Tocogel

Indications

d-Alpha Tocopherol is the natural form of vitamin E, a fat-soluble vitamin and antioxidant. It is used to prevent and treat vitamin E deficiency, which can occur in people who cannot absorb fat properly (for example with chronic pancreatitis, cystic fibrosis, liver or bile duct disease) and in some premature babies. It is also widely taken as an antioxidant supplement and for skin and hair care, although evidence for benefits beyond correcting deficiency is limited.

How It Works

Vitamin E sits in the fatty membranes of cells and protects them from damage by unstable molecules called free radicals. This helps keep nerves, muscles, the eyes, the skin and red blood cells healthy, and supports normal immune function. The natural form (d-alpha) is used by the body somewhat better than the synthetic form (dl-alpha).

Dosage and Administration

The recommended daily intake for adults is about 15 mg of vitamin E, which most people get from a balanced diet. As a supplement, the usual adult dose is one capsule daily (commonly 200 IU or 400 IU) taken with a meal containing some fat, or as directed by a doctor. Do not exceed 1,000 mg a day (about 1,500 IU of the natural form) unless a doctor advises it. Doses for treating deficiency, and doses for children, are as prescribed.

Interactions

High doses of vitamin E may increase the risk of bleeding with Warfarin, Clopidogrel, Aspirin and other blood thinners. Orlistat, Cholestyramine and mineral oil can reduce its absorption. People receiving chemotherapy or radiotherapy should ask their cancer doctor before taking antioxidant supplements. Tell your doctor or pharmacist about all medicines and supplements you use.

Contraindications

• Known allergy to vitamin E or any ingredient in the capsule (such as soya oil or gelatin).
• High-dose use in people with bleeding disorders or vitamin K deficiency, unless a doctor advises it.

Side Effects

Vitamin E is usually well tolerated at normal doses. High doses may cause nausea, diarrhoea, stomach cramps, tiredness, headache, blurred vision and an increased tendency to bleed or bruise.

Get urgent medical help if you notice unusual bleeding (such as nosebleeds that will not stop, blood in urine, or black or bloody stools), a sudden severe headache, weakness on one side of the body, or swelling of the face, lips or throat with difficulty breathing.

Pregnancy and Lactation

Vitamin E is needed in pregnancy and breastfeeding, and normal dietary amounts or the amounts in standard prenatal vitamins are safe. Do not take high-dose vitamin E supplements during pregnancy or breastfeeding unless a doctor advises it.

Precautions and Warnings

Stop high-dose vitamin E at least 2 weeks before planned surgery. People with bleeding problems, a history of stroke, or vitamin K deficiency, and those taking blood thinners, should talk to a doctor first. Long-term high doses offer no proven extra benefit and may cause harm. Check whether your other supplements also contain vitamin E.

Overdose

Taking very large amounts may cause nausea, diarrhoea, tiredness, blurred vision and bleeding problems. Seek medical help if a large amount has been swallowed, especially by a child.

Therapeutic Class

Vitamin (fat-soluble vitamin, antioxidant).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children. Keep the container tightly closed.