Generic name:vitamin E (VYE ta min E), tocopherol alpha
Brand name:Aqua-E, Aquasol E, Aquavite-E, Aqueous Vitamin E, E-400 Clear Drug class: Vitamins
What is vitamin E?
Vitamin E is an antioxidant that occurs naturally in foods such as nuts, seeds, and leafy green vegetables. Vitamin E is a fat-soluble vitamin important for many processes in the body.
Vitamin E is used to treat or prevent vitamin E deficiency. People with certain diseases may need extra vitamin E.
Vitamin E (Evion) protects against hemolysis, prevents the oxidation ofVitamin AandVitamin C, and prevents the polyunsaturated fatty acids from free radicals.
Warnings
Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.
Before taking this medicine
Ask a doctor or pharmacist if it is safe for you to use vitamin E if you have other medical conditions, especially:
anemia (low red blood cells);
a bleeding or blood clotting disorder such as hemophilia;
liver disease;
kidney disease;
any allergies;
an eye disorder called retinitis pigmentosa;
a vitamin K deficiency;
high cholesterol or triglycerides (a type of fat in the blood);
diabetes;
a history of cancer;
a history of stroke or blood clot; or
if you need surgery, or have recently had surgery.
FDA pregnancy category C. It is not known whether vitamin E will harm an unborn baby. Taking vitamin E in amounts that do not exceed the recommended dietary allowance (RDA) is considered safe; however, supplementation is not generally recommended unless dietary vitamin E falls below the RDA. Do not use this medicine without a doctor's advice if you are pregnant.
It is not known whether vitamin E passes into breast milk or if it could harm a nursing baby. Do not use this medicine without a doctor's advice if you are breast-feeding a baby.
It is used as a dietary supplement in patients with malabsorption and chronic cholestatic jaundice.
It is not recommended for the prevention of stroke and ischemic heart disease.
Vitamin E Dose as a dietary supplement:
Dosages range from 100 – 400 units/day orally.
Aqueous Oral Drops: 30 units/day orally.
Vitamin E Supplementation in patients with chronic Cholestasis:
Infants:
20 – 50 units/kg/day orally.
Vitamin E dose in Biliary atresia, post-hepatoportoenterostomy:
100 units/day initially using Aqua ADEK (2 mL).
Titrate the dose based upon serum concentrations in 25 units/kg/day increments up to 100 units/kg/day.
The target alpha-tocopherol serum concentration range is 3.8 to 20.3 mcg/mL and vitamin E: Total serum lipids ratio of 0.6 mg/gms.
Patients with a total bilirubin of less than 2 mg/dL may require lower doses
Children:
1 unit/kg/day.
The water-soluble formulation is preferred
Vitamin E (Evion) Dose in the treatment of Deficiency of vitamin E associated with malabsorption:
Children:
1 unit/kg/day.
Adjust the dose based on serum concentrations.
The water-soluble formulation is preferred in patients with malabsorption.
Vitamin E (Evion) Supplementation in patients with Cystic fibrosis:
1 to 12 months:
40 – 50 units/day orally.
1 to 3 years:
80 – 150 units/day orally.
4 to 8 years:
100 – 200 units/day orally.
older than 8 years:
200 – 400 units/day orally.
Vitamin E (Evion) Dose in the prevention of deficiency or as a dietary supplement:
Aqueous Oral Drops (50 units/mL):
Infants:
5 units daily orally (0.1 mL)
Children less than 4 years:
10 units daily orally (0.2 mL)
Children older than 4 years and Adolescents:
30 units daily orally (0.6 mL)
Pregnancy Risk Factor: C
Vitamin E crosses the placental boundary
As pregnancy progresses, maternal serum levels of tocopherol rise.
Patients who are pregnant do not need to take an extra dose.
Use during breastfeeding:
It is excreted from breast milk.
The concentrations in the breasts are highest immediately after birth and gradually decrease with time.
Breast concentration is affected by maternal intake
Supplementation for breastfeeding mothers is not necessary.
Dose in kidney disease:
The manufacturer has not recommended any dose adjustment in patients with renal disease.
Dose in liver disease:
It may cause the deficiency of vitamin K. Patients with cirrhosis are deficient in coagulation factors. Its use may further lead to worsening of the bleeding diathesis as seen in patients with liver disease. It should be used with caution.
Side effects of Vitamin E:
There are no adverse reactions related to its use listed in the manufacturer’s labeling.
Contraindications to Vitamin E (Evion):
Allergy to tocopherol (vitamin A) or any component in the formulation
Warnings and Precautions
Vitamin K deficiency:
It could lead to a deficiency in vitamin K.
Intracranial bleeding
High doses or prolonged administration may cause intracranial bleeding, possibly due to vitamin K deficiency.
Monitoring Parameters:
Monitoring is usually not required, however, plasma tocopherol concentrations may be done.
How to administer Vitamin E (Evion)?
The capsules should be swallowed whole. It should not be crushed or chewed.
Mechanism of action of Vitamin E (Evion):
It protects vitamin A and C from oxidation, protects membranes from free radical attack, and protects red blood cells against hemolysis.
AbsorptionMalabsorption is lower in premature infants, low birth weight infants, and malabsorption. Higher doses of bile are more effective for absorption.
It isdistributedAll body tissues, including fat cells and adipose.
It isMetabolizedBy the liver to glucuronidesexcretedIn the feces.
International Brand Names of Vitamin E:
Alph-E
Alph-E-Mixed 1000
Alph-E-Mixed
Aqueous Vitamin E
E-400
E-400-Clear
E-400-Mixed
E-Max-1000
E-Pherol
Formula E 400
Natural Vitamin E
Nutr-E-Sol
SoluVita E
Vita-Plus E
Altocaps-400
Armilla
Auxina E
Best
Bio E
Bio-E
E Natural
E Viton
E-400
E-Cap
E-Drops
E-Fertoc
E-Tabs
Evicotrat
E-vimin
E-Viton
Egogyn
Enat
Enervon-E
Ephynal
Epol
Erevit
Etec
Etocovit
Eugerminol
Eusovit
Eviol
Evion
Evit
Evitol
Evon
Grandpherol
Hijuven
Ixopalet
Livingpherol
Nat E
Natopherol
Naturee
Nuenat
Optovit E
Su Le Kang
Vedrop
Vieta
Zyme
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