Drug Interactions between isotretinoin and vitamin a

GENERALLY AVOID: Concomitant use of a retinoid with vitamin A or other retinoids may result in hypervitaminosis A and additive toxicities. Patients may be at increased risk for potentially serious adverse effects such as vision impairment, pseudotumor cerebri (benign intracranial hypertension), mucositis, esophagitis, hepatitis, hypertriglyceridemia, pancreatitis, ileitis, and colitis.

MANAGEMENT: Patients receiving retinoid therapy should avoid concurrent use of other retinoids or vitamin A supplements in excess of the recommended daily allowance. Patients should be made aware of vitamin A sources in vitamin supplements, fortified foods and over-the-counter medications, and be advised to contact their physician if they experience signs of hypervitaminosis A such as inflammation or bleeding of the gums or lips; dry, scaly skin; alopecia; pruritus; erythema; headache; vertigo; and nausea. Patients should discontinue the medication and seek immediate medical attention if they develop signs and symptoms of pseudotumour cerebri (e.g., headache, nausea, vomiting, visual disturbances, papilledema) or hepatotoxicity (e.g., fever, rash, anorexia, nausea, vomiting, fatigue, right upper quadrant pain, dark urine, jaundice).