEL [see Warnings and Precautions (
Manufactured for:
                                                                                                                                                                                                            Revised: 11/2025
10PACKAGE LABEL.PRINCIPAL DISPLAY PANEL
tube label
NDC 59212-601-22
Panretin
(alitretinoin) 0.1%