Uses
Dietary Requirements
Adequate intake needed to prevent vitamin E deficiency and peripheral neuropathy associated with vitamin E deficiency.
Adequate intake of vitamin E usually can be accomplished through consumption of foodstuffs containing fat. Vitamin E is principally obtained from vegetable oils, unprocessed cereal grains, nuts, fruits, vegetables, and meats (especially those high in fat).
Recommended Dietary Allowance (RDA) in adults is based on induced vitamin E deficiency and the correlation between hydrogen peroxide-induced erythrocyte hemolysis and plasma α-tocopherol concentrations.
Adequate Intake (AI) established for infants ≤6 months of age is based on observed mean vitamin E intake of infants fed principally human milk; AI for infants 7–12 months of age is based on the AI for younger infants.
Vitamin E Deficiency
Treatment of vitamin E deficiency (e.g., patients with genetic abnormalities in α-tocopherol transfer protein, fat malabsorption syndromes, or protein-calorie malnutrition).
Alzheimer’s Disease
Has been evaluated in a dosage of 2000 units daily for the palliative treatment of moderately severe dementia of the Alzheimer’s type† (Alzheimer’s disease, presenile or senile dementia). Not recommended for the treatment of cognitive symptoms of dementia because of limited evidence of efficacy and safety concerns. (See Mortality under Cautions.)
Cardiovascular Risk Reduction
Current data does not support use of vitamin E supplements to reduce the risk of cardiovascular disease†.
Macular Degeneration
Suggested as a component of high-dose antioxidant supplements with zinc to reduce risk of developing advanced age-related macular degeneration† in high-risk patients (i.e., those with intermediate stage age-related macular degeneration or advanced stage macular degeneration in only one eye).
Use in Neonates
Has been used to prevent vitamin E deficiency in premature neonates†.
Pharmacologic doses of vitamin E not recommended for prevention or treatment of retinopathy of prematurity†, bronchopulmonary dysplasia†, or intraventricular hemorrhage†.
Cancer Risk Reduction
Current data does not support the use of vitamin E supplements to reduce the risk of cancer†.
Prophylaxis of Tardive Dyskinesia
Has been used to reduce the risk of tardive dyskinesia† associated with use of antipsychotic agents.
Dosage and Administration
Administration
Usually administered orally; may administer parenterally as a component of a multivitamin injection.
Oral Administration
Consider water-miscible oral vitamin E preparations for patients with malabsorption syndromes.
Dosage
Dosage expressed in terms of USP or International Units (IU).
Adequate Intake (AI) and Recommended Dietary Allowance (RDA) are expressed in mg in terms of the 2R-stereoisomeric forms of α-tocopherol.
Pediatric Patients
Dietary and Replacement Requirements
Oral
Infants ≤6 months of age: Recommended AI is 4 mg (0.6 mg/kg) of α-tocopherol daily.
Infants 7–12 months of age: Recommended AI is 5 mg (0.6 mg/kg) of α-tocopherol daily.
Children 1–3 years of age: RDA is 6 mg of α-tocopherol daily.
Children 4–8 years of age: RDA is 7 mg of α-tocopherol daily.
Children 9–13 years of age: RDA is 11 mg of α-tocopherol daily.
Children 14–18 years of age: RDA is 15 mg of α-tocopherol daily.
Vitamin E Deficiency
Oral
1 unit/kg daily (given as a water-miscible preparation) has been used in children with malabsorption syndromes.
Preterm, low-birthweight neonates weighing <1 kg at birth: 6–12 units/kg daily has been used to prevent vitamin E deficiency.
Adults
Dietary and Replacement Requirements
Oral
Men and women ≥19 years of age: RDA is 15 mg of α-tocopherol daily.
Vitamin E Deficiency
Oral
60–75 units daily.
Macular Degeneration
Oral
400 units in combination with ascorbic acid 500 mg, beta carotene 15 mg, and zinc (as zinc oxide) 80 mg, with copper (as cupric oxide) 2 mg (to prevent anemia) daily has been used.†
Tardive Dyskinesia
Oral
400–800 units daily has been recommended.†
Prescribing Limits
Adults
Oral
≥400 units daily generally not recommended. (See Mortality under Cautions.)
Special Populations
Pregnant Women
RDA for pregnant women 14–50 years of age is 15 mg of α-tocopherol daily.
Lactating Women
RDA for lactating women 14–50 years of age is 19 mg of α-tocopherol daily.
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