E 400

As a dietary supplement

• Vitamin E deficiency resulting from impaired absorption
• Increased requirements due to a diet rich in polyunsaturated fats
• Hemolytic anemia due to Vitamin E deficiency
• General antioxidant support and promotion of healthy hair and skin

Therapeutic use

• Cardiovascular disease
• Heavy metal poisoning
• Hepatotoxin poisoning
• Hemolytic anemia
• Oxygen therapy
• Nutritional deficiency states

Adults (Recommended Daily Amount)

The standard recommended intake is 15 mg (approximately 22 IU of natural-source or 33 IU of synthetic alpha-tocopherol) daily. The tolerable upper intake level for adults is 1000 mg per day.

Vitamin E Deficiency

60–75 IU once daily, or as directed by a physician.

Off-label uses (e.g., postherpetic neuralgia)

400 IU two to four times daily, only under medical supervision.

Pediatric patients

6–11 mg daily depending on age group; the upper limit ranges from 200 mg to 800 mg per day depending on age.

Pregnant and lactating women

15–19 mg daily; the specific upper limit varies by age. Use only under medical supervision.

Doses should be taken with food to ensure adequate fat intake, which is required for absorption.

Chew the tablet thoroughly before swallowing. Take with food to support absorption, as vitamin E is a fat-soluble nutrient and requires the presence of dietary fat for optimal uptake.

Vitamin E (alpha-tocopherol) is a fat-soluble vitamin that functions primarily as an antioxidant. It neutralises free radicals and protects cellular membranes from oxidative damage. It also inhibits platelet aggregation, helps protect red blood cells from haemolysis, and supports immune function.

Alpha-tocopheryl acetate is an ester form of vitamin E. The acetate ester is hydrolysed in the gastrointestinal tract and absorbed as free alpha-tocopherol, with absorption efficiency comparable to the free form. Following oral administration, peak absorption occurs at approximately 3 hours. Alpha-tocopherol is widely distributed to tissues and has an elimination half-life of approximately 73 hours. It is the most biologically active naturally occurring form of vitamin E.

• Common:
• Nausea, diarrhoea, stomach cramps, flatulence
• Headache, fatigue, blurred vision
• Weakness
• Serious (typically at high doses):
• Increased risk of bleeding and bruising
• Increased risk of haemorrhagic stroke (noted in clinical trials with alpha-tocopherol supplementation)
• Muscle weakness
• Elevated creatinine levels
• A meta-analysis of randomised studies found a statistically significant increase in all-cause mortality associated with supplemental doses of 400 IU per day or more; these doses should only be used under medical supervision.

• Hypersensitivity to vitamin E (alpha-tocopherol acetate) or to any other component of the formulation.
• Use with caution — and only under medical supervision — in patients with vitamin K deficiency, bleeding disorders (e.g., haemophilia), or active bleeding lesions such as peptic ulcers.
• Long-term supplementation at doses of 400 IU per day or more should be avoided in patients with cardiovascular disease, diabetes, or a history of head and neck cancer, as studies have shown an association with increased risk of serious adverse outcomes in these populations.

• Discontinue high-dose vitamin E supplementation at least one month before any surgical procedure due to the risk of increased bleeding.
• Use with caution in patients with vitamin K deficiency or a tendency to bleed.
• Adequate dietary fat intake is required for proper absorption of this fat-soluble vitamin.
• Patients with cardiovascular disease or diabetes should avoid doses of 400 IU per day or more unless specifically directed by a physician.
• Keep out of reach of children.
• Do not exceed the recommended dose without medical advice.

Elderly

No specific dose adjustment is established, but elderly individuals should use doses of 400 IU per day or more only under medical supervision given the potential association with increased all-cause mortality.

Patients with malabsorption syndromes

Vitamin E deficiency is more likely in patients with conditions that impair fat absorption (e.g., cholestatic liver disease, cystic fibrosis, short bowel syndrome). Supplementation is indicated in these patients and dosing should be guided by serum tocopherol levels and clinical response.

Premature infants

Premature infants are at particular risk of vitamin E deficiency. Supplementation in this population should be managed by a specialist.

Pregnancy

Vitamin E at recommended daily amounts is generally considered safe during pregnancy and is an important nutrient for both mother and fetus. However, supplementation beyond the recommended dietary allowance (15 mg/day) should only be used during pregnancy when clearly necessary and under medical supervision. The risks and benefits should be discussed with a healthcare provider.

Lactation

Vitamin E is excreted into breast milk. At recommended dietary amounts it is considered safe during breastfeeding. Supplementation beyond normal dietary requirements is generally not necessary unless a deficiency has been identified.

Acute toxicity from vitamin E is low. However, chronic ingestion of high doses may cause:

• Increased bleeding risk, particularly in patients on anticoagulant or antiplatelet therapy
• Muscle weakness, fatigue
• Nausea, diarrhoea

In the event of a suspected overdose, discontinue the supplement immediately and seek medical attention or contact a Poison Control Centre. Management may include discontinuation of the supplement and, where indicated, vitamin K administration.

Moderate interactions:

• Warfarin and other anticoagulants: High doses of vitamin E (approximately 10 times the RDA or more) may potentiate the anticoagulant effect of warfarin, increasing bleeding risk. Dose adjustment of the anticoagulant may be necessary.
• Betrixaban and other antiplatelet/anticoagulant agents: Additive risk of bleeding.
• Iron compounds (ferrous sulfate, iron sucrose, polysaccharide iron): Vitamin E may reduce the absorption or efficacy of supplemental iron.
• Selumetinib, vortioxetine, zanubrutinib: Moderate interactions have been documented; consult a physician before concurrent use.

Mild interactions have been reported with more than 58 additional drugs. Patients on any medication should inform their doctor before starting vitamin E supplementation.

Store in a cool, dry place away from direct sunlight and heat. Keep out of reach of children.

What is the price of E 400 400 IU in Bangladesh (BD)?

E 400 400 IU price in Bangladesh is ৳5 per tablet. Prices may vary by pharmacy and are updated regularly on this page.

What is E 400 used for?

As a dietary supplement: - Vitamin E deficiency resulting from impaired absorption - Increased requirements due to a diet rich in polyunsaturated fats - Hemolytic anemia due to Vitamin E deficiency - General…

Is E 400 an antibiotic?

No, E 400 is not an antibiotic.