Retinol - instructions for use, dose, side effects, contraindications

Pharmacokinetics:Absorption in the duodenum and ileum requires the presence of bile acids, protein lipases and fat. Biotransformation in the liver. Linkage to plasma proteins <5% (65% - with increased consumption). Elimination with feces, excess - kidneys. It accumulates in the liver, kidneys and lungs.

Indications:Hypovitaminosis and avitaminosis A.
Diseases of the eyes (pigment retinitis, hemostalopia, xerophthalmia, keratomalacia, eczematous lesions of the eyelids).
Diseases and skin lesions (frostbites, burns, wounds, ichthyosis, hyperkeratosis, psoriasis, some forms of eczema and other inflammatory and degenerative pathological processes).
Complex therapy of rickets, hypotrophy, ARI, chronic bronchopulmonary diseases, erosive-ulcerative and inflammatory gastrointestinal lesions, liver cirrhosis. Epithelial tumors and leukemia (to increase the resistance of the hematopoietic tissue to the action of cytostatics in complex chemotherapy).
Mastopathy (as part of a complex of non-hormonal drugs).

ICD-10

IV.E50-E64.E50 Insufficiency of vitamin A

IV.E50-E64.E55.0 Rickets active

VII.H00-H06.H01.1 Noninfectious dermatosis of the eyelid

VII.H15-H22.H18.0 Pigmentation and deposits in the cornea

X.J40-J47.J44 Other chronic obstructive pulmonary disease

XI.K20-K31.K25 Stomach ulcer

XI.K20-K31.K26 Duodenal ulcer

XI.K20-K31.K29 Gastritis and duodenitis

XI.K70-K77.K74 Fibrosis and cirrhosis of the liver

XII.L20-L30.L20.8 Other atopic dermatitis

XII.L40-L45.L40 Psoriasis

XII.L80-L99.L85.0 Acquired ichthyosis

XIV.N60-N64.N60 Benign breast dysplasia

XIX.T08-T14.T14.0 Superficial injury of unspecified area of the body

XIX.T20-T32.T30 Thermal and chemical burns, unspecified

XIX.T33-T35.T33 Surface frostbite

XXI.Z20-Z29.Z29.8 Other specified preventive measures

Contraindications:Gallstone disease, chronic pancreatitis (possibly exacerbation of the disease), I trimester of pregnancy.

Pregnancy and lactation:In humans retinol penetrates the placenta in a limited number. In children whose mothers took high doses of retinol during pregnancy, developmental abnormalities (malformations of the urinary tract, growth retardation, early closure of epiphyseal growth zones, etc.) are possible. It is not recommended to appoint retinol in a dose exceeding 6 thousand units / day, due to potential fetotoxicity. Penetrates into breast milk. When taken in recommended doses, complications are not documented.

Recommendations FDA category X (parenteral use, teratogenic effect).

Dosing and Administration:Apply inside, intramuscularly, externally.

Therapeutic doses for avitaminosis of mild and moderate degree: adults - up to 33 000 IU / day, with hemeralopia, xerophthalmia, pigment retinitis - 50 000-100 000 IU / day. During pregnancy and during breastfeeding, the daily dose of retinol is 10,000 IU / day. Children - 1000-5000 IU / day depending on the age. With skin diseases adults - 50 000-100 000 IU / day, children - 5000-20 000 IU / day.

Oily solutions can also be applied externally - for burns, ulcers, frostbites, lubricating 5-6 times / day and covering with gauze; simultaneously apply retinol inside or intramuscularly.

Side effects:

Hypervitaminosis A:

In adults - drowsiness, lethargy, headache, hyperemia of the face, nausea, vomiting, gait disorders, soreness in the bones of the lower limbs;

Children possible fever, drowsiness, sweating, vomiting, skin rashes.

Possible: increased cerebrospinal pressure (in infants, hydrocephalus may develop and protrusions of the fontanelle may develop).

Overdose:

Sharp (6 hours after a single dose at a dose of 300 thousand.Up to 1 million units): bleeding from the gums, bulging fontanel (in infants), CNS excitation, diarrhea, dizziness, drowsiness, diplopia, severe headache, irritability, skin flaking (especially on the lips and palms), dizziness, hydrocephalus in infants), a sharp increase in intracranial pressure (pseudotumour of the brain). Symptoms are reversible.

Chronic (reception for many years at a dose of 100-300 thousand units / day): bone pain, dry mouth, cracking of the skin or lips, fever, a feeling of weakness and discomfort, increased sensitivity to sunlight, irritability, loss of appetite , hair loss, cramps, abdominal pain, unusual fatigue, dizziness, yellow-orange staining of the feet, palms, nasolabial triangle and lips, toxic liver damage, intracranial hypertension, hypomenorrhoea, portal hypertension, hemolysis and anemia, radiologic changes Changes in bone tissues, in children - premature closure of the epiphyses.

Treatment is symptomatic. Symptoms can last from several weeks to several months.

Interaction:

Antibiotics of tetracycline - incompatibility (risk of developing malignant intracranial hypertension).

Vitamin E - decrease in toxicity of retinol; when taken in large doses helps reduce the vitamin A stores in the body.

Glucocorticoids and salicylates - reduce the risk of side effects.

Isotretinoin - increased toxic effects of the drug.

Kolestipol, colestramine, natural oils, neomycin (inside) - a violation of absorption of vitamin A.

Oral contraceptives - increase in the concentration of vitamin A.

Calcium preparations (in high doses) - hypercalcemia.

Special instructions:

Retinol is destroyed at high temperature, drying, under the influence of oxidants; remains when cooking.

Daily requirement: adults - 5 thousand IU (1.5 mg); pregnant women - 6.6 IU (2 mg); nursing mothers - 8250 IU (2.5 mg); children of the first year of life - 1650 IU (0.5 mg); children aged 1 year to 6 years - 3300 IU (1 mg); children aged 7-14 years - 5 thousand IU (1.5 mg). In the Far North, doses for pregnant, nursing mothers and children are increased by 50%.

Sources of vitamin A: yellow-orange fruits and vegetables, green vegetables, milk, liver, oil and margarine. About 20% of vitamin A is formed in the gastrointestinal tract from β-carotenes contained in green vegetables and fruits.The usual culinary processing of products does not lead to loss of vitamin A, but during storage for 12 months at a temperature of -23 ° C, from 5 to 10% of retinol is lost.

Do not use as a substitute for a balanced diet!

The recommended daily requirement for retinol varies from country to country.

There is no evidence of the effectiveness of the use of vitamins (alpha-tocopherol, retinol, betacarotene and their combinations) as a means of preventing lung cancer. In addition, the use of beta-carotene (both in monotherapy, and with alpha-tocopherol or retinol) can provoke the development of lung cancer.

The effectiveness of retinol for the prevention of pulmonary disease in premature babies with low body weight has not been proven.

The use of retinol in a dose of 50,000 IU / day for 30 days had a positive effect on the shadow adaptation in the elderly and the symptoms of early maculopathy.

Simultaneous use in children aged 9 months of the vaccine to prevent measles and retinol (at a dose of 100 thousand IU) improves the susceptibility to the vaccine and the content of the actual vitamin in the body, but the administration of retinol in high doses can cause seroconversion.

Instructions

Retinol (Retinolum)