Drug Interaction Report

MONITOR CLOSELY: Concomitant use of vitamin A or related compounds (i.e., retinoids) with tetracyclines may increase the risk of pseudotumor cerebri, also known as benign intracranial hypertension. These agents individually have been associated with the development of pseudotumor cerebri and may have additive effects during coadministration. The interaction has been suspected in reported cases involving the use of isotretinoin or vitamin A in combination with a tetracycline. Other vitamin A-related compounds may interact similarly. Both acute and chronic vitamin A intoxication have been identified as secondary causes of pseudotumor cerebri.

MANAGEMENT: Caution is advised if vitamin A is coadministered with tetracyclines. Concomitant use of most retinoids (vitamin A derivatives) with tetracyclines is considered contraindicated. Patients should be counseled to contact their healthcare provider immediately if they develop signs or symptoms of pseudotumor cerebri such as papilledema, headache, nausea, vomiting, and/or visual disturbances. The patient should be advised to discontinue vitamin A and the tetracycline and be referred for immediate neurological evaluation and care if pseudotumor cerebri is suspected as this could result in permanent vision loss.