vitamin A (OTC)

Brand and Other Names:Retinol, Aquasol A, more...retinyl acetate, retinyl palmitate
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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

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

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

Retinopathy of Prematurity (Orphan)

Retinol palmitate

Orphan designation for prevention of retinopathy of prematurity (ROP)

Sponsor

  • Orphanix GmbH; 41 Peter-Rosegger-Strabe; Ried im Innkreis; Austria
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Interactions

Interaction Checker

and vitamin A

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Contraindicated (0)

              Serious - Use Alternative (2)

              • pexidartinib

                vitamin A and pexidartinib both increase Other (see comment). Avoid or Use Alternate Drug. Pexidartinib can cause hepatotoxicity. Avoid coadministration of pexidartinib with other products know to cause hepatoxicity.

              • pretomanid

                vitamin A, pretomanid. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Pretomanid regimen associated with hepatotoxicity. Avoid alcohol and hepatotoxic agents, including herbal supplements and drugs other than bedaquiline and linezolid.

              Monitor Closely (7)

              • beta carotene

                vitamin A, beta carotene. Either increases levels of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Administration of beta-carotene with vitamin A usually is not necessary and should be avoided to prevent the development of hypervitaminosis A.

              • bexarotene

                bexarotene increases toxicity of vitamin A by pharmacodynamic synergism. Use Caution/Monitor. (Vitamin A) Additive retinoid effects. Avoid consuming vitamin-A containing supplements in amounts exceeding FDA recommended daily allowance.

              • dichlorphenamide

                dichlorphenamide, vitamin A. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Both drugs can cause metabolic acidosis.

              • etretinate

                etretinate increases toxicity of vitamin A by pharmacodynamic synergism. Use Caution/Monitor. (Vitamin A) Additive retinoid effects.

              • isotretinoin

                isotretinoin increases toxicity of vitamin A by pharmacodynamic synergism. Use Caution/Monitor. (Vitamin A) Additive retinoid effects.

              • mipomersen

                mipomersen, vitamin A. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs.

              • warfarin

                vitamin A increases effects of warfarin by unspecified interaction mechanism. Use Caution/Monitor.

              Minor (45)

              • acitretin

                acitretin increases toxicity of vitamin A by pharmacodynamic synergism. Minor/Significance Unknown. (Vitamin A) Additive retinoid effects.

              • busulfan

                vitamin A, busulfan. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • capecitabine

                vitamin A, capecitabine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • carboplatin

                vitamin A, carboplatin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • carmustine

                vitamin A, carmustine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • chitosan

                chitosan decreases levels of vitamin A by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • chlorambucil

                vitamin A, chlorambucil. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • cholestyramine

                cholestyramine decreases levels of vitamin A by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. (Vitamin A).

              • cisplatin

                vitamin A, cisplatin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • cladribine

                vitamin A, cladribine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • colestipol

                colestipol decreases levels of vitamin A by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. (Vitamin A).

              • cytarabine

                vitamin A, cytarabine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • dacarbazine

                vitamin A, dacarbazine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • decitabine

                vitamin A, decitabine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • docetaxel

                vitamin A, docetaxel. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • floxuridine

                vitamin A, floxuridine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • fludarabine

                vitamin A, fludarabine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • fluorouracil

                vitamin A, fluorouracil. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • gemcitabine

                vitamin A, gemcitabine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • ifosfamide

                vitamin A, ifosfamide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • irinotecan

                vitamin A, irinotecan. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • irinotecan liposomal

                vitamin A, irinotecan liposomal. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • lomustine

                vitamin A, lomustine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • mechlorethamine

                vitamin A, mechlorethamine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • melphalan

                vitamin A, melphalan. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • mercaptopurine

                vitamin A, mercaptopurine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • mineral oil

                mineral oil decreases levels of vitamin A by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • minocycline

                minocycline, vitamin A. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of benign intracranial hypertension.

              • nelarabine

                vitamin A, nelarabine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • neomycin PO

                neomycin PO decreases levels of vitamin A by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. (Vitamin A).

              • orlistat

                orlistat decreases levels of vitamin A by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. Separate by 2 hours.

              • oxaliplatin

                vitamin A, oxaliplatin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • paclitaxel

                vitamin A, paclitaxel. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • paclitaxel protein bound

                vitamin A, paclitaxel protein bound. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • pentostatin

                vitamin A, pentostatin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • pralatrexate

                vitamin A, pralatrexate. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • streptozocin

                vitamin A, streptozocin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • thioguanine

                vitamin A, thioguanine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • thiotepa

                vitamin A, thiotepa. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • topotecan

                vitamin A, topotecan. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • treosulfan

                vitamin A, treosulfan. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • vinblastine

                vitamin A, vinblastine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • vincristine

                vitamin A, vincristine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • vincristine liposomal

                vitamin A, vincristine liposomal. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • vinorelbine

                vitamin A, vinorelbine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

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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.

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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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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              vitamin A oral
              -
              10,000 unit capsule

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              A Patient Handout is not currently available for this monograph.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.