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Generic Tazarotene
Tazarotene 5% is a topical retinoid prodrug indicated for the treatment of stable plaque psoriasis affecting up to 20% of body surface area and for the treatment of mild to moderate facial acne vulgaris. Tazarotene is a prodrug that is rapidly converted to its active form, tazarotenic acid, which binds to retinoic acid receptors (RAR beta and RAR gamma). This normalizes keratinocyte differentiation, reduces epidermal inflammation, and inhibits the proliferation of keratinocytes. The 5% strength is specifically indicated for the treatment of stable plaque psoriasis, while lower strengths (0.05% and 0.1%) are used for acne. Tazarotene is available only by prescription in Canada.
Usual adult dose: For stable plaque psoriasis, apply a thin film of tazarotene 5% cream or gel once daily, preferably in the evening, to the affected psoriatic lesions only, avoiding surrounding uninvolved skin. The treated area should not be covered with occlusive dressings unless directed by a healthcare professional. The duration of treatment is usually up to 12 weeks; if no improvement is seen after 12 weeks, therapy should be reassessed. For acne vulgaris, lower strengths (0.05% or 0.1%) are used once daily. Patients should be advised that a transient sensation of warmth, stinging, or itching may occur during application, and that the medication may cause significant skin irritation, especially during the first weeks of therapy. Emollients may be applied as needed to reduce dryness and scaling. Concomitant use of other potentially irritating topical products (medicated soaps, astringents, high concentrations of alcohol) should be avoided. If severe irritation occurs, the frequency of application may be reduced to every other day or treatment interrupted until the skin recovers. Women of childbearing potential must use effective contraception during treatment and for at least 1 week after discontinuation because tazarotene is teratogenic.
Dosage form: Topical cream and topical gel: 5% tazarotene (50 mg per gram). Also available as 0.05% and 0.1% strengths in cream and gel formulations for acne and milder psoriasis. The 5% cream or gel is supplied in tubes of 15 g, 30 g, or 60 g.
Onset of action: For plaque psoriasis, visible improvement may begin within 2 to 4 weeks of once-daily application, with maximum benefit typically achieved after 8 to 12 weeks of continuous treatment. For acne, clinical improvement is usually observed after 4 to 8 weeks. Skin irritation, including erythema, scaling, dryness, and burning, often peaks during the first 2 to 4 weeks and then subsides with continued use.
Duration of action: Applied once daily; the therapeutic effect persists as long as the medication is used regularly. For psoriasis, the duration of a treatment course is usually limited to 12 weeks, after which maintenance therapy or discontinuation is based on clinical response. The elimination half-life of tazarotenic acid after topical application is approximately 18 hours, but the pharmacodynamic effect on keratinocyte differentiation is prolonged.
Alcohol recommendation: There is no known systemic interaction between topical tazarotene and the consumption of alcoholic beverages. However, patients should avoid applying alcohol-based skincare products, astringents, or peeling agents to the treated areas, as these can exacerbate skin irritation, dryness, and discomfort. Moderation in alcohol intake is advisable.
Most common side effects: Local skin reactions including erythema (redness), pruritus (itching), burning, stinging, scaling, dryness, and peeling at the application site. These effects are generally dose- and frequency-related, occur most often during the first 1 to 4 weeks of therapy, and may be managed with reduced application frequency or the use of a non-comedogenic moisturizer. Tazarotene significantly increases photosensitivity; patients must avoid or minimize exposure to sunlight and artificial ultraviolet light and should use a broad-spectrum sunscreen with SPF 30 or higher and protective clothing during treatment. Tazarotene is contraindicated during pregnancy (FDA Category X) and in women who may become pregnant who are not using effective contraception. It should not be applied to eczematous, sunburned, or broken skin, and contact with the eyes, mouth, and mucous membranes must be avoided. If severe irritation, blistering, or allergic reaction occurs, the medication should be discontinued and medical attention sought. Tazarotene is available only by prescription in Canada and should be used under the supervision of a healthcare professional experienced in dermatologic therapy.
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