Tocopherol
Synonyms :
Alpha Tocopherol, Vitamin E
Mechanism :
Vitamin E exhibit antioxidant activity. Vitamin E's anti-atherogenic activity involves the inhibition of the oxidation of low-density lipoprotein (oxLDL) and the accumulation of oxLDL in the arterial wall. It also appears to reduce oxLDL-induced apoptosis in human endothelial cells. Oxidation of LDL is a key early step in atherogenesis as it triggers a number of events which lead to the formation of atherosclerotic plaque.
Indication :
- Vitamin E Deficiency
- Neonatal cholestasis and chronic cholestasis
- Malabsorption syndrome
- Abetalipoproteinemia
- Cystic Fibrosis
- Dietary Supplement
- Prevention of retinopathy of prematurity or Bronchopulmonary dysplasia (BPD) secondary to oxygen therapy
Contraindications :
Pregnancy, Warfarin.
Dosing :
(1 unit vitamin E = 1 mg alpha-tocopherol acetate)
Cystic Fibrosis and cholestasis: Oral
Neonates, premature, low birth weight: 25-50 units/day.
1-12 months: 40-50 units daily.
1-3 years: 80-150 units daily. Max: 200 units/day.
4-8 years: 100 to 200 units daily. Max: 300 units/day.
>8 years: 200-400 units daily. Max: 600 units/day in 1-13 years and 800 units/day in 14-18 years).
Prevention of retinopathy of prematurity or Bronchopulmonary dysplasia (BPD) secondary to oxygen therapy:
15 to 30 units/kg/day to maintain plasma levels between 1.5 to 2 mcg/mL (May need as high as 100 units/kg/day).
Recommended Daily Allowance (RDA): Oral
1-6 months: 4 mg daily.
6-12 months: 5 mg daily.
1-3 years: 6 mg daily. Max: 200 mg/day.
4-8 years: 7 mg daily. Max: 300 mg/day.
9-13 years: 11 mg daily. Max: 600 mg/day.
13 years and older: 15 mg daily. Max: 800 mg/day.
Adverse Effect :
In some individuals who are vitamin K deficient, vitamin E may increase the risk for hemorrhage or bleeding. Vitamin E ointments, oils, or creams may trigger contact dermatitis. With doses >400 units a day and long-term use: blurred vision, diarrhea, flatulence, dizziness, headache, fatigue, nausea or stomach cramps, unusual tiredness or weakness, increased serum creatinine.
Interaction :
Warfarin (Coumadin): Interacts with VITAMIN E.
Niacin: Interacts with VITAMIN E.
Medications for cancer (Chemotherapy): Interacts with VITAMIN E.
Cyclosporine (Neoral, Sandimmune): Interacts with VITAMIN E.
Hepatic Dose :
No dosage adjustments are recommended.