Quali-A

Quali-A Uses, Dosage, Side Effects, Food Interaction and all others data.

Quali-A is structurally and pharmacologically related to vitamin A. Current evidence suggests that topical Quali-A decreases cohesiveness of follicular epithelial cells with decreased microcomedone formation. Additionally, Quali-A stimulates mitotic activity and increases turnover of follicular epithelial cells, causing extrusion of the comedones

Quali-A, also known as all-trans-retinoic acid (ATRA), is a naturally occurring derivative of vitamin A (retinol). Retinoids such as tretinoin are important regulators of cell reproduction, proliferation, and differentiation and are used to treat acne and photodamaged skin and to manage keratinization disorders such as ichthyosis and keratosis follicularis. Quali-A also represents the class of anticancer drugs called differentiating agents and is used in the treatment of acute promyelocytic leukemia (APL).

Trade Name Quali-A
Availability Prescription only
Generic Tretinoin
Tretinoin Other Names Acide retinoique, all trans Retinoic acid, all trans-Retinoic acid, all-(E)-Retinoic acid, all-trans-Retinoic acid, all-trans-Tretinoin, all-trans-Vitamin A acid, all-trans-Vitamin A1 acid, ATRA, beta-Retinoic acid, Retinoic acid, Retionic acid, trans-Retinoic acid, Tretin M, Tretinoin, Tretinoina, Trétinoïne, Tretinoinum, Vitamin A acid
Related Drugs arsenic trioxide, Trisenox, Vesanoid
Type
Formula C20H28O2
Weight Average: 300.442
Monoisotopic: 300.208930142
Protein binding

> 95%

Groups Approved, Investigational, Nutraceutical
Therapeutic Class Topical retinoid and related preparations
Manufacturer
Available Country Hong Kong
Last Updated: September 19, 2023 at 7:00 am
Quali-A
Quali-A

Uses

  • For the treatment of acne vulgaris in which comedones, papules and pustules predominate.
  • For the treatment of hyperpigmentation, roughness and fine wrinkling of photodamaged skin due to chronic sun exposure.
  • For the treatment of Acute promyelocytic leukaemia

Quali-A is also used to associated treatment for these conditions: Acne Vulgaris, Alopecia, Cornification and dystrophic skin disorders, FAB classification M3 Acute promyelocytic leukemia, Skin hyperpigmentation, Solar Lentigines, Facial fine wrinkling, Keratinization disorders of the feet, Keratinization disorders of the hand, Moderate Melasma, Mottled hyperpigmentation, Severe Melasma, Severe, recalcitrant Cystic acne, Tactile roughness of facial skin

How Quali-A works

Quali-A binds to alpha, beta, and gamma retinoic acid receptors (RARs). RAR-alpha and RAR-beta have been associated with the development of acute promyelocytic leukemia and squamous cell cancers, respectively. RAR-gamma is associated with retinoid effects on mucocutaneous tissues and bone. Although the exact mechanism of action of tretinoin is unknown, current evidence suggests that the effectiveness of tretinoin in acne is due primarily to its ability to modify abnormal follicular keratinization. Comedones form in follicles with an excess of keratinized epithelial cells. Quali-A promotes detachment of cornified cells and the enhanced shedding of corneocytes from the follicle. By increasing the mitotic activity of follicular epithelia, tretinoin also increases the turnover rate of thin, loosely-adherent corneocytes. Through these actions, the comedo contents are extruded and the formation of the microcomedo, the precursor lesion of acne vulgaris, is reduced. Quali-A is not a cytolytic agent but instead induces cytodifferentiation and decreased proliferation of APL cells in culture and in vivo. When Quali-A is given systemically to APL patients, tretinoin treatment produces an initial maturation of the primitive promyelocytes derived from the leukemic clone, followed by a repopulation of the bone marrow and peripheral blood by normal, polyclonal hematopoietic cells in patients achieving complete remission (CR). The exact mechanism of action of tretinoin in APL is unknown.

