Trifarotene (Aklief®)

Trifarotene is available as a prescription topical treatment. It is available in the form of a cream.

• Available forms:
  
  
  • Topical treatment: 
    
    
    • Cream:
      Available as prescription
      Generic available (US)
    • Brand names (US):
      • Aklief^®
• Available in this dose:
  
  
  • Cream: 0.005%
• Who is it for?
  
  
  • Gender:
    • Males and females
  • Severity of acne:
    • Mild-to-moderate acne
  • Age:
    • Children 9 years and older, adolescents, and adults
  • Other:
    • It is also prescribed to treat hypo-/hyperpigmentation marks left behind after acne lesions heal (post-inflammatory hypo- or hyperpigmentation)
    • It is also prescribed for ichthyoses – a skin condition characterized by dry, itchy skin, often red, rough, and flaky

How to use it:

Trifarotene is a topical treatment and is available as a cream for the treatment of acne. 

Trifarotene is usually applied once a day, in the evening before going to bed. 

When you start with trifarotene cream, your acne may initially seem to become worse. You may also experience skin irritation and sometimes moderate-to-severe irritation. Visible improvement in acne is usually seen after 4 weeks of treatment. Applying more trifarotene will not speed up the healing process. If your symptoms do not improve within 8 to 12 weeks or get worse even after the first 4 weeks, contact your physician. 

The amount and frequency of application may vary between individuals. Your physician will specify how much of the medication you need to apply and how often. Your physician may adjust the dose and frequency of the treatment, or even temporarily stop treatment, depending on the improvement of your acne or the side-effects you experience.

Keep regular appointments with your physician so that your response to the treatment may be monitored.

Trifarotene should only be applied to intact skin. If the skin is scraped, irritated, or sunburned, or eczematous, do not apply trifarotene until the skin has healed completely. If trifarotene gets into a cut or scrape, rinse it off with water. 

Moisturizers may be used to lessen skin irritation and other skin reactions such as dryness, redness, scaling, burning, or stinging when using trifarotene. Apply the moisturizer first and wait until it is fully absorbed (usually 1 hour) before applying trifarotene. 

Do not get trifarotene in your eyes, nose, or mouth. If it does get into your eyes, wash your eyes with a generous amount of water and seek medical attention if there is any persisting irritation. 

Follow the instructions on your prescription carefully and use trifarotene exactly as prescribed by your physician. Do not change the dose or the frequency of your medication because this may cause skin irritation. If you have any questions about the medication or the prescription, ask your physician or pharmacist. 

• Cream:
  • Before applying trifarotene, wash the acne-affected skin with water and a mild cleanser. Rinse the skin and pat dry with a soft towel. You can ask your physician to recommend a gentle cleanser. 
  • Wait at least 20 to 30 minutes after washing your skin before applying the trifarotene cream. Wash your hands again before applying it to your skin.
  • Trifarotene cream comes with a pump. Press down one time when applying trifarotene to face and two times when using trifarotene for acne on your upper back, shoulders and chest.
  • Apply a thin layer of cream on acne-affected areas.
  • Do not use bandages, dressings, or wrappings to cover the affected area.
  • Once you have finished applying the medication, wash your hands with soap and water. 
  • While on trifarotene treatment, apply skin moisturizing cream or lotion as often as needed to reduce trifarotene-induced skin irritation.
  • Keep trifarotene cream at room temperature away from heat in a well closed tube.

Be aware of:

