vitamin E (OTC)

Brand and Other Names:Aquasol E, alpha-tocopherol, more...tocopherol
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

capsule

  • 200units
  • 400units
  • 600units
  • 1000units

liquid

  • 400units/15mL

solution

  • 15units/0.3mL

RDA

15 mg PO qDay; not to exceed 1000 mg/day

Pregnant Females

  • <18 years: 15 mg PO qDay; not to exceed 800 mg/day
  • >18 years: 15 mg PO qDay; not to exceed 1000 mg/day

Lactating Females

  • <18 years: 19 mg PO qDay; not to exceed 800 mg/day
  • >18 years: 19 mg/day PO qDay; not to exceed 1000 mg/day

Vitamin E Deficiency

60-75 units PO qDay

Postherpetic Neuralgia (Off-label)

400 units PO twice or four times daily

Fragile X Syndrome (Orphan)

Orphan designation for fragile X syndrome in combination with ascorbic acid

Orphan sponsor

  • GenCo Pharmaceuticals LLC; 371 Lake Surprise Road; Cold Spring, New York 10516

Administration

Swallow capsules whole, do not crush or chew

Dosage Forms & Strengths

capsule

  • 200units
  • 400units
  • 600units
  • 1000units

liquid

  • 400units/15mL

solution

  • 15units/0.3mL

RDA

Swallow capsules whole, do not crush

1-3 years: 6 mg PO qDay; not to exceed 200 mg/day

3-8 years: 7 mg PO qDay; not to exceed 300 mg/day

8-13 years: 11 mg PO qDay; not to exceed 600 mg/day

13-18 years: 6 mg PO qDay; not to exceed 800 mg/day

Cystic Fibrosis Supplementation (Off-label)

1-12 months: 40-50 units/day

1-3 years: 80-150 units/day

4-8 years: 100-200 units/day

>8 years: 200-400 units/day

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Interactions

Interaction Checker

and vitamin E

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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             activity indicator 

            Contraindicated (0)

              Serious - Use Alternative (0)

                Monitor Closely (8)

                • betrixaban

                  vitamin E, betrixaban. Either increases levels of the other by anticoagulation. Use Caution/Monitor.

                • ferric maltol

                  vitamin E decreases levels of ferric maltol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                • ferrous sulfate

                  vitamin E decreases levels of ferrous sulfate by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                • iron sucrose

                  vitamin E decreases levels of iron sucrose by increasing hepatic clearance. Use Caution/Monitor.

                • polysaccharide iron

                  vitamin E decreases levels of polysaccharide iron by increasing hepatic clearance. Use Caution/Monitor.

                • selumetinib

                  vitamin E and selumetinib both increase Other (see comment). Modify Therapy/Monitor Closely. Selumetinib contains vitamin E. Daily vitamin E intake (ie, amount in selumetinib, supplement, dietary) that exceeds recommendations may increase bleeding risk.

                • vortioxetine

                  vitamin E, vortioxetine. Either increases effects of the other by anticoagulation. Use Caution/Monitor.

                • zanubrutinib

                  vitamin E, zanubrutinib. Either increases effects of the other by anticoagulation. Modify Therapy/Monitor Closely. Zanubrutinib-induced cytopenias increases risk of hemorrhage. Coadministration of zanubritinib with antiplatelets or anticoagulants may further increase this risk.

                Minor (59)

                • alfalfa

                  alfalfa decreases levels of vitamin E by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. (Vitamin E).

                • antithrombin alfa

                  vitamin E, antithrombin alfa. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Vitamin E at RDA does not change INR in pts. on chronic warfarin therapy; megadoses (~10x RDA) may enhance anticoagulant effects in vitamin K deficient pts.

                • antithrombin III

                  vitamin E, antithrombin III. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Vitamin E at RDA does not change INR in pts. on chronic warfarin therapy; megadoses (~10x RDA) may enhance anticoagulant effects in vitamin K deficient pts.

                • argatroban

                  vitamin E, argatroban. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Vitamin E at RDA does not change INR in pts. on chronic warfarin therapy; megadoses (~10x RDA) may enhance anticoagulant effects in vitamin K deficient pts.

                • bemiparin

                  vitamin E, bemiparin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Vitamin E at RDA does not change INR in pts. on chronic warfarin therapy; megadoses (~10x RDA) may enhance anticoagulant effects in vitamin K deficient pts.

                • bivalirudin

                  vitamin E, bivalirudin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Vitamin E at RDA does not change INR in pts. on chronic warfarin therapy; megadoses (~10x RDA) may enhance anticoagulant effects in vitamin K deficient pts.

                • busulfan

                  vitamin E, busulfan. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • capecitabine

                  vitamin E, capecitabine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • carbonyl iron

                  vitamin E decreases levels of carbonyl iron by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                • carboplatin

                  vitamin E, carboplatin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • carmustine

                  vitamin E, carmustine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • chitosan

                  chitosan decreases levels of vitamin E by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                • chlorambucil

                  vitamin E, chlorambucil. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • cisplatin

                  vitamin E, cisplatin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • cladribine

                  vitamin E, cladribine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • cytarabine

                  vitamin E, cytarabine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • dacarbazine

                  vitamin E, dacarbazine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • dalteparin

                  vitamin E, dalteparin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Vitamin E at RDA does not change INR in pts. on chronic warfarin therapy; megadoses (~10x RDA) may enhance anticoagulant effects in vitamin K deficient pts.

                • decitabine

                  vitamin E, decitabine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • docetaxel

                  vitamin E, docetaxel. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • enoxaparin

                  vitamin E, enoxaparin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Vitamin E at RDA does not change INR in pts. on chronic warfarin therapy; megadoses (~10x RDA) may enhance anticoagulant effects in vitamin K deficient pts.

