Aquasol A, Del-Vi-A
Classifications: vitamin; Therapeutic: vitamin a replacement
Pregnancy Category: a (X if >RDA)
5000 IU tablets 10,000 IU, 15,000 IU, 25,000 IU capsules; 50,000 IU/mL injection
Vitamin A, a fat-soluble vitamin, acts as a cofactor in mucopolysaccharide synthesis, cholesterol synthesis, and the metabolism
Essential for normal growth and development of bones and teeth, for integrity of epithelial and mucosal surfaces, and for
synthesis of visual purple necessary for visual adaptation to the dark. Has antioxidant properties.
Vitamin A deficiency and as dietary supplement during periods of increased requirements, such as pregnancy, lactation, infancy,
and infections. Used as replacement therapy in conditions that affect absorption, mobilization, or storage of vitamin A (e.g.,
steatorrhea, severe biliary obstruction, liver cirrhosis, total gastrectomy). Used in skin disorders [e.g., folliculosis
keratosis (Darier's disease), psoriasis]; however, other retinoids are being preferentially selected. Also used as a screening
test for fat malabsorption.
History of sensitivity to vitamin A or to any ingredient in formulation, hypervitaminosis A, oral administration to patients
with malabsorption syndrome. Safe use in amounts exceeding 6000 IU during pregnancy [category a (category X if >RDA)] is
Pregnancy (category A at RDA value); women on oral contraceptives, children, hepatic disease, hepatic dysfunction, hepatitis;
low-birth-weight infants; renal disease; lactation.
Route & Dosage
Adult: PO 500,000 IU/d for 3 d followed by 50,000 IU/d for 2 wk, then 10,00020,000 IU/d for 2 mo IM 100,000 IU/d for 3 d followed by 50,000 IU/d for 2 wk
Child: PO/IM <1 y, 10,000 IU/kg/d for 3 d followed by 750015,000 IU/d for 10 d; 18 y, 10,000 IU/kg/d for 3 d followed by 17,00035,000 IU/d for 2 wk; >8 y, same as for adult
Child: PO <4 y, 10,000 IU/d; 48 y, 15,000 IU/d
- Give on an empty stomach or following food or milk if GI upset occurs.
- Store in tight, light-resistant containers.
Adverse Effects (≥1%) CNS:
Irritability, headache, intracranial hypertension (pseudotumor cerebri), increased intracranial pressure, bulging fontanelles,
papilledema, exophthalmos, miosis, nystagmus. Metabolic:
Hypervitaminosis A syndrome (malaise, lethargy, abdominal discomfort, anorexia, vomiting), hypercalcemia. Musculoskeletal:
Slow growth; deep, tender, hard lumps (subperiosteal thickening) over radius, tibia, occiput; migratory arthralgia; retarded
growth; premature closure of epiphyses. Skin:
Gingivitis, lip fissures, excessive sweating, drying or cracking of skin, pruritus, increase in skin pigmentation, massive
desquamation, brittle nails, alopecia. Urogenital:
Polydipsia, polyurea. Hematologic:
Leukopenia, hypoplastic anemias, vitamin A plasma
levels >1200 IU/dL, elevations of sedimentation rate and prothrombin time. Body as a Whole: Anaphylaxis, death
Diagnostic Test Interference
Vitamin A may falsely increase serum cholesterol determinations (Zlatkis-Zak reaction); may falsely elevate bilirubin determination (with Ehrlich's reagent).
InteractionsDrug: Mineral oil, cholestyramine
may decrease absorption of vitamin A.
Readily absorbed from GI tract in presence of bile salts, pancreatic lipase, and dietary fat. Distribution:
Stored mainly in liver; small amounts also found in kidney and body fat; distributed into breast milk. Metabolism:
In liver. Elimination:
In feces and urine.
Assessment & Drug Effects
- Evaluate dosage with consideration of patient's average daily intake of vitamin A. Take dietary and drug history (e.g.,
intake of fortified foods, dietary supplements, self-administration or prescription drug sources). Women taking oral contraceptives
tend to have significantly high plasma vitamin A levels.
- Monitor therapeutic effectiveness. Vitamin A deficiency is often associated with protein malnutrition as well as other vitamin
deficiencies. It may manifest as night blindness, restriction of growth and development, epithelial alterations, susceptibility
to infection, abnormal dryness of skin, mouth, and eyes (xerophthalmia) progressing to keratomalacia (ulceration and necrosis
of cornea and conjunctiva), and urinary tract calculi.
Patient & Family Education
- Avoid use of mineral oil while on vitamin a therapy.
- Notify physician of symptoms of overdosage (e.g., nausea, vomiting, anorexia, drying and cracking of skin or lips, headache,
loss of hair).