Yes

Vitamin, Fat Soluble

Prevention and treatment hemolytic anemia secondary to vitamin E deficiency, dietary supplement

A/C (if dose exceeds RDA recommendation)

Hypersensitivity to vitamin E or any component; I.V. route

May induce vitamin K deficiency; necrotizing enterocolitis has been associated with oral administration of large dosages (eg, >200 units/day) of a hyperosmolar vitamin E preparation in low birth weight infants

<1%: Headache, fatigue, contact dermatitis with topical preparation, nausea, diarrhea, intestinal cramps, weakness, blurred vision, gonadal dysfunction

Vitamin E may impair the hematologic response to iron in children with iron-deficiency anemia; monitor

Vitamin E may alter the effect of vitamin K actions on clotting factors resulting in an increase hypoprothrombinemic response to warfarin; monitor

Protect from light

Prevents oxidation of vitamin A and C; protects polyunsaturated fatty acids in membranes from attack by free radicals and protects red blood cells against hemolysis

Absorption: Oral: Depends upon the presence of bile; absorption is reduced in conditions of malabsorption, in low birth weight premature infants, and as dosage increases; water miscible preparations are better absorbed than oil preparations

Distribution: Distributes to all body tissues, especially adipose tissue, where it is stored

Metabolism: In the liver to glucuronides

Elimination: In feces and bile

One unit of vitamin E = 1 mg dl-alpha-tocopherol acetate. Oral:

Premature infants less than or equal to 3 months: 17 mg (25 units)

Infants:

less than or equal to 6 months: 3 mg (4.5 units)

7-12 months: 4 mg (6 units)

Children:

1-3 years: 6 mg (9 units); upper limit of intake should not exceed 200 mg/day

4-8 years: 7 mg (10.5 units); upper limit of intake should not exceed 300 mg/day

9-13 years: 11 mg (16.5 units); upper limit of intake should not exceed 600 mg/day

14-18 years: 15 mg (22.5 units); upper limit of intake should not exceed 800 mg/day

Children >13 years and Adults: 15 mg (22.5 units); upper limit of intake should not exceed 1000 mg/day

Pregnant female:

less than or equal to 18 years: 15 mg (22.5 units); upper level of intake should not exceed 800 mg/day

19-50 years: 15 mg (22.5 units); upper level of intake should not exceed 1000 mg/day

Lactating female:

less than or equal to 18 years: 19 mg (28.5 units); upper level of intake should not exceed 800 mg/day

19-50 years: 19 mg (28.5 units); upper level of intake should not exceed 1000 mg/day

Vitamin E deficiency:

Children (with malabsorption syndrome): 1 unit/kg/day of water miscible vitamin E (to raise plasma tocopherol concentrations to the normal range within 2 months and to maintain normal plasma concentrations)

Adults: 60-75 units/day

Prevention of vitamin E deficiency: Adults: 30 units/day

Prevention of retinopathy of prematurity or BPD secondary to O₂ therapy: (American Academy of Pediatrics considers this use investigational and routine use is not recommended):

Retinopathy prophylaxis: 15-30 units/kg/day to maintain plasma levels between 1.5-2 mg/mL (may need as high as 100 units/kg/day)

Cystic fibrosis, beta-thalassemia, sickle cell anemia may require higher daily maintenance doses:

Cystic fibrosis: 100-400 units/day

Beta-thalassemia: 750 units/day

Sickle cell: 450 units/day

Alzheimer's disease: 1000 units twice daily

Tardive dyskinesia: 1600 units/day

Topical: Apply a thin layer over affected area

Therapeutic: 0.8-1.5 mg/dL (SI: 19-35 mmol/L), some method variation

May rarely cause drowsiness

Used to prevent or treat tardive dyskinesia and Alzheimer's disease

No information available to require special precautions

No effects or complications reported

Take exactly as directed; do not take more than the recommended dose. Do not use mineral oil or other vitamin E supplements without consulting prescriber. Report persistent nausea, vomiting, or cramping; or gonadal dysfunction.

Monitor plasma tocopherol concentrations (normal range: 6-14 mcg/mL)

Capsule: 100 units, 200 units, 330 mg, 400 units, 500 units, 600 units, 1000 units

Capsule, water miscible: 73.5 mg, 147 mg, 165 mg, 330 mg, 400 units

Cream: 50 mg/g (15 g, 30 g, 60 g, 75 g, 120 g, 454 g)

Drops, oral: 50 mg/mL (12 mL, 30 mL)

Liquid, topical: 10 mL, 15 mL, 30 mL, 60 mL

Lotion: 120 mL

Oil: 15 mL, 30 mL, 60 mL

Ointment, topical: 30 mg/g (45 g, 60 g)

Tablet: 200 units, 400 units

American Academy of Pediatrics Committee on Fetus and Newborn, "Vitamin E and the Prevention of Retinopathy of Prematurity," Pediatrics, 1985, 76(2):315-6.

Bieri JG, Corash L, and Hubbard VS, "Medical Uses of Vitamin E," N Engl J Med, 1983, 308(18):1063-71.

Hale TW, Rais-Bahrami K, Montgomery DL, et al, "Vitamin E Toxicity in Neonatal Piglets," J Toxicol Clin Toxicol, 1995, 33(2):123-30.

Hodis HN, Mack WJ, La Bree L, et al, "Serial Coronary Angiographic Evidence That Antioxidant Vitamin Intake Reduces Progression of Coronary Artery Atherosclerosis," JAMA, 1995, 273(23):1849-54.

Johnson L, Bowen FW Jr, Abbasi S, et al, "Relationship of Prolonged Pharmacologic Serum Levels of Vitamin E to Incidence of Sepsis and Necrotizing Enterocolitis in Infants With Birth Weight 1500 Grams or Less," Pediatrics, 1985, 75(4):619-38.

Karp WB and Robertson AF, "Vitamin E in Neonatology," Adv Pediatr, 1986, 33:127-47.

Saperstein H, Rapaport M, and Rietschel RL, "Topical Vitamin E as a Cause of Erythema Multiforme-Like Eruption," Arch Dermatol, 1984, 120(7):906-8.