Vitamin A + Vitamin D3 + Vitamin E

Vitamin A + Vitamin D3 + Vitamin E is a fat-soluble vitamin supplement medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

• Prevention and treatment of vitamin A, vitamin D3 and vitamin E deficiency.
• Supplementation when intake is inadequate or requirements are increased, as determined by a healthcare professional.
• Supplementation in selected malabsorption or nutritional deficiency states where fat-soluble vitamin replacement is needed under medical supervision.

The dose depends on age, nutritional status, indication, dosage form, strength, diet, and any laboratory findings. Adults should use Vitamin A + Vitamin D3 + Vitamin E exactly as directed on the product label or by the prescribing doctor, and should not take extra vitamin A, D or E supplements at the same time unless advised. Injectable preparations should be administered only by a trained healthcare professional.

• Mild stomach upset, nausea, vomiting, diarrhoea or constipation.
• Headache, dizziness, tiredness or unusual taste.
• Allergic reactions such as rash, itching, swelling or breathing difficulty; seek urgent help if these occur.
• Excess vitamin A may cause dry or peeling skin, hair loss, bone or joint pain, severe headache, blurred vision, liver problems, or raised pressure inside the skull.
• Excess vitamin D3 may cause high calcium levels with thirst, frequent urination, constipation, confusion, kidney stones or kidney damage.
• High vitamin E intake may increase bleeding tendency, especially in people using blood-thinning medicines.

Use with caution in people with liver disease, kidney disease, high blood calcium, kidney stones, sarcoidosis or other granulomatous disease, malabsorption disorders, bleeding disorders, or those taking retinoids, anticoagulants or other vitamin supplements. Infants, children, pregnant women and breastfeeding mothers need particular care because excessive fat-soluble vitamins can be harmful. Use under a registered doctor's or pharmacist's guidance.

• Other vitamin A, D or E products may increase the risk of overdose.
• Retinoid medicines such as isotretinoin or acitretin may increase vitamin A toxicity risk.
• Orlistat, cholestyramine, colestipol and mineral oil may reduce absorption of fat-soluble vitamins.
• Warfarin, other anticoagulants and antiplatelet medicines may have increased bleeding risk with high-dose vitamin E.
• Thiazide diuretics and calcium supplements may increase the risk of high calcium levels when combined with vitamin D3.
• Digoxin and other cardiac glycosides may have increased toxicity risk if vitamin D3 causes high calcium levels.
• Some anticonvulsants and long-term corticosteroids may affect vitamin D status and bone health.

• Known hypersensitivity to vitamin A, vitamin D3, vitamin E or any component of the formulation.
• Existing hypervitaminosis A, hypervitaminosis D or vitamin E toxicity.
• High blood calcium or high urine calcium related to vitamin D excess, unless specifically managed by a doctor.
• Use of high-dose vitamin A during pregnancy unless specifically prescribed by a doctor because excessive vitamin A can harm the unborn baby.

Vitamins A, D3 and E are important during pregnancy and breastfeeding, but excessive intake—especially vitamin A—can be harmful to the baby. Pregnant or breastfeeding women should use Vitamin A + Vitamin D3 + Vitamin E only at doses recommended by a doctor and should avoid combining multiple vitamin products unless advised.

Store at room temperature, protected from light, heat and moisture. Keep the container tightly closed and out of the reach of children. Do not freeze liquid preparations unless the label specifically allows it. Do not use after the expiry date or if the product appears discoloured, contaminated or damaged.