Trifarotene side effects: what 180 FDA adverse event reports show

Trifarotene · Aklief · 7 reaction terms · 83 drug–reaction co-reports · data 2026-09-14

Drug class

Retinoid

FDA label (Established Pharmacologic Class) · compare the class

Brand names

Aklief

openFDA label

Who reports

180 reports · 24% serious · 2 with death outcome · 89% female

openFDA FAERS counts, all years, deduplication not applied

Used for

AKLIEF Cream is a retinoid indicated for the topical treatment of acne vulgaris in patients 9 years of age and older. AKLIEF Cream is a retinoid indicated for the topical treatment of acne vulgaris in patients 9 years of age and older. ( 1 )

FDA label, Indications and Usage

What it is

AKLIEF Cream for topical administration contains 0.005% (50 mcg/g) trifarotene. Trifarotene is a terphenyl acid derivative and is a retinoid.

FDA label, Description section

Boxed warning

None in the current label

How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 7 strongest signals

Labeled adverse reaction 2Labeled (related wording) 2Likely indication confounding 1Not in label — unassessed 2

What the badges mean

Labeled adverse reaction The exact term appears in the label's warnings or adverse-reactions sections: a known, expected effect. The FAERS signal confirms the label rather than discovering anything.
Labeled (related wording) The label describes this effect under different wording (e.g. 'neutropenia' for 'neutrophil count decreased'). Treated as known.
Likely indication confounding The term appears in the label's indications: reports probably describe the disease being treated (or its progression), not a drug effect. Classic confounding by indication.
Not in label — unassessed Not found in the label text, not an artifact pattern. This is a genuine candidate for a formal causality assessment (Bradford Hill / WHO-UMC); it has NOT had one here.

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only and flags pairs whose reports are unusually skewed by sex or come mostly from consumers rather than clinicians. 0 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show: hide coding/lab/outcome terms hide indication terms unlabeled only hide PRR-only

Reaction	Reports	PRR 95% CI · ROR · χ²/p	EBGM EB05 · IC025	Label screen	Serious-only & strata	Trial cross-check
Mydriasis	15	136.5 84.0–221.6ROR 148.8 · χ² 1,883 / p <1e-300	116.5 EB05 74.9 · IC025 +3.8 3/3 methods agree	Not in label — unassessed	serious PRR 396.8	no trial data cached
Pain of skin	9	38.8 20.5–73.4ROR 40.8 · χ² 295 / p 2e-66	36.1 EB05 20.3 · IC025 +2.6 3/3 methods agree	Labeled (related wording) related wording	–	no trial data cached
Skin irritation	13	33.0 19.6–55.7ROR 35.5 · χ² 373 / p 2e-83	31.6 EB05 19.6 · IC025 +3.0 3/3 methods agree	Labeled adverse reaction exact term	–	no trial data cached
Application site pain	6	31.8 14.5–69.7ROR 32.8 · χ² 149 / p 1e-34	28.4 EB05 13.0 · IC025 +1.8 3/3 methods agree	Labeled adverse reaction exact term	serious n=1	no trial data cached
Skin burning sensation	17	27.8 17.7–43.8ROR 30.6 · χ² 415 / p 2e-92	27.1 EB05 17.9 · IC025 +3.2 3/3 methods agree	Not in label — unassessed	serious PRR 30.5	no trial data cached
Application site erythema	6	26.6 12.1–58.3ROR 27.4 · χ² 123 / p 6e-29	23.6 EB05 9.9 · IC025 +1.7 3/3 methods agree	Labeled (related wording) related wording	serious n=1	no trial data cached
Acne	17	26.0 16.5–40.9ROR 28.6 · χ² 385 / p 4e-86	25.3 EB05 16.7 · IC025 +3.1 3/3 methods agree	Likely indication confounding term in indications; also in warnings	serious PRR 36.3	no trial data cached

Trial evidence (ClinicalTrials.gov)

Trial cross-check not yet run for this drug (ClinicalTrials.gov pull covers the 800 most-reported drugs first).

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

Reaction	Reports	PRR 95% CI · ROR · χ²/p	EBGM EB05 · IC025	Label screen	Serious-only & strata	Trial cross-check
Acne	17	26.0 16.5–40.9ROR 28.6 · χ² 385 / p 4e-86	25.3 EB05 16.7 · IC025 +3.1 3/3 methods agree	Likely indication confounding term in indications; also in warnings	serious PRR 36.3	no trial data cached
Skin burning sensation	17	27.8 17.7–43.8ROR 30.6 · χ² 415 / p 2e-92	27.1 EB05 17.9 · IC025 +3.2 3/3 methods agree	Not in label — unassessed	serious PRR 30.5	no trial data cached
Mydriasis	15	136.5 84.0–221.6ROR 148.8 · χ² 1,883 / p <1e-300	116.5 EB05 74.9 · IC025 +3.8 3/3 methods agree	Not in label — unassessed	serious PRR 396.8	no trial data cached
Skin irritation	13	33.0 19.6–55.7ROR 35.5 · χ² 373 / p 2e-83	31.6 EB05 19.6 · IC025 +3.0 3/3 methods agree	Labeled adverse reaction exact term	–	no trial data cached
Pain of skin	9	38.8 20.5–73.4ROR 40.8 · χ² 295 / p 2e-66	36.1 EB05 20.3 · IC025 +2.6 3/3 methods agree	Labeled (related wording) related wording	–	no trial data cached
Application site erythema	6	26.6 12.1–58.3ROR 27.4 · χ² 123 / p 6e-29	23.6 EB05 9.9 · IC025 +1.7 3/3 methods agree	Labeled (related wording) related wording	serious n=1	no trial data cached
Application site pain	6	31.8 14.5–69.7ROR 32.8 · χ² 149 / p 1e-34	28.4 EB05 13.0 · IC025 +1.8 3/3 methods agree	Labeled adverse reaction exact term	serious n=1	no trial data cached

Unlabeled candidate signals

Every screened signal with n ≥ 20 was either labeled, an indication term, or an artifact pattern — no unlabeled candidate stood out in the top signals.

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Trifarotene?

In FDA FAERS, the most frequently co-reported reaction terms for Trifarotene are acne, skin burning sensation, mydriasis, skin irritation, pain of skin, application site erythema. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Trifarotene have an FDA boxed warning?

No. The FDA label retrieved for Trifarotene has no boxed warning; see the label's Warnings and Precautions for the recognised risks.

Do FAERS signals prove that Trifarotene causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

FDA label via openFDA (set ID 62d910db-85a6-4696-b69b-4bd2f3080cfc, effective 20240916; matched on openfda.generic_name.exact:"TRIFAROTENE")
Bayesian shrinkage measures computed offline over all 1,317,300 cached pairs: BCPNN information component (IC, with Norén closed-form IC025) and MGPS empirical-Bayes geometric mean (EBGM, EB05) with a two-component gamma prior fitted by maximum marginal likelihood (α₁=0.57, β₁=0.02, α₂=1.42, β₂=0.70, w=0.17); unstratified
FAERS pair statistics from the OpenPV build of 2026-09-14 (openFDA count= aggregation, field patient.drug.openfda.generic_name.exact, 7 reaction terms, min 3 co-reports); PRR/ROR with 95% CI, chi-square with Yates correction
Serious-only and stratified counts (serious:1, patient.patientsex, primarysource.qualification) from openFDA count queries; serious-only PRR uses the drug serious report total and the term global serious total (N_serious=11,882,979); strata shown only when n ≥ 20
Seriousness and sex counts from openFDA count=serious, patient.patientsex, seriousnessdeath

Page generated 2026-10-08. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.