Vitamin e

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: 150-200 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).

Should be taken with food.

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

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.

Symptoms: Transient gastrointestinal disturbances. Management: Supportive treatment.

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.

May potentiate the antiplatelet effects of garlic and ginkgo.

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.
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.

Oral: Store below 30°C. Protect from light.

Vitamins A, D & E