What is it?

Vitamin E is a fat-soluble vitamin used to treat deficiency (low Vitamin E). It may improve some skin conditions, male infertility, and prevent heart disease. Other uses for Vitamin E include the treatment of Alzheimer's disease, type 1 diabetes, circulatory problems, arthritis, premenstrual symptoms, and aging. It is also used as an antioxidant and to enhance immune system functioning in the elderly.

Other names for Vitamin E include: Alpha Tocopherol.

Ask your doctor, nurse, or pharmacist if you need more information about this medicine or if any information in this leaflet concerns you.

Before Using:

Tell your doctor if you

• are taking medicine or are allergic to any medicine (prescription or over-the-counter (OTC) or dietary supplement)
• are pregnant or plan to become pregnant while using this medicine
• are breastfeeding
• have any other health problems, such as high blood pressure or heart or blood vessel disease

Dosage:

Talk with your caregiver about how much Vitamin E you should take. The amount depends on the strength of the medicine and the reason you are taking Vitamin E. If you are using this medicine without instructions from your caregiver, follow the directions on the medicine bottle. Do not take more medicine or take it more often than the directions tell you to.

To store this medicine:

Keep all medicine locked up and away from children. Store medicine away from heat and direct light. Do not store your medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down and not work the way it should work. Throw away medicine that is out of date or that you do not need. Never share your medicine with others.

Drug and Food Interactions:

Do not take Vitamin E without talking to your doctor first if you are taking:

• Blood thinning medicine (anticoagulants, examples: warfarin (Coumadin(R))
• Colestipol (Colestid(R))
• Orlistat (Xenical(R))

Warnings:

• Before taking Vitamin E, tell your doctor if you are pregnant or breastfeeding
• Do not use Vitamin E on the skin for the first few weeks following a chemical peel or dermabrasion (9)
• Talk to your doctor before taking Vitamin E if you have a blood clotting problem (10)

Side Effects:

Stop taking your medicine right away and talk to your doctor if you have any of the following side effects. Your medicine may be causing these symptoms which may mean you are allergic to it.

• Breathing problems or tightness in your throat or chest
• Chest pain
• Skin hives, rash, or itchy or swollen skin

Other Side Effects:

You may have the following side effects, but this medicine may also cause other side effects. Tell your doctor if you have side effects that you think are caused by this medicine.

• Too much Vitamin E can cause you to feel tired, weak, have an upset stomach, headache, blurred vision, gas, or diarrhea (loose stools)
• If used topically (on the skin), Vitamin E can cause your skin to become red and have a rash (3)

References:

1. Shinn AS (ed): Evaluations of Drug Interactions. CV Mosby Company, St. Louis, MO, USA, 1985.

2. National Research Council: Vitamin E. Recommended Dietary Allowances, 10th ed. National Academy Press, Washington, DC; 1998.

3. Reynolds, J (eds). Martindale: The Extra Pharmacopeia. The Pharmaceutical Press, London, UK; 1993.

4. Gilman AG, Goodman LS, Rall TW et al: Goodman and Gilman's The Pharmacological Basis of Therapeutics, 7th ed. Mcmillan Publishing Company, New York, NY; 1985.

5. Sano M, Ernesto C, Thomas RG et al: A controlled trial of selegiline, alpha-tocopherol, or both as a treatment for Alzheimer's disease: the Alzheimer's disease cooperative study. N Engl J Med 1997; 336(17): 1216-1222.

6. Jain SK, McVie R, Jaramillo JJ et al: Effect of modest vitamin E supplementation on blood glycated hemoglobin and triglyceride levels and red cell indices in type 1 diabetic patients. J Am Coll Nutr 1996; 15(5): 458-461.

7. London RS, Murphy L, Kitlowski KE et al: Efficacy of alpha-tocopherol in the treatment of the premenstrual syndrome. J Reprod Med 1987; 32(6): 400-404.

8. Scherak O, Kolarz G, Schodl C et al: High dosage Vitamin E therapy in patients with activated arthrosis (German). Z Rheumatol 1990; 49(6): 369-373.

9. Hunter D & Frumkin A: Adverse reactions to vitamin E and aloe vera preparations after dermabrasion and chemical peel. Cutis 1991; 47(3): 193-196.

10. Kappus H & Diplock AT: Tolerance and safety of vitamin E: a toxicological position report. Free Radic Biol Med 1992; 13(1): 55-74.

11. Anon: Vitamin supplements. Med Lett Drugs Ther 1985; 27(693): 66-68.

12. Brown KM, Morrice PC & Duthie GG: Erythrocyte vitamin E and plasma ascorbate concentrations in relation to erythrocyte peroxidation in smokers and nonsmokers: dose response to vitamin E supplementation. Am J Clin Nutr 1997; 65(2): 496-502.

13. Kushi LH, Folsom AR, Prineas RJ et al: Dietary antioxidant vitamins and death from coronary heart disease in postmenopausal women. N Engl J Med 1996; 334(18): 1156-1162.

14. Kodama H, Yamaguchi R & Fukuda J et al: Increased oxidative deoxyribonucleic acid damage in the spermatoza of infertile male patients. Fertil Steril 1997; 68(3): 519-424.

15. Meydani SN, Meydani M, Blumberg JB et al: Vitamin E supplementation and in vivo immune response in healthy elderly subjects: a randomized controlled trial. JAMA 1997; 277(17): 1380-1386.

16. Product Information: Xenical(R), orlistat. Roche Pharmaceuticals Inc., Nutley, NJ, 1999.