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vitamin A (OTC)Brand and Other Names:Retinol, Aquasol A, more...retinyl acetate, retinyl palmitate

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

capsule

  • 7,500 U
  • 8000 U
  • 10,000 U
  • 25,000 U

injectable solution

  • 50,000 U/mL

tablet

  • 10,000 U
  • 15,000 U
more...

RDA

Described as retinol activity equivalent (RAE)

1 RAE = Retinol 1 mcg

Males: 900 mcg/day (3000 U/day)

Females

  • 700 mcg/day (2330 U/day)
  • >18 years pregnant: 750-770 mcg/day (2500-2600 U/day)
  • >18 years breastfeeding: 1300 mcg RAE (4330 U)

Upper Intake Levels

>18 years: 3000 mcg/day RAE (10,000 U)

Pregnancy: 3000 mcg/day RAE (10,000 U)

Lactation: 3000 mcg/day RAE (10,000 U)

Vitamin A Deficiency

Malabsorption or oral administration not feasible: 100,000 U/day IM for 3 days; then 50,000 U/day for 2 weeks; follow with oral therapy.

Oral therapy: Take oral therapeutic multivitamin containing 10,000-20,000 U/day vitamin A for 2 months

Deficiency prophylaxis: 10,000-50,000 U PO qDay

Xerophthalmia (Off-label)

Recommended dose except for females of reproductive age: 200,000 units PO qDay for 2 days; repeat dose again after 2 weeks

Females of reproductive age with night blindness or Bitot's spots: 5000-10,000 units/day; 10,000 units/day maximum or ≤25,000 units once weekly for ≥4 weeks

Bronchopulmonary Dysplasia (Orphan)

Orphan designation of vitamin A palmitate for prevention of bronchopulmonary dysplasia

Sponsors

  • Fox Pharma, Inc; 6097 Hidden Valley Drive; Doylestown, PA 18902
  • Advent Therapeutics, Inc; 6500 Old Carversville Road; Lumberville, PA 18933-9729

Dosage Forms & Strengths

capsule

  • 7,500 U
  • 8,000 U
  • 10,000 U
  • 25,000 U

injectable solution

  • 50,000 U/mL

tablet

  • 10,000 U
  • 15,000 U
more...

RDA

0-6 months: 400 mcg/day RAE (1333 U/day)

6-12 months: 500 mcg/day RAE (1666 U/day)

1-3 years: 300 mcg/day RAE (1000 U/day)

3-8 years: 400 mcg/day RAE (1333 U/day)

8-13 years: 600 mcg/day RAE (2000 U/day)

13-18 years: 900 mcg/day RAE (3000 U/day)

Upper Intake Levels

0-3 years: 600/day mcg RAE (2000 U/day)

3-8 years: 900/day mcg RAE (3000 U/day)

8-13 years: 1700 mcg/day RAE (5667 U/day)

13-18 years: 2800 mcg/day RAE (9333 U/day)

13-18 years pregnant: 2800 mcg/day RAE (9333 U/day)

13-18 years breastfeeding: 2800 mcg/day RAE (9333 U/day)

Deficiency

Use IM route when oral administraiton is not possible or in malabsorption syndrome

Infants: 7500-15000 units/day for 10 days

1-8 years: 17,500-35,000 units/day for 10 days

>8 years

  • Malabsorption or oral administration not feasible: 100,000 U/day IM for 3 days; then 50,000 U/day for 2 weeks; follow with oral therapy.
  • Oral therapy: Take oral therapeutic multivitamin containing 10,000-20,000 U/day vitamin A for 2 months
  • Deficiency prophylaxis: 10,000-50,000 U PO qDay

Xerophthalmia

<6 months: 50,000 units qDay for 2 days; repeat once with single dose after 2 weeks

6-12 months: 100,000 units qDay for 2 days; repeat with single dose after 2 weeks

>1 year except females of reproductive age: 200,000 units qDay for 2 days; repeat with single dose after 2 weeks

Females of reproductive age with night blindness or Bitot's spots: 5000-10,000 units/day; 10,000 units/day maximum or ≤25,000 units once weekly for ≥4 weeks

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Interactions

Interaction Checker

vitamin A and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Frequency Not Defined

            Anaphylaxsis & death after IV use

            Facial dermatitis

            Stratum corneum fragility

            Conjunctivities

            Sticky skin

            Granuloma-like lesions in acne

            Dry mucus

            Paranochia

            Corneal opacities

            Palmoplanar peeling

            Cheilitis

            Alopecia

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            Warnings

            Contraindications

            Hypersensitivity

            IV use

            Hypervitaminosis A

            Malabasorption syndrome (oral therapy)

            Pregnancy (dose >RDA)

            Cautions

            Use caution if dose >25,000 units/day (monitor closely)

            Evaluate additional vitamin deficiencies if diagnosis of vitamin deficiency occurs (single vitamin A deficiency rare)

            Caution in renal impairment (toxicity reported)

            Monitor prolonged administration over 25,000 units/day; take into account vitamin intake from other dietary and supplement sources

            Efficacy of large systemic doses of 100,000 to 300,000 units/day vitamin A for the treatment of acne not established

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            Pregnancy & Lactation

            Pregnancy Category: A (oral); C (doses exceeding RDA); X (>6,000 units/day administered parenterally)

            Lactation: Distributed into milk; safe at RDA levels

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
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            Nutrition

            Sources: Liver, butter, eggs, green leafy vegetables, colorful fruits & vegetables (carrots, mango, pumpkin, sweet potatoes)

            Functions: Growth & development, maintenance of epithelial tissue

            Deficiency: Night blindness, dry eyes, susceptibility to infections, follicular hyperkeratosis

            Toxicity: hypervitaminosis A

            Acute: Nausea, fatigue, dizziness, dry skin, cerebral edema, increased ICP, skin loss, liver failure

            Chronic: Osteoporosis, hair loss, high cholesterol, coma, swelling of the optic eye, rash, mouth sores, liver failure

            Teratogenicity: fetal toxicity, birth defects (>10,000 units/day)

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            Pharmacology

            Mechanism of Action

            Vitamin A supplementation plays a role in embryonic development, visual adaptation to darkness, immune function, and maintenance of epithelial cells

            Pharmacokinetics

            Serum concentration: 300-700 ng/mL (adults); 200-500 ng/mL (infants)

            Peak plasma time: 4-5 hr (oil solution); 304 hr (water-miscible)

            Protein Bound: Retinol binding protein

            Distribution: Mainly stored in liver as retinyl palmitate

            Metabolism: hepatic glucuronidation, decarboxylation

            Metabolites: retinoic acid, retinal

            Excretion: Urine and feces (via bile)

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