Special information on Vitamin E
Vitamin E is contraindicated in those with known hypersensitivity to any component of a vitamin E-containing product.
Those on warfarin should be cautious in using high doses of vitamin E (i.e., doses greater than 100 milligrams daily of d-alpha-tocopherol or 200 milligrams daily of d1-alpha-tocopherol), and if they do use such doses, they should have their INRs monitored and their warfarin dose appropriately adjusted if indicated. Likewise, those with vitamin K deficiencies, such as those with liver failure, should be cautious in using high doses of vitamin E. Vitamin E should be used with extreme caution in those with any lesions that have a propensity to bleed (e.g., bleeding peptic ulcers), those with a history of hemorrhagic stroke and those with inherited bleeding disorders (e.g., hemophilia). Supplemental doses of vitamin E higher than RDA amounts should be avoided by pregnant women and nursing mothers.
High dose vitamin E supplementation should be stopped about one month before surgical procedures and may be resumed following recovery from the procedure. Use of supplemental vitamin E in low birth weight premature infants must be undertaken with extreme caution and only by trained medical personnel.
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