Retinoids may cause fetal harm when administered to a pregnant woman.
In rats, tazarotene 0.05% gel, administered topically during gestation
days 6 through 17 at 0.25 mg/kg/day (1.5 mg/m²/day) resulted in reduced
fetal body weights and reduced skeletal ossification. Rabbits dosed topically
with 0.25 mg/kg/day (2.75 mg/m² total body surface area/day) tazarotene
gel during gestation days 6 through 18 were noted with single incidences of
known retinoid malformations, including spina bifida, hydrocephaly, and heart
anomalies. Systemic daily-exposure (AUCde) to tazarotenic acid at topical doses
of 0.25 mg/kg/day tazarotene in a gel formulation in rats and rabbits represented
0.62 and 6.7 times, respectively, the AUC0-24h observed in psoriatic patients
treated with 2 mg/cm² of tazarotene gel 0.1% (extrapolated for topical
application over 20% body surface area), and 0.78 and 8.4 times, respectively,
the maximum AUC0-24h in acne patients treated with 2 mg/cm² of tazarotene
gel 0.1% over 15% (targeted) body surface area.
As with other retinoids, when tazarotene was given orally to experimental animals,
developmental delays were seen in rats, and teratogenic effects and post-implantation
loss were observed in rats and rabbits at AUCde values that were 0.55 and 13.2
times, respectively, the AUC0-24h observed in psoriatic patients treated with
2 mg/cm² of tazarotene gel 0.1% (extrapolated for topical application over
20% body surface area), and 0.68 and 16.4 times, respectively, the maximum AUC0-24h
in acne patients treated with 2 mg/cm² of tazarotene gel 0.1% over 15%
(targeted) body surface area.
In a study of the effect of oral tazarotene on fertility and early embryonic
development in rats, decreased number of implantation sites, decreased litter
size, decreased numbers of live fetuses, and decreased fetal body weights, all
classic developmental effects of retinoids, were observed when female rats were
administered 2 mg/kg/day from 15 days before mating through gestation day 7.
A low incidence of retinoid-related malformations at that dose was reported
to be related to treatment. This dose produced an AUCde that was 1.7 times the
AUC0-24h observed in psoriatic patients treated with 2 mg/cm² tazarotene
gel 0.1% (extrapolated for topical application over 20% body surface area) and
2.1 times the maximum AUC0-24h in acne patients treated with 2 mg/cm² of
tazarotene gel 0.1% over 15% (targeted) body surface area.
SYSTEMIC EXPOSURE TO TAZAROTENIC ACID IS DEPENDENT UPON THE EXTENT OF THE BODY
SURFACE AREA TREATED. IN PATIENTS TREATED TOPICALLY OVER SUFFICIENT BODY SURFACE
AREA, EXPOSURE COULD BE IN THE SAME ORDER OF MAGNITUDE AS IN THESE ORALLY TREATED
ANIMALS. ALTHOUGH THERE MAY BE LESS SYSTEMIC EXPOSURE IN THE TREATMENT OF ACNE
OF THE FACE ALONE DUE TO LESS SURFACE AREA FOR APPLICATION, TAZAROTENE IS A
TERATOGENIC SUBSTANCE, AND IT IS NOT KNOWN WHAT LEVEL OF EXPOSURE IS REQUIRED
FOR TERATOGENICITY IN HUMANS (SEE CLINICAL PHARMACOLOGY: Pharmacokinetics).
There were thirteen reported pregnancies in patients who participated in clinical
trials for topical tazarotene. Nine of the patients were found to have been
treated with topical tazarotene, and the other four had been treated with vehicle.
One of the patients who was treated with tazarotene cream elected to terminate
the pregnancy for non-medical reasons unrelated to treatment. The other eight
pregnant women who were inadvertently exposed to topical tazarotene during clinical
trials subsequently delivered apparently healthy babies. As the exact timing
and extent of exposure in relation to the gestation times are not certain, the
significance of these findings is unknown.
TAZORAC® (tazarotene gel) Gel is contraindicated in women who are or may become pregnant.
If this drug is used during pregnancy, or if the patient becomes pregnant while
taking this drug, treatment should be discontinued and the patient apprised
of the potential hazard to the fetus. Women of child-bearing potential should
be warned of the potential risk and use adequate birth-control measures when
TAZORAC® (tazarotene gel) Gel is used. The possibility that a woman of childbearing
potential is pregnant at the time of institution of therapy should be considered.
A negative result for pregnancy test having a sensitivity down to at least 50
mIU/mL for human chorionic gonadotropin (hCG) should be obtained within 2 weeks
prior to TAZORAC® (tazarotene gel) Gel therapy, which should begin during a normal
menstrual period (see also PRECAUTIONS: Pregnancy: Teratogenic
Effects).
TAZORAC® (tazarotene gel) Gel is contraindicated in individuals who have shown hypersensitivity
to any of its components.
Last reviewed on RxList: 4/19/2011
This monograph has been modified to include the generic and brand name in many instances.