Public record
Tretinoin: the public record
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.
| Measure | Value | Note |
|---|---|---|
| Label revision date | 2026-10-14 | |
| Label read | Altreno | NDA209353, brand-name application |
| Boxed warning | No | |
| Pregnancy section | Present | |
| Lactation section | Present | |
| Pediatric use section | Present | |
| Geriatric use section | Present |
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.
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.
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.
| Measure | Value | Note |
|---|---|---|
| Earliest FDA approval on file | 1971-10-20 | |
| Applications with an approval on file | 47 | |
| New drug applications (NDA) | 14 | |
| Generic applications (ANDA) | 33 | |
| Approved supplements | 238 | label, manufacturing and efficacy changes |
| Most recent supplement approval | 2025-09-10 | |
| Sponsoring companies | 22 |
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.
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.
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.
| Measure | Value | Note |
|---|---|---|
| Brand-name applications (NDA) | 14 | |
| Approved generic applications (ANDA) | 33 | first approved 1998-06-19 |
| Companies with a generic not marked discontinued | 10 | |
| Listed patents not yet expired | 2 | |
| Latest listed patent expiry | 2038-08-22 | on any product; may cover only one brand formulation |
| Earliest approval date on file | before 1982 | |
| Products not marked discontinued | 39 of 52 |
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.
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.
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.
| Measure | Value | Note |
|---|---|---|
| Total spending, 2024 | $22.2M | |
| Total spending, 2023 | $24.2M | |
| Change in spending, 2023 to 2024 | -8.0% | |
| Claims (prescription fills), 2024 | 268,282 | |
| Average spending per claim, 2024 | $82.91 | |
| Tretinoin*: spending, 2024 | $21.1M | 235,091 claims |
| Retin-A: spending, 2024 | $1.0M | 32,166 claims |
| Altreno: spending, 2024 | $92,120 | 1,009 claims |
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.
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.
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.
| Measure | Value | Note |
|---|---|---|
| Prescriptions paid by Medicaid, 2025 | 1,360,384 | |
| Total reimbursed before rebates, 2025 | $69.8M | |
| States and territories reporting | 50 | with at least one count CMS did not suppress |
| California | 354,614 prescriptions | $19.2M reimbursed |
| New York | 197,159 prescriptions | $18.7M reimbursed |
| Texas | 76,510 prescriptions | $3.6M reimbursed |
| Ohio | 49,615 prescriptions | $2.3M reimbursed |
| Florida | 48,772 prescriptions | $1.5M reimbursed |
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.
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.
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.
| Measure | Value | Note |
|---|---|---|
| TRETINOIN 0.025% CREAM | $0.4633 per gram | 12 months earlier $1.04 (-55.6%) |
| TRETINOIN 0.1% CREAM | $0.7966 per gram | 12 months earlier $1.16 (-31.3%) |
| TRETINOIN 0.05% CREAM | $1.18 per gram | 12 months earlier $1.70 (-30.6%) |
| TRETINOIN 0.01% GEL | $2.15 per gram | 12 months earlier $3.34 (-35.7%) |
| TRETINOIN 0.025% GEL | $2.20 per gram | 12 months earlier $3.18 (-30.9%) |
| TRETINOIN 10 MG CAPSULE | $8.53 per unit | 12 months earlier $12.49 (-31.7%) |
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.
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.
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).
| Measure | Value | Note |
|---|---|---|
| All reports received | 8,546 | |
| Reports the reporter marked serious | 4,916 | death, hospitalisation, disability or similar outcome |
| Pain | 552 reports | |
| Vomiting | 496 reports | |
| Rash | 454 reports | |
| Nausea | 445 reports | |
| Headache | 440 reports |
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.
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.
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).
| Measure | Value | Note |
|---|---|---|
| Recall entries on record | 14 | |
| For products FDA lists under an approved or registered label | 3 | |
| For compounded or other unlisted products | 11 | matched by the name in the product description |
| Class I (most serious) | 0 | |
| Class II | 11 | |
| Class III | 3 | |
| Most recent recall reported | 2026-10-14 | |
| Most common stated reason | impurities or nitrosamines | 3 of 14 entries |
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.
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.
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.
| Measure | Value |
|---|---|
| Registered studies | 409 |
| Recruiting now | 28 |
| Not yet recruiting | 23 |
| Completed | 224 |
| Terminated, withdrawn or suspended | 51 |
| Phase 3 (including phase 2/3) | 82 |
| Phase 2 (including phase 1/2) | 167 |
| Phase 1 | 57 |
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.
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.
Articles on Tretinoin
- Tretinoin Adult (30-49) Dosing: Complete Clinical Guide
- Tretinoin Monitoring for Adults (30 to 49): Lab Tests, Skin Checks, and Follow-Up Schedule
- Does Anthem (Elevance Health) Cover Tretinoin?
- Tretinoin Compounded vs Branded: A Clinical Comparison
- Tretinoin Cost vs. Alternatives in Class: A Clinical Comparison
- How to Safely Stop Tretinoin: An Evidence-Based Discontinuation Guide