Drug General Information (ID: DDIY9458DH)
Drug Name			Tretinoin		Drug Info		Aprotinin		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Keratolytic Agents				Serine Protease Inhibitor
Structure

Mechanism of Tretinoin-Aprotinin Interaction (Severity Level: Major)
Additive thrombogenic effects Click to Show/Hide Mechanism Graph
Drug Name		Tretinoin				Aprotinin
Mechanism		Thrombogenic effects				Thrombogenic effects
Key Mechanism Factor 1
		Factor Name		Thrombogenic effects
		Factor Description		Drug-induced thrombosis disrupts the balance between thrombogenic factors and protective mechanisms and tends to produce thrombosis. Drug-induced thrombosis usually causes venous thrombotic events, and arterial thrombotic events are also noted as a result of drug administration
Mechanism Description		Additive thrombogenic effects by the combination of Tretinoin and Aprotinin

Recommended Action
Management		Caution is advised when tretinoin is prescribed in combination with antifibrinolytic agents such as aminocaproic acid, aprotinin, or tranexamic acid. Patients should be advised to seek medical attention immediately if they experience potential signs and symptoms of blood clots such as chest pain, shortness of breath, hemoptysis, hematuria, sudden loss of vision, and pain, redness or swelling in an extremity.

References
1	Product Information. Vesanoid (tretinoin). Roche Laboratories, Nutley, NJ.
2	Product Information. LYSTEDA (tranexamic acid). Xanodyne Pharmaceuticals Inc, Newport, KY.
3	Hashimoto S, Koike T, Tatewaki W, et al. "Fatal thromboembolism in acute promyelocytic leukemia during all-trans retinoic acid therapy combined with antifibrinolytic therapy for prophylaxis of hemorrhage." Leukemia 8 (1994): 1113-5.[PMID: 8035603]