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Generic Name: vitamin E
Brand and Other Names: Aquasol E, alpha-tocopherol, tocopherol
Drug Class: Vitamins, Fat-Soluble
What is vitamin E, and what is it used for?
Vitamin E is one of the micronutrients essential for good health. Vitamin E refers to a group of fat-soluble compounds known as tocopherols and tocotrienols, and alpha-tocopherol is the most bioactive form of the vitamin.
Vitamin E is not naturally synthesized in the body and must be obtained from dietary intake. Oral formulations of vitamin E are available over the counter and may be taken as dietary supplements to compensate for natural deficiency.
Vitamin E has many important functions in the body that include:
- Antioxidant that neutralizes free radicals, unstable molecules that result from normal cellular activity, which damage tissue and are involved in many diseases.
- Protects fatty molecules (phospholipids) on cellular membranes from being damaged by free radicals.
- Inhibits platelet aggregation and reduces clot formation.
- Protects red blood cells from destruction (hemolysis).
- Boosts the immune system.
- Plays a role in preventing oxidation of vitamin A and C.
Vitamin E absorption requires adequate intake of fat. Most healthy people can get sufficient vitamin E from their diet and do not require supplements. Vitamin E rich foods include edible vegetable oils such as wheat germ oil sunflower oil, nuts and seeds including almonds, sunflower, peanuts and hazelnuts, leafy green vegetables and fruits.
Vitamin E deficiency is rare and is usually linked with certain conditions that affect fat absorption and metabolism, such as Crohn’s disease, cystic fibrosis and a rare inherited disorder known as abetalipoproteinemia. Very low birth weight, premature infants also may have vitamin E deficiency. Uses of vitamin E supplementation include:
- Vitamin E deficiency
- Dietary supplement
Off-label uses include:
- Nonalcoholic fatty liver disease (steatohepatitis)
- Postherpetic neuralgia
- Cystic fibrosis in children
The use of vitamin E is being studied in many conditions including certain types of cancers, plaque buildup in arteries (atherosclerosis), age-related vision diseases, neurodegenerative diseases and fragile X syndrome. There is, however, insufficient scientific evidence to support any of these uses. Vitamin E is also believed to be beneficial for skin health and used in skin care products for topical application.
Warnings
- Do not take if you are hypersensitive to vitamin E or any of the components in its formulation.
- Vitamin E supplementation can induce vitamin K deficiency and increase bleeding risks. Use with caution in patients with vitamin K deficiency, bleeding disorders, or bleeding peptic ulcers.
- Vitamin E does not increase bleeding time or affect warfarin effects in recommended doses. Adjustment of warfarin may be necessary for high doses.
- Discontinue high dose vitamin E supplementation 1 month before surgery, and resume after recovery.
- Some studies indicate high doses of vitamin E (400 units or more daily) taken for a long term (longer than 1 year) may increase all-cause mortality, however, the studies were small and results inconclusive.
What are the side effects of vitamin E?
Common side effects of vitamin E include:
- Diarrhea
- Gas (flatulence)
- Nausea
- Headache
- Fatigue
- Blurred vision
- Increase in serum creatinine levels
- Increased bleeding risk and hemorrhagic stroke
- Intestinal inflammatory disease (necrotizing enterocolitis) in low birth weight infants
- Possible vitamin K deficiency
- May suppress action of other antioxidants
Call your doctor immediately if you experience any of the following symptoms or serious side effects while using this drug:
- Serious heart symptoms include fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness;
- Severe headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;
- Severe nervous system reaction with very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, and feeling like you might pass out; or
- Serious eye symptoms include blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.
This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.
QUESTION
Next to red peppers, you can get the most vitamin C from ________________.
See Answer
What are the dosages of vitamin E?
Capsule
- 200 units
- 400 units
- 600 units
- 1000 units
Liquid
- 400 units/15 mL
Solution
- 15 units/0.3mL
Adult:
Recommended Daily Allowance (RDA)
- 15 mg orally once/day; not to exceed 1000 mg/day
Pregnant Females
- Under 18 years: 15 mg orally once/day; not to exceed 800 mg/day
- Over 18 years: 15 mg orally once/day; not to exceed 1000 mg/day
Lactating Females
- Under 18 years: 19 mg orally once/day; not to exceed 800 mg/day
- Over 18 years: 19 mg/day orally once/day; not to exceed 1000 mg/day
Vitamin E Deficiency
- 60-75 units orally once/day
Postherpetic Neuralgia (Off-label)
- 400 units orally twice or four times daily
Pediatric:
Recommended Daily Allowance (RDA)
- Children 1-3 years: 6 mg orally once/day; not to exceed 200 mg/day
- Children 3-8 years: 7 mg orally once/day; not to exceed 300 mg/day
- Children 8-13 years: 11 mg orally once/day; not to exceed 600 mg/day
- Children 13-18 years: 6 mg orally once/day; not to exceed 800 mg/day
Cystic Fibrosis Supplementation (Off-label)
- Children 1-12 months: 40-50 units/day
- Children 1-3 years: 80-150 units/day
- Children 4-8 years: 100-200 units/day
- Children over 8 years: 200-400 units/day
Administration
- Swallow capsules whole, do not crush or chew
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Overdose
- Vitamin E overdose does not occur with dietary intake, however, overuse of supplemental vitamin E can lead to overdose.
- Vitamin E overdose can increase the risk of bleeding, particularly in patients already on anticoagulant or antiplatelet therapy. Vitamin E overdose may also cause muscle weakness, fatigue, nausea and diarrhea.
- Treatment of vitamin E overdose is discontinuation of supplementary vitamin E. Bleeding may be treated with vitamin K, if necessary.
- In case of vitamin E overdose, discontinue taking supplementary vitamin E and seek medical help or contact Poison Control if symptoms don’t resolve or if you notice any unexplained, unusual or excessive bleeding.
What drugs interact with vitamin E?
Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.
- Vitamin E has no known severe or serious interactions with other drugs.
- Moderate interactions of vitamin E include:
- betrixaban
- ferric maltol
- ferrous sulfate
- iron sucrose
- polysaccharide iron
- selumetinib
- vortioxetine
- warfarin
- zanubrutinib
- Vitamin E has mild interactions with at least 58 different drugs.
The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.
It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.
Pregnancy and breastfeeding
- Vitamin E is a beneficial nutrient for mother and fetus in recommended daily amounts during pregnancy. Supplementary vitamin E is generally not required during pregnancy unless the mother is deficient.
- Vitamin E is present in breast milk and is safe in recommended amounts in nursing mothers.
- If you are pregnant or breastfeeding, check with your healthcare provider before taking any supplement including vitamin E.
What else should I know about vitamin E?
- The best way to meet daily requirement of vitamin E is to obtain it from dietary intake.
- Do not exceed the daily recommended dose if you take OTC vitamin E supplement.
- Vitamin E is marketed as a dietary supplement and does not require extensive pre-marketing approval from the FDA; use with caution.
- Store safely out of reach of children.