Dosage

Quali-A dosage

Quali-A cream: Quali-A cream should be applied sparingly to the whole affected area once or twice daily. The skin should be thoroughly cleaned and dried before application. Patient should be advised that 6 to 8 weeks of treatment may be required before a therapeutic effect is observed. Moisturisers and cosmetics may be used during treatment with Cosmotrin cream but should not be applied to the skin at the same time. Astringent toiletries should be avoided.

Quali-A gel: Quali-A gel should be applied once or twice a day, before retiring, to the skin where lesions appear, using enough to cover the entire affected area lightly. The frequency of application can be adjusted to obtain maximum clinical efficacy with minimal erythema and scaling.

If Quali-A gel is applied excessively, no more rapid or better results will be obtained and marked redness, peeling or discomfort may occur. Should this occur accidentally or through over-enthusiastic use, application should be discontinued for few days.

Patience is needed in this treatment, since the therapeutic effects will not usually be observed until after 6-8 weeks of treatment. During the early weeks of treatment, an apparent exacerbation of inflammatory lesions may occur. This is due to the action of the medication on deep, previously unseen comedones and papules. Once the acne lesions have responded satisfactorily, it should be possible to maintain the improvement with less frequent applications.

Moisturizers and cosmetics may be used during treatment with Quali-A gel but should not be applied to the skin at the same time. The skin should be thoroughly washed before application of Quali-A gel. Astringent toiletries should be avoided.

Capsule: The recommended dose is 45 mg/m2/day administered as two evenly divided doses until complete remission is documented. Therapy should be discontinued 30 days after achievement of complete remission or after 90 days of treatment, whichever occurs first.

If after initiation of treatment of Quali-A the presence of the translocation is not confirmed by cytogenetics and/or by polymerase chain reaction studies and the patient has not responded to Quali-A, alternative therapy appropriate for acute myelogenous leukemia should be considered.

Side Effects

True allergic contact dermatitis is rare but a primary irritant dermatitis, manifesting itself as irritation, erythema, peeling and sensation of warmth, is common. Slight stinging is common as a mild reaction in many people but usually settles with continuous use and/or reduction in the frequency of application of the drug.

Interaction

Particular caution should be exercised in using preparations containing peeling agents (i.e. sulfur, resorcinol, benzoyl peroxide or salicylic acid). Use of topical preparations with high concentrations of alcohol, menthol, spices or lime- such as shaving lotions, astringents and perfume- should be avoided, especially during initial therapy.

Food Interaction

  • Take with food. Quali-A absorption may be increased by co-administration with food.

Quali-A Cholesterol interaction

[Moderate] A reversible elevation of cholesterol and

Venous thrombosis and myocardial infarction have occurred in patients at low risk for such complications.

Therapy with tretinoin should be administered cautiously in patients with or predisposed to hypercholesterolemia and

Clinical monitoring of lipid profile is recommended.

Elimination Route

1-31% (topical)

Half Life

0.5-2 hours

Pregnancy & Breastfeeding use

Quali-A is contraindicated in pregnancy or suspected pregnancy. The drug should be avoided by breast feeding mothers.

Contraindication

Quali-A is contraindicated in patients who are allergic to this drug. It is contraindicated in pregnancy or suspected pregnancy. It is also contraindicated in personal or familial history of cutaneous epithelioma.

Local irritation: The presence of cutaneous irritative signs (e.g. erythema, peeling, pruritus, sunburn, etc.) should prohibit initiation or recommencement of treatment with Quali-A until the symptoms resolve. Quali-A has been reported to cause severe irritation on eczematous skin and should be used with caution in patients with this condition.

Exposure to sunlight: Exposure to sunlight, including ultraviolet sun-lamps, should be avoided or minimised during the use of Quali-A.

General precaution: Before application of Quali-A, areas to be treated should be cleansed thoroughly. Abstain from washing the treated area frequently; twice daily is sufficient. Use of mild soap is recommended. Dry the skin without rubbing.

Avoid contact with eyes, eyelids, nostrils, mouth and mucous membranes. If contact in these areas occurs, careful washing with water is recommended.

Storage Condition

Store in a cool and dry place, away from light. Keep out of reach of children.