                • ethanol

                  ethanol decreases levels of vitamin E by unspecified interaction mechanism. Minor/Significance Unknown.

                • ferrous fumarate

                  vitamin E decreases levels of ferrous fumarate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                • ferrous gluconate

                  vitamin E decreases levels of ferrous gluconate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                • floxuridine

                  vitamin E, floxuridine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • fludarabine

                  vitamin E, fludarabine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • fluorouracil

                  vitamin E, fluorouracil. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • fondaparinux

                  vitamin E, fondaparinux. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Vitamin E at RDA does not change INR in pts. on chronic warfarin therapy; megadoses (~10x RDA) may enhance anticoagulant effects in vitamin K deficient pts.

                • gemcitabine

                  vitamin E, gemcitabine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • heparin

                  vitamin E, heparin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Vitamin E at RDA does not change INR in pts. on chronic warfarin therapy; megadoses (~10x RDA) may enhance anticoagulant effects in vitamin K deficient pts.

                • ifosfamide

                  vitamin E, ifosfamide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • irinotecan

                  vitamin E, irinotecan. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • irinotecan liposomal

                  vitamin E, irinotecan liposomal. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • iron dextran complex

                  vitamin E decreases levels of iron dextran complex by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                • lomustine

                  vitamin E, lomustine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • mechlorethamine

                  vitamin E, mechlorethamine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • melphalan

                  vitamin E, melphalan. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • mercaptopurine

                  vitamin E, mercaptopurine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • mineral oil

                  mineral oil decreases levels of vitamin E by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                • nelarabine

                  vitamin E, nelarabine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • orlistat

                  orlistat decreases levels of vitamin E by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. May cause fat-soluble vitamin malabsorption. Separate by 2 hours.

                • oxaliplatin

                  vitamin E, oxaliplatin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • paclitaxel

                  vitamin E, paclitaxel. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • paclitaxel protein bound

                  vitamin E, paclitaxel protein bound. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • pentostatin

                  vitamin E, pentostatin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • phenindione

                  vitamin E, phenindione. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Vitamin E at RDA does not change INR in pts. on chronic warfarin therapy; megadoses (~10x RDA) may enhance anticoagulant effects in vitamin K deficient pts.

                • pralatrexate

                  vitamin E, pralatrexate. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • protamine

                  vitamin E, protamine. Mechanism: pharmacodynamic antagonism. Minor/Significance Unknown. Vitamin E at RDA does not change INR in pts. on chronic warfarin therapy; megadoses (~10x RDA) may enhance anticoagulant effects in vitamin K deficient pts.

                • rose hips

                  vitamin E decreases levels of rose hips by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                • streptozocin

                  vitamin E, streptozocin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • thioguanine

                  vitamin E, thioguanine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • thiotepa

                  vitamin E, thiotepa. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • topotecan

                  vitamin E, topotecan. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • treosulfan

                  vitamin E, treosulfan. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • vinblastine

                  vitamin E, vinblastine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • vincristine

                  vitamin E, vincristine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • vincristine liposomal

                  vitamin E, vincristine liposomal. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • vinorelbine

                  vitamin E, vinorelbine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

                • warfarin

                  vitamin E, warfarin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Vitamin E at RDA does not change INR in pts. on chronic warfarin therapy; megadoses (~10x RDA) may enhance anticoagulant effects in vitamin K deficient pts.

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                Adverse Effects

                Frequency Not Defined

                Fatigue

                Headache

                Flatulence

                Diarrhea

                Blurred vision

                Necrotizing enterocolitis (infants)

                Increased serum creatinine

                Increased risk of hemorrhagic stroke

                Recent evidence suggests that Vitamin E may suppress action of other antioxidants

                Very modest but statistically significant increase in all-cause mortality with supplemental intake of vitamin E =400 IU/day

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                Warnings

                Contraindications

                Hypersensitivity to vitamin E or formulation components

                Cautions

                Vitamin E, at RDA levels, does not increase bleeding time or affect warfarin except at megadoses (~10x RDA or higher) - adjustment of warfarin may be necessary for such doses

                Discontinue high dose Vitamin E supplementation 1 month before surgery, may resume after recovery

                Use with caution in Vitamin K deficiency, bleeding propensity or lesions (bleeding peptic ulcers, hemophilia etc)

                Vitamin E increases efficacy & decreases toxicity of antineoplastic drugs

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                Pregnancy & Lactation

                Pregnancy Category: A (RDA levels)

                Lactation: Excreted in breast milk; safe

                Pregnancy Categories

                A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

                B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

                C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

                D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

                X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

                NA: Information not available.

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                Nutrition

                Sources: Wheat germ oil, sunflower seeds; richest source is vegetable oils

                Functions: Lipid antioxidant, protects membrane phospholipids, intracellular antioxidant, inhibits platelet aggregation

                Deficiency: Rare; occurs in premature infants & those who cannot absorb fat; sterility; muscle weakness, visceral impairment; infants: anemia, nerve, eye & balance problems that may be permanent

                Toxicity: Extremely rare

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                Pharmacology

                Mechanism of Action

                Plays a role in protecting red blood cells against hemolysis; has protective effects against free radicals on polyunsaturated fatty acids found in cell membranes; plays a role in preventing oxidation of vitamin A and C

                Pharmacokinetics

                Absorption: Reduced in patients with history of malabsorption; water preparations better absorbed than oil preparations

                Distribution: All body tissues especially adipose tissues where it is stored

                Metabolism: Liver

                Excretion: Feces

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                Images

                BRAND FORM. UNIT PRICE PILL IMAGE
                vitamin E oral
                -
                1,000 unit capsule

                Copyright © 2010 First DataBank, Inc.

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                Patient Handout

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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.