• Before using trifarotene, let your physician or pharmacist know if you are allergic to trifarotene or to any of the other ingredients in the cream. 
• Before using trifarotene, inform your physician about the prescription and non-prescription medications, vitamins, nutritional supplements, and herbal products you are using/taking. 
• If you are using trifarotene, talk to your physician before taking vitamin A supplements because trifarotene cream contains a form of vitamin A.
• If you are using benzoyl peroxide in addition to trifarotene, apply benzoyl peroxide at a different time of day.
• Before applying trifarotene, inform your physician if you have or you ever had eczema.
• Before using trifarotene, inform your physician if you or a family member currently has or has ever had skin cancer. 
• If you are using trifarotene, you should not become pregnant because the impact of trifarotene on the fetus is poorly understood. You need to have a negative pregnancy test within 2 weeks before starting trifarotene. Stop trifarotene immediately when you become pregnant during treatment and call your physician. Talk to your physician about birth control methods during the treatment period to avoid pregnancy. If you are planning to become pregnant, talk to your physician. 
• If you are using trifarotene and are breastfeeding, talk to your physician about using trifarotene during this period.
• Trifarotene may make your skin more sensitive to sunlight or extreme weather so avoid unnecessary direct or prolonged exposure to sunlight, especially between 10am and 3pm, and wear protective clothing, sunglasses, and sunscreen (with an SPF of at least 15) while using trifarotene. Avoid prolonged exposure to cold and wind as well. Do not use a sunlamp or tanning bed. Inform your physician if you develop a skin rash, itching, redness or other discoloration of the skin, or a severe sunburn after exposure to the sun. 
• Before using trifarotene, inform your physician about the skin and hair care products you use, including soaps, shampoos, cleansers, moisturizers, and cosmetics. Certain products may irritate the skin if used with trifarotene, especially products that are harsh, dry the skin, or contain alcohol, spices, or lime rind. Your physician may want to wait before prescribing trifarotene if you use these products. Ask your physician to recommend products that do not irritate the skin. 
• When using trifarotene, do not use hot wax or remove unwanted hair from an area treated with trifarotene. 
• If trifarotene was prescribed for acne, you can continue your regular diet unless your physician advises otherwise.
• Do not use trifarotene for a skin condition that it was not prescribed for, without consulting your physician first. 
• Do not share your medication with anyone else. 
• Keep your regular appointments with your physician to track your response to trifarotene.

Drug interactions: 

Do not use alcohol-containing or abrasive skin care products or peel off products (including facial masks) while using trifarotene. Inform your physician or pharmacist about all the prescription and non-prescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take before starting trifarotene. Also inform your physician or pharmacist of any skin products you use including soaps, cleansers, moisturizers, and cosmetics. 

The full list of drug interactions (From National Library of Medicine and DailyMed):

• Aminolevulinic acid topical
• Porfimer
• Tazarotene topical
• Acitretin
• Adapalene topical
• Benzoyl peroxide topical
• Isotretinoin
• Methoxsalen
• Salicylic acid topical
• Sulfur topical
• Tretinoin topical
• Verteporfin

Do not swallow

If trifarotene is swallowed, contact an emergency facility or call the American Association of Poison Control Centers at 1 (800) 222-1222 (available 24/7).

If immediate assistance is necessary because the victim has collapsed, had a seizure, has trouble breathing, or can’t be awakened, call 911.

Information can also be found online at https://www.poisonhelp.org/help

What if I miss a dose?

If you are using trifarotene cream, apply the missed dose as soon as you recall that you have missed a dose. However, skip the missed dose if it is almost time for your next dose and continue with your prescribed dosing schedule.

Do not increase the quantity or frequency of application to make up for the missed dose.

Storage:

Store your medication in the container that the pharmacist provided and keep it out of reach and out of sight of children. Many containers can be opened by children. Keep the container tightly closed. Always lock safety caps and immediately place the medication in a safe location that is up and away from the sight of young children, to prevent poisoning (www.upandaway.org).

Store the medication at room temperature. Keep the medication away from excessive heat and moisture – do not store in the bathroom. Do not freeze trifarotene.

Disposal:

Do not keep outdated medication and medication that you no longer use. Unneeded medications should be disposed of in a way that pets, children, and other people cannot consume them. Do not flush the medication down the toilet. Contact your pharmacist to learn about the availability of a medicine take-back program in your neighborhood, or get in touch with your local garbage/recycling department to ensure safe disposal. If you do not have access to a take-back program, you can find more information on safe disposal of medication on the FDA website: (https://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/EnsuringSafeUseofMedicine/SafeDisposalofMedicines/ucm186187.htm)