Vitamin A (Retinol)

DEA Class;  

Common Brand Names; Retinol, Aquasol A, retinyl acetate, retinyl palmitate

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

One type comes from animal sources of food. It helps you see at night, make red blood cells, and fight off infections. The other type is in plant foods. It helps prevent damage to cells and an eye problem called age-related macular degeneration. (But too much vitamin A can hurt your liver.) Eat orange veggies and fruits like sweet potato and cantaloupe, spinach and other greens, dairy foods, and seafood such as shrimp and salmon.

Food Sources

Green leafy vegetables, nuts, tomatoes, oranges, ripe yellow fruits, guava, milk, liver, carrots, broccoli and watermelon.

• 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

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

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

Lactation: Distributed into milk; safe at RDA levels

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

vitamin A (OTC)

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