Aquasol A Parenteral

Name: Aquasol A Parenteral

Introduction

Fat-soluble vitamin.a

Uses for Aquasol A Parenteral

Vitamin A Deficiency

Used to treat and prevent symptoms of vitamin A deficiency such as xerophthalmia and night blindness.137 138 a

Used as a dietary supplement to prevent vitamin A deficiency in patients with GI diseases (e.g., malabsorption syndromes) and those with abnormal storage and transport of vitamin A (e.g., abetalipoproteinemia, protein deficiency, diabetes mellitus, hyperthyroidism, fever, liver disease, cystic fibrosis with hepatic involvement).a

Guidelines from WHO, the United Nations Children's Fund (UNICEF), and the International Vitamin A Consultative Group (IVACG, now the Micronutrient Forum) recommend high-dose vitamin A supplements in the prevention and treatment of severe vitamin A deficiency in certain populations.127 128 129 131 In developing countries where vitamin A deficiency is a public health problem, periodic supplementation with high-dose vitamin A (50,000–200,000 units, depending on age) has been recommended in certain high-risk populations (i.e., postpartum women, children), with reduced doses recommended for pregnant women.127 128 131 Such high doses of vitamin A generally are not used in the US except in individuals with vitamin A deficiency.135 137 138

WHO and IVACG consider patients with active xerophthalmia (e.g., night blindness, conjunctival xerosis with Bitot's spots, corneal xerosis, corneal ulceration, keratomalacia) to be in imminent danger of corneal destruction and recommend immediate treatment with high dosages of vitamin A.127 129 131 (See Xerophthalmia under Dosage and Administration.)

Children with severe measles have been found to have low serum concentrations of vitamin A; WHO and AAP recommend that vitamin A supplements be given to all children with acute measles, regardless of their country of residence.115 127

Dietary Requirements

Adequate intake needed to prevent vitamin A deficiency and ocular complications (e.g., xerophthalmia) associated with vitamin A deficiency.126

Adequate intake of vitamin A usually can be accomplished through consumption of foodstuffs that contain preformed vitamin A (e.g., liver, dairy products, fish) and provitamin A carotenoids (e.g., darkly colored fruits and vegetables).126

Adequate intake (AI) established for infants ≤6 months of age based on observed mean vitamin A intake of infants fed principally human milk;126 AI for infants 7–12 months of age based on the AI for younger infants and the observed mean vitamin A intake from human milk and from solid food.126

The Estimated Average Requirement (EAR) and Recommended Dietary Allowance (RDA) for children 1–18 years of age based on data in adults.126

Other Uses

Because of the risk of hypervitaminosis A, some clinicians recommend against the use of vitamin A preparations except in vitamin A deficiency and in appropriate preventive situations.a

Interactions for Aquasol A Parenteral

Specific Drugs and Laboratory Tests

Drug or Test

Interaction

Comments

Cholestyramine

May result in decreased absorption of vitamin Aa

Consider daily supplements of water-miscible preparations of vitamin A during long-term cholestyramine administrationa

Mineral oil

May impair absorption of vitamin Aa

Avoid concomitant usea

Neomycin

May result in decreased absorption of vitamin Aa

Oral contraceptives

Possible increase in vitamin A concentrations137

Orlistat

May result in decreased GI absorption of vitamin A117

Allow ≥ 2 hours to elapse between (before or after) an orlistat dose and vitamin A administration117 119 123 125

Retinoids (e.g., etretinate, isotretinoin)

Possible additive adverse effectsa

Avoid concomitant use of preparations containing vitamin A or its derivativesa

Tests, bilirubin (Ehrlich’s reagent)

May falsely elevate bilirubin determinationsa

Warfarin

Possible increased hypoprothrombinemic effect from large doses of vitamin Aa

Stability

Storage

Oral

Capsules and Tablets

Tight, light-resistant containers.127 139 a

Parenteral

Injection

2–8°C;137 do not freeze.137 a Protect from air and light.127 137 a

Advice to Patients

  • Advise women of child-bearing age to limit their intake of dietary sources (e.g., liver) containing high concentrations of vitamin A to avoid possible teratogenic effects.114 133 Inform these patients to choose fortified foods that contain vitamin A in the form of beta-carotene (e.g., fruits and vegetables) rather than preformed vitamin A.

  • Keep out of reach of children.137

  • Importance of proper dietary habits, including taking appropriate AI or RDA of vitamin A.137 a

  • Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, as well as any concomitant illnesses.137

  • Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.137 a (See Fetal/Neonatal Morbidity and Mortality under Cautions.) Advise lactating women that their vitamin A requirements increase to ensure adequate concentration of the vitamin in milk.a

  • Importance of informing patients of other important precautionary information.137 (See Cautions.)

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