Vitamins a and d
- Drugs List
- Therapeutic Indications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
Vitamin A 4000 international units (1.2mg)
Vitamin D 400 international units (10 micrograms)
Prophylaxis of vitamin A and D deficiency.
One capsule daily.
No dosage adjustment necessary (see Dosage, Adults)
Children 1 year and over
One capsule daily.
Children under 1 year
Capsule formulation may not be suitable for this age group.
Patients with Renal Impairment
Avoid in severe renal impairment
For oral administration.
Hypersensitivity to arachis oil (peanuts)
Severe renal impairment
Precautions and Warnings
Not all available brands are licensed for all age groups
Infants under 1 year: Capsule formulation may not be suitable for this age group
Children: May have increased sensitivity to the effects of vitamin A and D
Patients with renal impairment, calculi or heart disease may be at increased risk of organ damage if hypercalcaemia occurs
Pregnancy (see Pregnancy section)
Lactation (see Lactation section)
Excessive prolonged dosage of vitamin A and D may lead to hypervitaminosis
Patients should not exceed recommended dose
Absorption of vitamin A may be impaired in cholestatic jaundice, fat-malabsorption conditions, hepatic or pancreatic impairment
Patients with hepatic impairment may have enhanced susceptibility to the effects of vitamin A
Plasma calcium levels should be checked regularly in patients receiving pharmacological doses of vitamin D particularly when nausea and vomiting are present
Plasma phosphate concentrations should be controlled during vitamin D therapy to reduce the risk of ectopic calcification
Some formulations may contain arachis oil.
Pregnancy and Lactation
The fat soluble vitamins A and D may be toxic or teratogenic in high doses. Deficiencies of vitamins may also be teratogenic. Doses in excess of those recommended should be avoided during pregnancy.
Caution should be used in pregnancy as excessive doses of vitamin A may be teratogenic, especially when taken in the first trimester. Various recommendations concerning dosage of vitamin A in pregnancy have been made but further research is needed to define more clearly the boundary between risk and benefit in vitamin A supplementation. Some authorities advise that women who are, or who wish to become pregnant, should not take vitamin A supplements except on the advice of a doctor or an antenatal clinic.
High doses of vitamin D have been shown to be teratogenic in animals but there is no conclusive evidence of problems in humans and very high doses of vitamin D used to treat maternal hypoparathyroidism during pregnancy have not been associated with foetal abnormalities.
Is found in the breast milk of lactating mothers and there is therefore a theoretical risk of neonatal toxicity.
Vitamin D is excreted into breast milk in limited amounts.
Large doses of vitamin D in lactating mothers may cause hypercalcaemia in infants.
Doses in excess of those recommended should be avoided during lactation.
Serum calcium levels of the infant should be monitored if the mother is receiving pharmacological doses.
Effects on Ability to Drive and Operate Machinery
There are no known effects on the ability to drive or operate machinery.
Advise patients not to exceed the stated dose.
None in the absence of overdosing.
It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.
The following number will direct the caller to the relevant local centre (0844) 892 0111
Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet (https://www.toxbase.org/)
Shelf Life and Storage
Protect from light
Store in a dry place below 25 degrees C
Summary of Product Characteristics for Vitamins A & D Capsules BPC from RP Scherer Limited dated February 1998
BNF 52 September 2006
BNF for Children 2006
Martindale 35th Edition
Therapeutics in Pregnancy and Lactation
ed. Lee, A et al
Radcliffe Medical Press, Abingdon, 2000
Drugs in Pregnancy and Lactation, 7th edition
ed. Briggs, G et al
Lippincott Williams & Wilkins, Philadelphia 2005
Medicines For Children
RCPCH Publications Ltd, London, 2003
Dietary Supplements, 2nd edition
ed. Mason, P
Pharmaceutical Press, London, 2001
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