Classes
DEA Class; OTC
Common Brand Names; Aquasol E, alpha-tocopherol, tocopherol
- Vitamins E
- Vitamins, Fat-Soluble
Description
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
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
Indications
Vitamin E is an antioxidant also known as tocopherol. It helps the body form red blood cells and use vitamin K.
Also Indicated For
- Vitamin E Deficiency
- RDA
- Postherpetic Neuralgia (Off-label)
- Fragile X Syndrome (Orphan)
- Dermatologic Pain/Irritation
Contraindications
Hypersensitivity to vitamin E or formulation components
Adverse Effects
- 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
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 and Lactation
Pregnancy Category: A (RDA levels)
Lactation: Excreted in breast milk; safe
Maximum Dosage
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
Dermatologic Pain/Irritation
Apply topically to affected areas PRN
How supplied
Vitamin E (Tocopherol)
capsule
- 200units
- 400units
- 600units
- 1000units
tablets
- 100units
- 200units
- 400units
liquid
- 400units/15mL
solution
- 15units/0.3mL
cream
- 30,000units/57g
- 1000units/120g
- 100units/g
- 30units/g
ointment
- 30units/g
oil
- 28,000units/30mL