Dosing & Uses
Dosage Forms & Strengths
capsule
- 200units
- 400units
- 600units
- 1000units
tablets
- 100units
- 200units
- 400units
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
tablets
- 100units
- 200units
- 400units
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
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (0)
Monitor Closely (9)
- 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.
- warfarin
vitamin E increases effects of warfarin by unspecified interaction mechanism. 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 (58)
- 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.
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
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
May induce vitamin K deficiency; use with caution in Vitamin K deficiency, bleeding propensity or lesions (bleeding peptic ulcers, hemophilia etc)
High doses of vitamin E (≥400 units daily) administered long-term administration (>1 year) may increase all-cause mortality
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.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
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
