VITAMIN E (TOCOPHEROL)
| VITAMIN E (TOCOPHEROL) (vit'a-min E) Aquasol E, Vita-Plus E, Vitec Classifications: vitamin; Therapeutic: vitamin e Pregnancy Category: A within RDA |
Availability
100 IU, 200 IU, 400 IU, 500 IU, 800 IU tablets; 100 IU, 200 IU, 400 IU, 1000 IU capsules; 15 IU/0.3 mL, 15 IU/30 mL liquid
Action
A group of naturally occurring fat-soluble substances known as tocopherols. Alpha tocopherol, comprising 90% of the tocopherols, is the most biologically potent. An antioxidant, it prevents peroxidation, a process that gives rise to free radicals (highly reactive chemical structures that damage cell membranes and alter nuclear proteins).
Therapeutic Effect
Prevents cell membrane and protein damage, protects against blood clot formation by decreasing platelet aggregation, enhances vitamin A utilization, and promotes normal growth, development, and tone of muscles.
Uses
To treat and prevent hemolytic anemia due to vitamin E deficiency in premature neonates; to prevent retrolental fibroplasia secondary to oxygen treatment in neonates, and in treatment of diseases with secondary erythrocyte membrane abnormalities (e.g., sickle cell anemia, and G6PD deficiency and as supplement in malabsorption syndromes). Used in patients on diets containing large amounts of polyunsaturated fats for long periods and in the patient who abruptly discontinues such a diet. Also used topically for dry or chapped skin and minor skin disorders.
Unlabeled Uses
Muscular dystrophy and a number of other conditions with no conclusive evidence of value. A component of many multivitamin formulations and of topical deodorant preparations as an antioxidant.
Contraindications
Bleeding disorders; thrombocytopenia; concurrent administration with Coumadin.
Cautious Use
Pregnancy (category A within RDA). Large doses may exacerbate iron deficiency anemia.
Route & Dosage
| Vitamin E Deficiency Adult: PO/IM 60–75 IU/d Child: PO 1 IU/kg/d Prophylaxis for Vitamin E Deficiency Adult: PO 12–15 IU/d Child: PO 7–10 IU/d Neonate: PO 5 IU/d |
Administration
Oral- Give on an empty stomach or following food or milk if GI upset occurs.
- Store in tight containers protected from light.
Adverse Effects (≥1%)
Body as a Whole: Skeletal muscle weakness, headache, fatigue (with excessive doses). GI: Nausea, diarrhea, intestinal cramps. Urogenital: Gonadal dysfunction. Metabolic: Increased serum creatine kinase, cholesterol, triglycerides; decreased serum thyroxine and triiodothyronine; increased urinary estrogens, androgens; creatinuria. Skin: Sterile abscess, thrombophlebitis, contact dermatitis. Special Senses: Blurred vision.Interactions
Herbal: Mineral oil, cholestyramine may decrease absorption of vitamin E; may enhance anticoagulant activity of warfarin.Pharmacokinetics
Absorption: 20–60% absorbed from GI tract if fat absorption is normal; enters blood via lymph. Distribution: Stored mainly in adipose tissue; crosses placenta. Metabolism: In liver. Elimination: Primarily in bile.Nursing Implications
Patient & Family Education
- If taking a large dose of iron, the RDA of vitamin E may be increased.
- Natural sources of vitamin E are found in wheat germ (the richest source) as well as in vegetable oils (sunflower, corn, soybean, cottonseed), green leafy vegetables, nuts, dairy products, eggs, cereals, meat, and liver.
Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; 
Canadian drug name; 
Prototype drug