Public record

Tretinoin: the public record

9 tables from US federal sources. Latest data date: Nov 11, 2026.

Each table is computed from the named federal dataset as of its data date; the method is under each one.

Label

FDA label facts for tretinoin

The FDA label read for tretinoin (Altreno, application NDA209353) was last revised on 2026-10-14. It carries no boxed warning. Of the 4 population sections checked, 4 are present: pregnancy, lactation, pediatric use, geriatric use.

FDA label facts for tretinoin: the figures
MeasureValueNote
Label revision date2026-10-14
Label readAltrenoNDA209353, brand-name application
Boxed warningNo
Pregnancy sectionPresent
Lactation sectionPresent
Pediatric use sectionPresent
Geriatric use sectionPresent

Source: FDA drug label via openFDA, viewable on NIH DailyMed, data as of Nov 11, 2026

How this was calculated

Selected the most recently revised prescription label for this single ingredient from an original manufacturer, preferring a brand-name application. Checked which sections exist and quoted headings and sentences exactly as printed.

Scope: One label: the newest prescription label for single-ingredient tretinoin from an original manufacturer

Read from one label. Labels for other brands, strengths or forms of the same ingredient can differ. A missing section heading does not mean there is no guidance. Read the full label before relying on it.

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Approvals

FDA approval history for tretinoin

The earliest FDA approval on file for a tretinoin product is 1971-10-20. Drugs@FDA lists 47 applications for it and 238 approved supplements, the most recent on 2025-09-10.

FDA approval history for tretinoin: the figures
MeasureValueNote
Earliest FDA approval on file1971-10-20
Applications with an approval on file47
New drug applications (NDA)14
Generic applications (ANDA)33
Approved supplements238label, manufacturing and efficacy changes
Most recent supplement approval2025-09-10
Sponsoring companies22

Source: FDA, Drugs@FDA, data as of Nov 11, 2026

How this was calculated

Selected applications with a product whose only active ingredient is this substance, then counted approved original and supplemental submissions. The earliest approved original submission is the first approval.

Scope: Applications with a single-ingredient tretinoin product in Drugs@FDA, all sponsors and strengths

Older approvals can be missing dates, and tentative approvals are not counted. An approved application does not mean the product is currently marketed.

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Patents and generics

Patents and generic approvals for tretinoin

The FDA Orange Book lists 33 approved generic applications for tretinoin, the first approved on 1998-06-19. 2 listed patents on specific brand products have not yet expired, the last on 2038-08-22; generics of other versions are already approved.

Patents and generic approvals for tretinoin: the figures
MeasureValueNote
Brand-name applications (NDA)14
Approved generic applications (ANDA)33first approved 1998-06-19
Companies with a generic not marked discontinued10
Listed patents not yet expired2
Latest listed patent expiry2038-08-22on any product; may cover only one brand formulation
Earliest approval date on filebefore 1982
Products not marked discontinued39 of 52

Source: FDA, Orange Book (Approved Drug Products with Therapeutic Equivalence Evaluations), data as of Oct 9, 2026

How this was calculated

Selected Orange Book products whose only active ingredient is this substance, then counted applications by type and the distinct patents and exclusivities listed against them. Expired patents are left out.

Scope: All single-ingredient tretinoin products in the Orange Book, every brand and strength, files dated 2026-10-09

An approved generic or an expired patent does not show that a generic is on sale. Launch timing also depends on litigation, settlements and supply. Biologics and compounded products are not in the Orange Book.

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Medicare Part D

Medicare Part D spending on tretinoin

Medicare Part D spending on tretinoin products was $22.2M in 2024 across 268,282 claims, compared with $24.2M in 2023 (-8.0%). Average spending per claim was $82.91, before rebates.

Medicare Part D spending on tretinoin: the figures
MeasureValueNote
Total spending, 2024$22.2M
Total spending, 2023$24.2M
Change in spending, 2023 to 2024-8.0%
Claims (prescription fills), 2024268,282
Average spending per claim, 2024$82.91
Tretinoin*: spending, 2024$21.1M235,091 claims
Retin-A: spending, 2024$1.0M32,166 claims
Altreno: spending, 2024$92,1201,009 claims

Source: CMS, Medicare Part D Spending by Drug, data as of 2024

How this was calculated

Summed total spending and claims over every brand and generic row with this generic name in the CMS file, using the Overall manufacturer rows. Combination products excluded. Average per claim is spending divided by claims.

Scope: Every single-ingredient tretinoin product in Part D (Tretinoin*, Retin-A, Altreno), 2024.

Gross drug cost before manufacturer rebates, so net cost is lower. Part D excludes some uses by law (for example erectile dysfunction, weight loss and hair growth), so claims reflect covered uses only. Compounded products are not included.

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Medicaid

Medicaid prescriptions for tretinoin by state

State Medicaid programmes paid for 1,360,384 tretinoin prescriptions in 2025, with $69.8M reimbursed before rebates. California reported the most (354,614), followed by New York (197,159) and Texas (76,510); 50 states and territories reported any.

Medicaid prescriptions for tretinoin by state: the figures
MeasureValueNote
Prescriptions paid by Medicaid, 20251,360,384
Total reimbursed before rebates, 2025$69.8M
States and territories reporting50with at least one count CMS did not suppress
California354,614 prescriptions$19.2M reimbursed
New York197,159 prescriptions$18.7M reimbursed
Texas76,510 prescriptions$3.6M reimbursed
Ohio49,615 prescriptions$2.3M reimbursed
Florida48,772 prescriptions$1.5M reimbursed

Source: CMS, Medicaid State Drug Utilization Data 2025, data as of 2025

How this was calculated

Matched each Medicaid product code to the FDA NDC Directory by labeler and product code, kept finished single-ingredient products, then summed prescriptions and reimbursement by state. National roll-up and suppressed rows dropped.

