VITAMIN E (TOCOPHEROL)
(vit′a-min E)
Aquasol E, Vita-Plus E, Vitec
Classification: VITAMIN SUPPLEMENT
Therapeutic: VITAMIN E SUPPLEMENT
Pregnancy Category: A within
RDA AVAILABILITY
Tablet; capsule; liquid
ACTION & THERAPEUTIC EFFECT
A group of naturally occurring fatsoluble 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). 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). 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.
CAUTIOUS USE
Large doses may exacerbate iron deficiency anemia; pregnancy (category A within RDA).
ROUTE & DOSAGE
Vitamin E Deficiency
Adult: PO 60–75 international units/day
Child: PO 1 international unit/ kg/day
Prophylaxis for Vitamin E Deficiency
Adult: PO 12–15 international units/day
Child: PO 7–10 international units/day
Neonate: PO 5 international units/day
ADMINISTRATION
Oral
- Give on an empty stomach or following food or milk if GI upset occurs.
- Ensure that capsules are swallowed whole. They should not be crushed or chewed.
- 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
- 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.
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