E-Cap

As a dietary supplement

• Vitamin E deficiency resulting from impaired absorption
• Increased requirements due to a diet rich in polyunsaturated fats
• Promotion of healthy hair and skin
• Antioxidant protection against oxidative cell damage
• Hemolytic anemia due to Vitamin E deficiency

Therapeutic uses

• Cardiovascular disease
• Heavy metal poisoning
• Hepatotoxin poisoning
• Hemolytic anemia
• Oxygen therapy (prevention of retinopathy of prematurity or bronchopulmonary dysplasia in neonates receiving supplemental oxygen)
• Nutritional deficiency states including malabsorption syndromes, abetalipoproteinemia, and cystic fibrosis

Dosing should follow prescriber or package instructions. General guidance is as follows:

Adults

For dietary supplementation or deficiency, the recommended dietary allowance (RDA) is approximately 15 mg (22.4 IU) per day. The tolerable upper intake level is 1,000 mg alpha-tocopherol (approximately 1,500 IU) per day. Doses of 400 IU/day or greater carry an increased risk of adverse effects and should not be exceeded without medical supervision.

Pediatric Patients (deficiency or malabsorption)

• Premature neonates: 25–50 IU/day
• 1–12 months: 40–50 IU/day
• 1–3 years: 80–150 IU/day (maximum 200 IU/day)
• 4–8 years: 100–200 IU/day (maximum 300 IU/day)
• Over 8 years: 200–400 IU/day

Prevention of retinopathy of prematurity or bronchopulmonary dysplasia (neonates on oxygen therapy): 15–30 IU/kg/day to maintain plasma levels of 1.5–2 mcg/mL; doses up to 100 IU/kg/day may be required.

Do not increase the dose or take it more frequently than recommended.

Take orally with a meal or snack, as Vitamin E is a fat-soluble vitamin and food (particularly fat-containing food) improves its absorption. Swallow capsules whole. Do not exceed the recommended dose.

Vitamin E is a fat-soluble antioxidant. Alpha tocopheryl acetate, the ester form used in supplementation, is hydrolyzed in the intestinal lumen before absorption. Absorption depends on adequate biliary and pancreatic secretions to form mixed micelles containing bile acids, fatty acids, and monoglycerides. Approximately 20–40% of ingested Vitamin E is absorbed under normal conditions; about 75% of the absorbed amount enters the lymphatic system via chylomicrons, with the remainder transported in other lipoproteins.

Vitamin E is stored primarily in adipose tissue, liver, and muscle. Its principal mechanism of action is as a chain-breaking, lipophilic antioxidant that neutralises free radicals and inhibits oxidation of low-density lipoprotein (LDL), thereby reducing atherosclerotic plaque formation. At high doses, Vitamin E competes with Vitamin K epoxide reductase, impairing the activation of Vitamin K and the gamma-carboxylation of Vitamin K-dependent clotting factors, which can increase bleeding risk.

At standard dietary doses, Vitamin E is generally well tolerated and adverse effects are uncommon.

With doses of 400 IU/day or greater, the following effects may occur

Common: fatigue, headache, nausea, diarrhoea, stomach cramps, flatulence, blurred vision, dizziness

Less common: weakness, elevated serum creatinine

Serious (seek medical attention promptly):

• Easy bruising or unusual bleeding (due to impairment of Vitamin K-dependent clotting factors)
• Signs of allergic reaction: rash, itching, swelling of the face/tongue/throat, severe dizziness, or difficulty breathing

Long-term supplementation with 400 IU/day or more has been associated with a modest but statistically significant increase in all-cause mortality.

• Known hypersensitivity to Vitamin E or any component of the formulation
• Pre-existing bleeding disorders or blood clotting abnormalities (high-dose use)
• Severe renal impairment
• Severe hepatic impairment
• Markedly elevated blood lipids (hypercholesterolaemia or hypertriglyceridaemia)
• Concurrent warfarin therapy at high doses (use with caution and medical supervision)

High-dose Vitamin E supplementation should be discontinued at least one month before elective surgery.

