vitamin e

REMS

PO: Used as a dietary supplement.
Used in low-birth-weight infants to prevent and treat hemolysis due to vitamin E deficiency.
Topical Treatment of irritated, chapped, or dry skin.

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity to ingredients in preparations (parabens, propylene, glycol).

Use Cautiously in:

Anemia due to iron deficiency;
Vitamin K deficiency (may ↑ risk of bleeding);
Pedi: Oral administration may cause necrotizing enterocolitis in low-birth-weight infants.

Adv. Reactions/Side Effects ⬆ ⬇

Seen primarily with large doses over long periods of time

Derm: rash

EENT: blurred vision

Endo: gonadal dysfunction

GI: cramps, diarrhea, nausea, NECROTIZING ENTEROCOLITIS (ORAL ADMINISTRATION IN LOW-BIRTH-WEIGHT INFANTS)

Neuro: fatigue, headache, weakness

Interactions ⬆ ⬇

Drug-drug:

Cholestyramine, colestipol, orlistat, mineral oil, and sucralfate↓ absorption.
May ↓ hematologic response to iron supplements.
May ↑ the risk of bleeding with warfarin or aspirin.

Drug-Natural Products:

↑bleeding risk with anise, arnica, chamomile, clove, dong quai, fenugreek, feverfew, garlic, ginger, ginkgo, Panax ginseng, licorice, and others.

Availability ⬆ ⬇

Capsules: 100 units^OTC; 200 units^OTC; 400 units^OTC; 600 units^OTC; 800 units^OTC; 1000 units^OTC
Oral solution: 26.6 units/mL^OTC; 50 units/mL^OTC; 77 units/mL^OTC
Tablets: 100 units^OTC; 200 units^OTC; 400 units^OTC; 500 units^OTC; 800 units^OTC
Chewable tablets: 400 units^OTC
Ointment: ^OTC
Cream: ^OTC
Lotion: ^OTC
Oil: ^OTC

Route/Dosage ⬆ ⬇

Other dosing regimens may be used
PO (Adults and Children ): Determined by nutritional intake or degree of deficiency.
(Adults and Children ): Apply to affected areas as needed.

US Brand Names ⬆ ⬇

alpha tocopherol, Amino-Opti-E, Aquasol E, E-200, E-400, E-1000, E-Complex-600, E-Vitamin, Liqui-E, Pheryl-E, Vita Plus E

Action ⬆ ⬇

Prevents the oxidation (antioxidant) of other substances.
Protects RBC membranes against hemolysis, especially in low-birth-weight neonates.

Therapeutic effects:

Prevention and treatment of deficiency in high-risk patients.

Classifications ⬆ ⬇

Therapeutic Classification: vitamins

Pharmacologic Classification: fat soluble vitamins

Pharmacokinetics ⬆ ⬇

Absorption: 20–80% absorbed following oral administration. Absorption requires fat and bile salts.

Distribution: Widely distributed, stored in adipose tissue (4-yr supply).

Metabolism/Excretion: Metabolized by the liver, excreted in bile.

Half-Life: Unknown.

Canadian Brand Names ⬆ ⬇

Time/Action Profile ⬆ ⬇

ROUTE	ONSET	PEAK	DURATION
PO	unknown	unknown	unknown

Patient/Family Teaching ⬆ ⬇

Instruct patient to take medication as directed. If a dose is missed, it should be omitted, because fat-soluble vitamins are stored in the body for long periods.
Encourage patient to comply with diet recommendations of health care professional. Explain that the best source of vitamins is a well-balanced diet with foods from the four basic food groups.
Foods high in vitamin E include vegetable oils, wheat germ, whole-grain cereals, egg yolk, and liver. Vitamin E content is not markedly affected by cooking.
Patients self-medicating with vitamin supplements should be cautioned not to exceed RDA. The effectiveness of megadoses for treatment of various medical conditions is unproved, and this may cause side effects and toxicity.
Review symptoms of overdosage (blurred vision, flu-like symptoms, headache, breast enlargement). Instruct patient to report these promptly to health care professional.
Mineral oil may interfere with the absorption of fat-soluble vitamins and should not be used concurrently.

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Indications ⬇