Innovators Monograph

You find simplified version here Quali-A

Quali-A contains Tretinoin see full prescribing information from innovator Quali-A Monograph, Quali-A MSDS, Quali-A FDA label

FAQ

What is Quali-A used for?

Quali-A used to treat acne and sun-damaged skin. It can't erase deep wrinkles, but it can help improve the appearance of surface wrinkles, fine lines, and darks spots.

How safe is Quali-A?

Quali-A is a safe and effective medication. However, some users experience side effects ranging from minor skin irritation that goes away with long-term use to more severe adverse effects.

What are the common side effects of Quali-A?

Common side effects of Quali-A are include:

  • Burning, itching, stinging, scaling, or redness of the skin.
  • chapping or slight peeling of the skin (mild)
  • darkening of the skin.
  • lightening of normal skin color.
  • lightening of treated areas of dark skin.
  • redness of skin (mild)
  • unusual dryness of skin (mild)
  • unusually warm skin (mild)

Is Quali-A safe during pregnancy?

Because many individuals have used tretinoin during pregnancy and have not had babies with a birth defect, the chance for birth defects is probably low. However, it is generally recommended not to use tretinoin in pregnancy.

Is Quali-A safe during breastfeeding?

Quali-A is generally considered compatible with breastfeeding. absorption of Quali-A via topical sources is reported to be minimal, and breastmilk concentrations would likely be minimal to none.

Can I drink alcohol with Quali-A?

Topical retinoid drugs do not have interactions with alcoholic beverages.

Can I drive after taking Quali-A?

You should know that Quali-A may cause dizziness or severe headache.Do not drive a car or operate machinery until you know how this medication affects you.

What should I not use after tretinoin?

Unless your doctor tells you otherwise, it is especially important to avoid using the following skin products on the same area as Quali-A: Any other topical acne product or skin product containing a peeling agent.

When should I not use Quali-A?

Most of the time, Quali-A cream is safe even if you have sensitive skin. However, if you experience a severe skin reaction, an uncomfortable or painful skin rash, or a severe breakout that doesn't heal within one month, you should contact your doctor for assistance.

Where should I not use Quali-A?

Do not apply this medicine to windburned or sunburned skin or on open wounds. Do not use this medicine in or around the eyes or lips, or inside of the nose. Spread the medicine away from these areas when applying. If it accidentally gets on these areas, wash with water at once.

Does Quali-A lighten skin?

It works by lightening the skin, replacing older skin with newer skin, and slowing down the way the body removes skin cells that may have been harmed by the sun.

Can I leave Quali-A on overnight?

Usually Quali-A is applied at night so that it does not cause a problem with any other topical products that you might use during the day.

Does Quali-A affect fertility?

Quali-A must not be taken by patients who are pregnant or who may become pregnant. There is a high risk that tretinoin will cause the baby to be born with birth defects.

Does Quali-A increase facial hair?

Quali-A was shown to stimulate some hair regrowth in approximately of the subjects studied.

Can Quali-A cause liver damage?

Liver damage which may cause yellowing of eyes and skin enlarged liver and spleen.

Does Quali-A heal scars?

Quali-A in several forms has been tested successfully as an effective way to treat acne scars.Quali-A is also sometimes used to prep skin for chemical peel treatments that target scarring.

What happens if I stop using Quali-A?

If you stop using the medication or are inconsistent with your treatment, any improvements you see may disappear over time.

Will I breakout if I stop using Quali-A?

Most people can expect to see results within four to six weeks and will continue to see results for as long as they use it. While it's possible for tretinoin to eliminate some dark spots and discolorations, it's also possible for acne to come back once discontinuing Quali-A.

Can I use Quali-A forever?

Studies also show that it's safe to use Quali-A over the long term, with some studies examining the effects of Quali-A for as long as four years.

What happens if I use too much Quali-A?

excessive amounts of Quali-A onto the skin to make acne go away faster will not work. This can make the skin worse by causing extreme dryness, peeling, or redness. It may take up to six weeks of Quali-A treatment to see results.

Is Quali-A bad for my skin?

Like all retinoids Quali-A can thin your skin, making it more prone to sun damage and sunburn.

*** Taking medicines without doctor's advice can cause long-term problems.
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