Vitamin A (Retinol, Betacarotene)

Category:

• Vitamin

Description:

• Dietary supplement; fat-soluble vitamin

Indications:

• Vitamin A deficiency

• Conditions associated with vitamin A deficiency include: biliary tract or pancreatic disease, sprue, colitis, hepatic cirrhosis, celiac disease, regional enteritis, cystic fibrosis, partial gastrectomy or severe dietary inadequacy

• Vision, night blindness

• Tooth and bone development

Contraindications:

• Do not administer intravenously.

Precautions:

• Pregnancy category C

• Patients may develop hypervitaminosis A with excessive dosages  Symptoms of hypervitaminosis A are cirrhotic-like liver syndrome, malaise, irritability, headache, lip fissures, dry and cracking skin, alopecia, and arthralgia.

• Do not administer over 25,000 IU per day.

• Long term use of large systemic doses of vitamin A to treat acne have not been established.  However topical vitamin A derivatives (tretinoin and isotretinoin) are available.

• Oral contraceptives significantly increase plasma vitamin A levels.

Adverse Reactions (Side Effects):

• Relatively non-toxic in therapeutic doses

Dosage:

• Vitamin A activity is expressed in Retinol Equivalents (RE)

• 1 RE = 1mcg retinol or 6mcg beta-carotene = 3.33 IU (international units)

• Dietary sources: Yellow-orange vegetables (carrots), dark leafy vegetables (spinach), fatty foods (liver, fish, dairy products)

• Administered orally (soft gelatin capsules, tablets, drops) and injection

• Dietary supplementation (RDA: recommended daily allowance):

  • Males: 3300 IU per day

  • Females: 2640 IU per day

• Treatment of deficiency:

  • Adults and Children (>8 years):

  • severe deficiency with xerophthalmia: 5000,000 IU/day for 3 days,t hen 50,000 IU/day for 2 weeks

  • severe deficiency: 100,000 IU/day for 3 days, then 50,000 IU/day for 2 months

• Follow-up:

  • Adults: 10,000-20,000 IU/day for 2 months

  • Children (1-8 years): 5000-10,000 IU/day for 2 months

• Parenteral (IM):

  • Adults: 100,000 IU/day for 3 days, then 50,000 IU/day fir 2 weeks

  • Children (1-8 years): 17,500-35,000 IU/day for 10 days

  • Infants: 7500-15,000 IU/day for 10 days