Vitamin E: Indication, Dosage, Side Effect, Precaution

Generic Medicine Info Patient Medicine Information

This information is not country-specific. Please refer to the Myanmar prescribing information.

Generic Medicine Info

Indications and Dosage

Oral
Vitamin E deficiency

Adult: Doses of vitamin E preparations may be expressed in IU or in mg. This may vary depending on the formulation used (natural or synthetic form) in individual products. For prevention and treatment: As dl-alpha tocopheryl acetate or d-alpha tocopherol softgel cap: 200-400 IU daily. In cystic fibrosis: As dl-alpha tocopheryl acetate susp: 100-200 mg daily. In abetalipoproteinaemia: As dl-alpha tocopheryl acetate susp: 50-100 mg/kg daily. Dosage recommendations may vary among individual products and between countries (refer to specific product guidelines).
Child: As dl-alpha tocopheryl acetate susp: In cystic fibrosis: <1 year 50 mg daily; ≥1 year 100 mg daily. In abetalipoproteinaemia: Same as adult dose. In chronic cholestasis: 200 mg/kg daily. All doses must be adjusted according to individual response and tolerability. Treatment recommendations may vary among individual products and between countries (refer to specific product guidelines).

Administration

Should be taken with food.

Special Precautions

Patients with predisposition to thrombosis, including those taking estrogens; vitamin K deficiency, bleeding tendencies (e.g. bleeding peptic ulcers), history of haemorrhagic stroke, inherited bleeding disorder (e.g. haemophilia). Children. Pregnancy and lactation.

Adverse Reactions

Significant: Vitamin K deficiency; increased risk of thrombosis; necrotising enterocolitis (particularly at large doses in low-birth-weight premature infants).
Eye disorders: Blurred vision.
Gastrointestinal disorders: Nausea; abdominal pain, diarrhoea (at high doses).
General disorders and administration site conditions: Fatigue.
Nervous system disorders: Dizziness, headache.
Psychiatric disorders: Emotional disturbances.
Skin and subcutaneous tissue disorders: Rash.

Monitoring Parameters

Monitor serum tocopherol levels regularly; prothrombin time, INR (in patients taking anticoagulants).

Overdosage

Symptoms: Transient gastrointestinal disturbances. Management: Supportive treatment.

Drug Interactions

May increase the risk for bleeding with anticoagulants (e.g. warfarin) or antiplatelets (e.g. aspirin, clopidogrel, ticlopidine). May increase the risk of thrombosis with estrogens. Concomitant use with colestyramine, colestipol or orlistat may interfere with the absorption of vitamin E.

Food Interaction

May potentiate the antiplatelet effects of garlic and ginkgo.

Action

Description: Vitamin E is a general term used to refer to a large number of natural or synthetic compounds. Tocopherols, particularly the alpha tocopherols, are the most active and widely distributed. Alpha tocopherols occur naturally in the d optical isomer form which is more active than the dl synthetic racemic form. Vitamin E is a fat-soluble vitamin that inhibits Vitamin A and C oxidation. It protects the polyunsaturated fatty acids in the membrane from the attack of free radicals and the RBCs against haemolysis. It may be given as d- or dl-alpha tocopherol or as the respective acetates or acid succinates.
Pharmacokinetics:
Absorption: Absorption from the gastrointestinal tract depends on the presence of bile and normal pancreatic function.
Distribution: Widely distributed into all body tissues; stored in adipose tissue. Crosses the placenta and enters the breast milk.
Metabolism: Metabolised in the liver into glucuronides of tocopheronic acid and its γ-lactone.
Excretion: Mainly via bile; remainder via urine.

Chemical Structure

Storage

Store below 30°C. Protect from light.

MIMS Class

Vitamins A, D & E

ATC Classification

A11HA03 - tocopherol (vit E) ; Belongs to the class of other plain vitamin preparations. Used as dietary supplements.

References

Anon. Vitamin E (Systemic). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 26/04/2022.

Buckingham R (ed). Vitamin E Substances. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 26/04/2022.

Evirose-400 Softgel Capsule (Actimed, Inc.). MIMS Philippines. http://www.mims.com/philippines. Accessed 04/01/2022.

Joint Formulary Committee. Alpha Tocopheryl Acetate. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 09/12/2021.

Myra 300-E (UL Skin Sciences). MIMS Philippines. http://www.mims.com/philippines. Accessed 03/01/2022.

Myra 400-E (UL Skin Sciences). MIMS Philippines. http://www.mims.com/philippines. Accessed 21/04/2022.

Pharex Vitamin E 400 IU Softgel Capsule (Pharex Healthcorp). MIMS Philippines. http://www.mims.com/philippines. Accessed 04/01/2022.

Vitamin E Jamieson (Jamieson Lab). MIMS Hong Kong. http://www.mims.com/hongkong. Accessed 03/01/2022.

Vitamin E Suspension 100 mg/mL (Alliance Pharmaceuticals Limited). MHRA. https://products.mhra.gov.uk. Accessed 26/04/2022.

Vitamin E. Drugs and Lactation Database (LactMed) [Internet]. Bethesda, MD. U.S. National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK501922. Accessed 27/04/2022.

Disclaimer: This information is independently developed by MIMS based on Vitamin E from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2024 MIMS. All rights reserved. Powered by MIMS.com