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

 

Source: Operational Medicine 2001,  Health Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington, D.C., 20372-5300 


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