Vitamin A

Vitamin A is an over-the-counter (OTC) vitamin that is naturally present in many foods. Vitamin A is important for normal vision, the immune system, and reproduction. Vitamin A also helps the heart, lungs, kidneys and other organs work properly. There are two different types of Vitamin A. The first, preformed vitamin A, is found in meat, poultry, fish and dairy products. The second, provitamin A, is found in fruits, vegetables and other plant-based products. The most common type of provitamin A is beta-carotene which can be found in foods and dietary supplements.

• Vitamin A is available under the following different brand names: Retinol, Aquasol A, Retinyl Acetate, and Retinyl Palmitate.

Dosages of Vitamin A:

Adult and pediatric

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

Recommended Daily Allowance (RDA)

Described as retinol activity equivalent (RAE)

• 1 RAE = Retinol 1 mcg

Adults:

• Males: 900 mcg per day (3,000 units per day)

Females:

• 700 mcg per day (2330 units per day)
• Older than 18 years pregnant: 750-770 mcg per day (2,500-2,600 units per day)
• Older than 18 years breastfeeding: 1300 mcg retinol activity equivalent (4330 units per day)

Pediatrics:

• Infants 0-6 months: 400 mcg/day retinol activity equivalent (1,333 units per day)
• Infants 6-12 months: 500 mcg/day retinol activity equivalent (1,666 units per day)
• Children 1-3 years: 300 mcg/day retinol activity equivalent (1,000 units per day)
• Children 3-8 years: 400 mcg/day retinol activity equivalent (1,333 units per day)
• Children 8-13 years: 600 mcg/day retinol activity equivalent (2,000 units per day)
• Children 13-18 years: 900 mcg/day retinol activity equivalent (3,000 units per day)

Upper Intake Levels

Adults:

• Older than 18 years: 3,000 mcg per day retinol activity equivalent (10,000 units per day)
• During pregnancy: 3,000 mcg per day retinol activity equivalent (10,000 units per day)
• Lactation: 3,000 mcg per day retinol activity equivalent (10,000 units per day)

Pediatrics:

• Children 0-3 years: 600 mcg per day retinol activity equivalent (2,000 units per day)
• Children 3-8 years: 900 mcg per day retinol activity equivalent (3,000 units per day)
• Children 8-13 years: 1,700 mcg per day retinol activity equivalent (5,667 units per day)
• Children 13-18 years, pregnant: 2,800 mcg per day retinol activity equivalent (9,333 units per day)
• Children 13-18 years, breastfeeding: 2,800 mcg per day retinol activity equivalent (9,333 units per day)

Vitamin A Deficiency

Adults:

• Malabsorption or oral administration not feasible: 100,000 units per day injected intramuscularly for 3 days; then 50,000 units per day for 2 weeks, to be followed with oral therapy
• Oral therapy: take an oral therapeutic multivitamin containing 10,000-20,000 units per day of vitamin A for 2 months
• Deficiency prophylaxis: 10,000-50,000 units orally once per day

Pediatrics:

• Use intermuscular route when oral administration is not possible or in malabsorption syndrome
• Infants: 7,500-15,000 units per day for 15 days
• Children 1-8 years: 17,500-35,000 units per day for 10 days
• Children 8 years and older:
  • Malabsorption or oral administration not feasible: 100,000 units per day, intramuscular for 3 days, then 50,000 units per day for 2 weeks; follow with oral therapy
  • Oral therapy: take an oral therapeutic multivitamin containing 10,000-20,000 units of daily vitamin A for 2 months
  • Deficiency prophylaxis: 10,000-50,000 units orally once per day

Xerophthalmia (off label)

Adults:

• Recommended dose except for females of reproductive age: 200,000 units orally once daily for 2 days. Repeat dose again after 2 weeks
• Females of reproductive age with night blindness or Bitot's spots: 5,000-10,000 units per day; 10,000 units per day maximum of 25,000 units once weekly for no more than 4 weeks

Pediatrics:

• Infants under 6 months: 50,000 units once per day for 2 days, repeat once with single-dose after 2 weeks
• Infants 6-12 months: 100,000 units once per day for 2 days, repeat with single-dose after 2 weeks
• Children over 12 months, except females of reproductive age: 200,000 units once per day for 2 days, repeat with a single dose after 2 weeks
• Females of reproductive age with night blindness or Bitot's spots: 5,000-10,000 units per day, 10,000 units per day with a maximum of 25,000 units once weekly for no more than 4 weeks

Dosage Considerations – Should be Given as Follows:

• None.

Side effects of vitamin A include:

• severe allergic reaction (anaphylaxis) and death after IV use
• facial dermatitis
• the fragility of the outer layer of the skin
• pink eye (conjunctivitis)
• sticky skin
• granuloma or mass-like lesions in acne
• dry mucus
• infection around the fingernails
• clouding or scarring of the cornea
• peeling of the palms and soles of the feet
• inflammation of the lips
• hair loss

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Vitamin A has no known severe interactions with other drugs.
• Vitamin A has no known serious interactions with other drugs.
• Moderate Interactions of Vitamin A include:
  • alitretinoin
  • beta carotene
  • bexarotene
  • dichlorphenamide
  • etretinate
  • isotretinoin
  • mipomersen
• Vitamin A has minor interactions with at least 45 different drugs.

This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns, or for more information about this medicine.

Warnings

Avoid the use of hypersensitivity, intravenous use, hypervitaminosis A, malabsorption syndrome (oral therapy), and pregnancy (recommended daily average).

This medication contains vitamin A. Do not take Retinol, Aquasol A, Retinyl Acetate, or Retinyl Palmitate if you are allergic to vitamin A or any ingredients contained in this drug.

Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

• Avoid the use of hypersensitivity, intravenous use, hypervitaminosis A, malabsorption syndrome (oral therapy), and pregnancy (recommended daily average).

Effects of Drug Abuse

• No information available

Short-Term Effects

• See "What Are Side Effects Associated with Using Vitamin A?"

Long-Term Effects

• Caution in impairment (toxicity reported)
• See "What Are Side Effects Associated with Using Vitamin A?"

Cautions

• Use caution if the dose exceeds 25,000 units per day, monitor closely
• Evaluate additional vitamin deficiencies if diagnosis of vitamin deficiency occurs (single vitamin A deficiency rare)
• Monitor prolonged administration over 25,000 units per day, take into account vitamin intake from other dietary and supplement sources
• Efficacy of large systemic doses of 100,000 to 300,000 units per day of vitamin A for the treatment of acne is not established

Pregnancy and Lactation

• Oral vitamin A use during pregnancy is generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk
• Use vitamin A (doses exceeding recommended daily average) during pregnancy with caution if benefits outweigh risks. Animal studies show risk and human studies are not available, or neither animal nor human studies were done
• If the vitamin A dose is greater than 6,000 units per day, administered parentally, do not use vitamin A during pregnancy. The risk involved outweighs the potential benefits. Safer alternatives exist
• Breastfeeding: vitamin A is distributed into breastmilk, safe at recommended daily average levels