Is there any documented interaction between alcohol and vitamin A? Is alcohol contraindicated durin

Fråga: Is there any documented interaction between alcohol and vitamin A? Is alcohol contraindicated during treatment with vitamin A palmitate (ex tempore preparation)?

Sammanfattning: Alcohol may either exacerbate deficiency of vitamin A by accelerated microsomal degradation or aggravate toxicity when excess vitamin A is present. Vitamin A supplements should be given to the alcoholic patient, not only to correct problems of night blindness, but also to alleviate potential liver dysfunction. There is no absolute contraindication for alcohol intake during treatment with vitamin A, although individual consideration is necessary with respect to dose, as well as nutritional and liver status.

Svar: Possible interactions between alcohol, drugs, and nutrients, including vitamin A, have been reviewed. It has been pointed out that alcohol may either exacerbate deficiency of vitamin A by accelerated microsomal degradation of the vitamin or aggravate toxicity when excess vitamin A is present. Vitamin A supplements should be given to the alcoholic patient, not only to correct problems of night blindness, but also to alleviate potential liver dysfunction. However, such therapy is complicated by the fact that excessive amounts of vitamin A are hepatotoxic and that long-term ethanol consumption enhances this effect. However, very large amounts of vitamin A (in excess of 50 to 100 times the daily requirement) given over prolonged periods are necessary to cause this unusual adverse effect. A smaller vitamin A supplement (eg five times the normal intake) causes, by itself, no detectable adverse effects, but when combined with alcohol it results in a striking leakage of mitochondrial enzymes into the bloodstream. It has therefore been concluded that, in heavy drinkers, vitamin A supplementation might hasten rather than alleviate a liver disease process (1). 1 Lieber CS: Interaction of alcohol with other drugs and nutrients. Implication for the therapy of alcoholic liver disease. Drugs 1990; 40(suppl 3): 23-44