• Do not exceed recommended doses; doses of 400 IU/day or greater are associated with increased risk of harm with long-term use.
• Exercise caution in patients with Vitamin K deficiency or a history of bleeding disorders, as Vitamin E may further impair clotting.
• Discontinue high-dose supplementation at least one month before any planned surgical procedure.
• Patients taking warfarin should be monitored closely; megadoses of Vitamin E may enhance anticoagulant effects.
• High-dose Vitamin E may compete with other fat-soluble vitamins (A, D, and K) for absorption, potentially causing their deficiency.
• Caution in patients with diabetes, phenylketonuria (PKU), or alcohol dependence, as some formulations may contain sugar or alcohol.
• Avoid driving or operating machinery if dizziness or visual disturbance occurs.
• Disclose all supplement use to your healthcare provider before surgery or starting new medications.

Paediatric patients

Dosing for deficiency and malabsorption syndromes in children is weight- and age-based (see Dosage). Vitamin E is used therapeutically in neonates, particularly premature infants at risk of haemolytic anaemia or retinopathy of prematurity.

Elderly patients (over 65 years)

Formal pharmacokinetic studies in the elderly have not been conducted. Older individuals with severe or chronic Vitamin E deficiency may be at greater risk of peripheral neuropathy, skeletal myopathy, and impaired immune function.

Renal impairment

No specific dose adjustment is established. Vitamin E therapy has been investigated in chronic kidney disease for secondary prevention of cardiovascular and haematological complications.

Hepatic impairment

No dose adjustment is generally required. However, hepatic alpha-tocopherol transfer protein plays a key role in Vitamin E metabolism and distribution; significant hepatic dysfunction may affect Vitamin E handling.

Pregnancy

At Recommended Daily Allowance (RDA) levels, Vitamin E is generally considered acceptable during pregnancy; controlled studies have not demonstrated fetal risk. There is no evidence that Vitamin E requirements differ in pregnant women compared to non-pregnant women. Use above RDA levels should only be undertaken when clearly necessary and under medical supervision.

Lactation

Safety at RDA levels during breastfeeding is generally considered acceptable. It is not known whether supplemental doses pass into breast milk in significant quantities. Consult a healthcare provider before using Vitamin E supplements while breastfeeding.

At very high doses, Vitamin E may inhibit Vitamin K-dependent coagulation factors, substantially increasing the risk of bleeding. Excessive intake may also impair absorption of other fat-soluble vitamins (A, D, and K), potentially leading to their deficiency.

In the event of a suspected overdose, seek emergency medical attention immediately or contact a Poison Control Center.

Vitamin E has no known severe or serious drug interactions. The following moderate or clinically relevant interactions have been identified:

• Warfarin (anticoagulants): At RDA levels, Vitamin E does not meaningfully affect bleeding time or warfarin activity. At megadoses (approximately 10× RDA or higher), Vitamin E may potentiate anticoagulant effects and warfarin dose adjustment may be necessary. In Vitamin K-deficient individuals, even moderate doses may increase haemorrhage risk.
• Niacin: May reduce the beneficial effects of niacin on HDL cholesterol.
• Chemotherapy agents: High-dose antioxidant supplementation, including Vitamin E, may reduce the efficacy of certain chemotherapy regimens.
• Cyclosporine: Concurrent use may alter cyclosporine levels.
• Bile acid-binding resins (cholestyramine, colestipol): May reduce intestinal absorption of Vitamin E.
• Orlistat: Reduces absorption of fat-soluble vitamins including Vitamin E; separate administration by at least 2 hours.
• Iron supplements (ferrous sulfate, iron sucrose, polysaccharide iron): Mild interaction reported.
• Mineral oil: May reduce absorption of fat-soluble vitamins.

Store as directed on the product packaging, away from heat, light, and moisture. Keep out of reach of children. Do not store in humid environments such as bathrooms. Keep the container tightly closed when not in use.

What is the price of E-Cap 600 IU in Bangladesh (BD)?

E-Cap 600 IU price in Bangladesh is ৳5 per capsule. Prices may vary by pharmacy and are updated regularly on this page.

What is E-Cap used for?

As a dietary supplement: - Vitamin E deficiency resulting from impaired absorption - Increased requirements due to a diet rich in polyunsaturated fats - Promotion of healthy hair and skin - Antioxidant protection…

Is E-Cap an antibiotic?

No, E-Cap is not an antibiotic.