EVV

As a dietary supplement

• Vitamin E deficiency resulting from impaired absorption
• Increased requirements due to a diet rich in polyunsaturated fats
• Support for healthy hair and skin
• As an antioxidant
• Hemolytic anemia due to Vitamin E deficiency

Therapeutic use

• Cardiovascular disease
• Heavy metal poisoning
• Hepatotoxin poisoning
• Hemolytic anemia
• Oxygen therapy
• Nutritional deficiency states
• Ataxia with Vitamin E deficiency (a condition affecting movement and motor control caused by very low Vitamin E levels in the blood)

Adults (Dietary supplement / maintenance)

The recommended daily allowance (RDA) is approximately 15 mg (22.4 IU) per day for adults.

Adult males (19 years and above): 10 mg alpha-tocopherol equivalents (alpha-TE) per day.

Adult females (19 years and above): 8 mg alpha-TE per day.

Therapeutic use (deficiency correction)

Doses of 200 to 800 mg daily have been used in studies evaluating therapeutic effects. The tolerable upper intake level for adults is 1000 mg per day from any tocopherol form.

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

Pediatric patients

Requirements vary by age; generally 6–11 mg daily depending on age group, with maximum tolerable limits ranging from 200 to 800 mg per day depending on age. Dosage should be determined by a physician.

The tablet is to be chewed before swallowing. It may be taken with or without food. Swallow with sufficient water after chewing.

Vitamin E (alpha tocopherol acetate) is a fat-soluble vitamin that functions primarily as an antioxidant in the body. It protects cell membranes and other cellular structures from damage caused by free radicals and oxidative stress.

Key pharmacological actions include

• Promotion of nitric oxide (NO) synthesis
• Decomposition of fatty acid hydroperoxides and hydrogen peroxides
• Maintenance of cell membrane stability and integrity
• Maintenance of red blood cell (RBC) deformability
• Reduction of blood viscosity and viscoelasticity
• Prevention of DNA strand breakage
• Suppression of oxidation of oxidised low-density lipoprotein (oxLDL)

After oral ingestion, Vitamin E is absorbed from the gastrointestinal tract and stored in body tissues, including adipose tissue, where it can remain for up to one year, contributing to the total body pool.

Vitamin E supplements are generally well tolerated at recommended doses. Adverse effects are more likely at high doses.

• Common (especially at higher doses):
• Fatigue
• Headache
• Flatulence
• Diarrhea
• Blurred vision
• Nausea
• Muscle weakness
• Serious (associated with prolonged high-dose use):
• Increased risk of bleeding, particularly when combined with anticoagulants
• Modest but statistically significant increase in all-cause mortality reported with supplemental intake of 400 IU/day or more in long-term use
• Increased risk of prostate cancer reported in adult males taking 400 IU/day (as dl-alpha-tocopheryl acetate)
• Necrotising enterocolitis in premature infants (associated with intravenous high-dose use)
• Changes in blood electrolytes leading to heart function disorders, muscle weakness, and liver damage with prolonged excessive use

• Known hypersensitivity or allergy to Vitamin E (alpha tocopherol acetate) or any other component of the formulation.

• Discontinue high-dose Vitamin E supplementation at least one month before any surgical procedure, due to increased bleeding risk.
• Use with caution in patients with Vitamin K deficiency, bleeding disorders, or peptic ulcers.
• Patients on anticoagulant therapy (e.g., warfarin) should use Vitamin E only under medical supervision, as megadoses may potentiate anticoagulant effects.
• Long-term use of doses significantly exceeding the recommended daily allowance may cause adverse effects including electrolyte disturbances, muscle weakness, and liver damage.
• Inform your healthcare provider about all medications, supplements, and health conditions before starting Vitamin E supplementation.

Elderly patients

Low-dose Vitamin E supplementation may improve antioxidant defences in elderly patients. However, high-dose supplementation has been associated with an increased risk of falls in this population and should be used with caution.

Pediatric patients

Vitamin E deficiency in children is more common in those with severe protein-energy malnutrition, fat malabsorption syndromes (such as cholestatic liver disease or cystic fibrosis), and certain infections. Dosage and supplementation in children should be determined by a physician based on age and clinical condition.

Patients with fat malabsorption disorders

Conditions such as cystic fibrosis, cholestatic liver disease, and other malabsorption syndromes impair Vitamin E absorption. These patients may require higher doses and closer monitoring under medical supervision.

Pregnancy: Vitamin E at recommended daily allowance (RDA) levels is considered safe during pregnancy, with no evidence of fetal risk at those doses. Supplementation beyond the RDA during pregnancy should only be undertaken on the advice of a physician.

Lactation: Vitamin E is excreted in breast milk and is considered safe during breastfeeding when taken at recommended doses.

Vitamin E is relatively non-toxic compared to other fat-soluble vitamins. The tolerable upper intake level for adults is 1000 mg per day.

Symptoms of excessive intake may include

• Muscle weakness
• Fatigue
• Nausea
• Diarrhea
• Bleeding tendencies (the primary clinical concern at very high doses)

Management

Vitamin E toxicity is managed by discontinuing supplementation or reducing intake to below the upper limit of 1000 mg per day. There is no specific antidote. Supportive care should be provided as needed.

Vitamin E has no known severe or serious interactions with most drugs. However, clinically relevant interactions include:

Anticoagulants (e.g., warfarin/coumarin): High doses of Vitamin E may enhance the anticoagulant effect and increase the risk of bleeding. Patients on anticoagulant therapy should use Vitamin E with caution and under medical supervision.

Iron supplements (e.g., ferrous sulfate, iron sucrose, polysaccharide iron): Moderate interaction reported; Vitamin E may affect iron utilisation.

Antineoplastic (chemotherapy) agents: Vitamin E may increase the efficacy of certain antineoplastic drugs while potentially reducing their toxicity.

Vitamin E has mild interactions documented with more than 61 different drugs. Patients taking any regular medications should inform their healthcare provider before starting Vitamin E supplementation.

Vitamin E is susceptible to oxidation, which can significantly reduce its potency. Store in a cool, dry place away from direct sunlight and heat. Keep out of reach of children.

What is the price of EVV 200 mg in Bangladesh (BD)?

EVV 200 mg price in Bangladesh is ৳5.52 per tablet. Prices may vary by pharmacy and are updated regularly on this page.

What is EVV used for?

As a dietary supplement: - Vitamin E deficiency resulting from impaired absorption - Increased requirements due to a diet rich in polyunsaturated fats - Support for healthy hair and skin - As an antioxidant - Hemolytic…

Is EVV an antibiotic?

No, EVV is not an antibiotic.