Scope: All single-ingredient tretinoin products in the FDA NDC Directory, fee-for-service and managed care, 2025

Counts under 11 are suppressed by CMS and left out, so totals are a floor. Amounts are before rebates. Differences between states reflect programme size and coverage rules. Compounded products are not included.

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Pharmacy cost

Pharmacy acquisition cost (NADAC) for tretinoin

Retail pharmacies paid an average of $0.4633 per gram for TRETINOIN 0.025% CREAM as of 2026-11-11, compared with $1.04 twelve months earlier (-55.6%). This is a pharmacy purchase cost, not a patient price.

Pharmacy acquisition cost (NADAC) for tretinoin: the figures
MeasureValueNote
TRETINOIN 0.025% CREAM$0.4633 per gram12 months earlier $1.04 (-55.6%)
TRETINOIN 0.1% CREAM$0.7966 per gram12 months earlier $1.16 (-31.3%)
TRETINOIN 0.05% CREAM$1.18 per gram12 months earlier $1.70 (-30.6%)
TRETINOIN 0.01% GEL$2.15 per gram12 months earlier $3.34 (-35.7%)
TRETINOIN 0.025% GEL$2.20 per gram12 months earlier $3.18 (-30.9%)
TRETINOIN 10 MG CAPSULE$8.53 per unit12 months earlier $12.49 (-31.7%)

Source: CMS, National Average Drug Acquisition Cost (NADAC), data as of Nov 11, 2026

How this was calculated

Matched NADAC product codes to the FDA NDC Directory, kept finished single-ingredient products, and listed the product descriptions with the most package codes. The earlier price is the same package code in the file one year before.

Scope: Generic versions of tretinoin in the weekly NADAC file of 2026-11-11, compared with the file of 2025-11-12

NADAC is the average invoice price retail pharmacies pay, from a voluntary survey. It leaves out rebates, dispensing fees and markups, and it is not what a patient or insurer pays. Compounded products are not surveyed.

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Adverse event reports

Most reported events in FDA adverse event reports for tretinoin

Through 2026-10-28, FDA had received 8,546 adverse event reports for tretinoin, 4,916 of them marked serious by the reporter. The symptom terms named most often were pain (552), vomiting (496) and rash (454).

Most reported events in FDA adverse event reports for tretinoin: the figures
MeasureValueNote
All reports received8,546
Reports the reporter marked serious4,916death, hospitalisation, disability or similar outcome
Pain552 reports
Vomiting496 reports
Rash454 reports
Nausea445 reports
Headache440 reports

Source: FDA Adverse Event Reporting System (FAERS) via openFDA, data as of Oct 28, 2026

How this was calculated

Counted FAERS reports listing this active substance, then the reaction terms named most often. A report can name several reactions, and a term can describe the illness being treated and not an effect of the drug. Terms about product use or complaints rather than symptoms (for example off label use) were left out of the list.

Scope: Reports where FDA recorded tretinoin as a single-ingredient active substance (any brand), all years to 2026-10-28

FAERS reports are unverified and do not prove the drug caused the event. Reporting rises with use, publicity and lawsuits, so these counts cannot give rates or risks and cannot be compared between drugs.

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Recalls

FDA drug recalls naming tretinoin

FDA enforcement reports list 14 drug recall entries naming tretinoin from 2015 to 2026-10-14. 11 of them are for compounded or other unlisted products and 3 for products FDA lists under a label. The most common stated reason was impurities or nitrosamines (3 of 14).

FDA drug recalls naming tretinoin: the figures
MeasureValueNote
Recall entries on record14
For products FDA lists under an approved or registered label3
For compounded or other unlisted products11matched by the name in the product description
Class I (most serious)0
Class II11
Class III3
Most recent recall reported2026-10-14
Most common stated reasonimpurities or nitrosamines3 of 14 entries

Source: FDA, Enforcement Reports (drug recalls) via openFDA, data as of Nov 10, 2026

How this was calculated

Counted enforcement report entries matched by FDA's listed active substance, or by the name in the product description where FDA lists none. Reasons were grouped by keywords in FDA's stated reason.

Scope: Recalls of single-ingredient tretinoin products, plus compounded or unlisted products whose description names it

Each recall covers specific lots from one firm and is not a statement about every product with this ingredient. One event can appear as several entries, one per product.

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Clinical studies

Registered clinical studies of tretinoin

ClinicalTrials.gov lists 409 registered studies that name tretinoin as an intervention as of 2026-11-11. Of these, 28 are recruiting, 224 are completed and 82 are phase 3 studies.

Registered clinical studies of tretinoin: the figures
MeasureValue
Registered studies409
Recruiting now28
Not yet recruiting23
Completed224
Terminated, withdrawn or suspended51
Phase 3 (including phase 2/3)82
Phase 2 (including phase 1/2)167
Phase 157

Source: NIH National Library of Medicine, ClinicalTrials.gov, data as of Nov 11, 2026

How this was calculated

Searched the ClinicalTrials.gov intervention field for the name, downloaded every matching record and counted by overall status and phase. Combined phases are counted under the higher phase. Phase not applicable covers observational, device and behavioural studies.

Scope: Studies whose intervention field matches tretinoin, any condition, any country, all statuses

A registered study is not a result. Counts include studies where the drug is a comparator or background treatment, and studies that never finished or reported.

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Articles on Tretinoin