Dosing and uses of Aquasol E, alpha-tocopherol (vitamin E)
Adult dosage forms and strengths
capsule
- 200units
- 400units
- 600units
- 1000units
liquid
- 400units/15mL
solution
- 15units/0.3mL
RDa
15 mg PO qDay; not to exceed 1000 mg/day
Pregnant Females
- <18 years: 15 mg PO qDay; not to exceed 800 mg/day
- >18 years: 15 mg PO qDay; not to exceed 1000 mg/day
Lactating Females
- <18 years: 19 mg PO qDay; not to exceed 800 mg/day
- >18 years: 19 mg/day PO qDay; not to exceed 1000 mg/day
Vitamin E Deficiency
60-75 units PO qDay
Postherpetic Neuralgia (Off-label)
400 units PO twice or four times daily
Administration
Swallow capsules whole, do not crush or chew
Pediatric dosage forms and strengths
capsule
- 200units
- 400units
- 600units
- 1000units
liquid
- 400units/15mL
solution
- 15units/0.3mL
RDa
Swallow capsules whole, do not crush
1-3 years: 6 mg PO qDay; not to exceed 200 mg/day
3-8 years: 7 mg PO qDay; not to exceed 300 mg/day
8-13 years: 11 mg PO qDay; not to exceed 600 mg/day
13-18 years: 6 mg PO qDay; not to exceed 800 mg/day
Cystic Fibrosis Supplementation (Off-label)
1-12 months: 40-50 units/day
1-3 years: 80-150 units/day
4-8 years: 100-200 units/day
>8 years: 200-400 units/day
Aquasol E, alpha-tocopherol (vitamin E) adverse (side) effects
Frequency not defined
Fatigue
Headache
Flatulence
Diarrhea
Blurred vision
Necrotizing enterocolitis (infants)
Increased serum creatinine
Increased risk of hemorrhagic stroke
Recent evidence suggests that Vitamin E may suppress action of other antioxidants
Very modest but statistically significant increase in all-cause mortality with supplemental intake of vitamin E =400 IU/day
Warnings
Contraindications
Hypersensitivity to vitamin E or formulation components
Cautions
Vitamin E, at RDA levels, does not increase bleeding time or affect warfarin except at megadoses (~10x RDA or higher) - adjustment of warfarin may be necessary for such doses
Discontinue high dose Vitamin E supplementation 1 month before surgery, may resume after recovery
Use with caution in Vitamin K deficiency, bleeding propensity or lesions (bleeding peptic ulcers, hemophilia etc)
Vitamin E increases efficacy & decreases toxicity of antineoplastic drugs
Pregnancy and lactation
Pregnancy category: A (RDA levels)
Lactation: Excreted in breast milk; safe
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Nutrition
Sources: Wheat germ oil, sunflower seeds; richest source is vegetable oils
Functions: Lipid antioxidant, protects membrane phospholipids, intracellular antioxidant, inhibits platelet aggregation
Deficiency: Rare; occurs in premature infants & those who cannot absorb fat; sterility; muscle weakness, visceral impairment; infants: anemia, nerve, eye & balance problems that may be permanent
Toxicity: Extremely rare
Pharmacology of Aquasol E, alpha-tocopherol (vitamin E)
Mechanism of action
Plays a role in protecting red blood cells against hemolysis; has protective effects against free radicals on polyunsaturated fatty acids found in cell membranes; plays a role in preventing oxidation of vitamin A and C
Pharmacokinetics
Absorption: Reduced in patients with history of malabsorption; water preparations better absorbed than oil preparations
Distribution: All body tissues especially adipose tissues where it is stored
Metabolism: Liver
Excretion: Feces
