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Medications/pharmaceuticals known to increase/aggravate/cause Poison/"Vitamin A" toxicity

I will add to this list as I figure more out.  Many medications that "interact" with Poison/"Vitamin A" do so by directly inhibiting one or more of the pathways the body uses to break down or detoxify it, so the symptoms (side effects) are those of Poison/"Vitamin A" toxicity.

Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis (SJS/TEN): Could Retinoids Play a Causative Role?

It is suggested here that a wide variety of medications interact with endogenous sources of vitamin A to induce SJS/TEN via cholestatic liver dysfunction and retinoid toxicity.
The drugs most commonly implicated in SJS/TEN are anticonvulsants (phenobarbital, phenytoin, carbamazepine, lamotrigine, valproate), sulfonamides (cotrimoxazole, sulfasalazine) [sulfa drugs], other antibiotics (aminopenicillins, quinolones [fluoroquinolones like Cipro], cephalosporins), certain nonsteroidal anti-inflammatory drugs (oxicams and Butazone derivatives), antifungals [-azoles, I have another post on this], antimalarials [chloroquine, mefloquine, I have another post on this], and allopurinol [7,8,10,11,35,36].

Possible Interactions with: Vitamin A (Retinol)

Tetracycline antibiotics -- People who take a type of antibiotics called tetracyclines and also take high doses of vitamin A may be at risk for a condition called intracranial hypertension, a rise in the pressure of brain fluid. Tetracyclines include:

  • Demeclocycline (Declomycin)
  • Minocycline (Minocin)
  • Tetracycline (Achromycin)

Another class of cholesterol-lowering medications called statins may actually increase vitamin A levels in the blood.

Retinoids -- These medications are a synthetic form of vitamin A and are sometimes prescribed in high doses. People who take retinoids should not take any additional vitamin A supplements. In addition, these drugs can cause severe birth defects. Women of child-bearing age must have two negative pregnancy tests and be on two forms of birth control before taking these medications. Anyone taking retinoids will be monitored closely by their doctor. Retinoids include:

  • Acitretin (Soriatane)
  • Bexarotene (Targretin)
  • Isotretinoin (Accutane)
  • Tazarotene (Avage)
  • Tretinoin (Retin-A) is usually prescribed for topical use to treat acne or reduce wrinkles and is not as concentrated as other retinoids. However, it is still a good precaution to avoid taking a vitamin A supplement while using Retin-A.


Medications that can harm the liver (Hepatotoxic drugs) - Taking large amounts of vitamin A might harm the liver. Taking large amounts of vitamin A along with medications that might also harm the liver can increase the risk of liver damage. Do not take large amounts of vitamin A if you are taking a medication that can harm the liver. Some medications that can harm the liver include:

  • acetaminophen (Tylenol and others)
  • amiodarone (Cordarone)
  • carbamazepine (Tegretol)
  • isoniazid (INH)
  • methotrexate (Rheumatrex)
  • methyldopa (Aldomet)
  • fluconazole (Diflucan)
  • itraconazole (Sporanox)
  • erythromycin (Erythrocin, Ilosone, others)
  • phenytoin (Dilantin)
  • lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor)
  • and many others


Warfarin (Coumadin) - Warfarin (Coumadin) is used to slow blood clotting. Large amounts of vitamin A can also slow blood clotting. Taking vitamin A along with warfarin (Coumadin) can increase the chances of bruising and bleeding. 

I will incorporate the other links to medication posts from this very forum later.

Dr. Garrett Smith, the "Nutrition Detective"
Licensed Naturopathic Physician (NMD) in Arizona
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