What are the guidelines for taking Evion (Vitamin E) tablets?

Guidelines for Taking Evion (Vitamin E) Tablets

For most healthy adults, the recommended daily intake of Vitamin E (Evion) is 15 mg (approximately 22.4 IU) per day, with supplementation only indicated in cases of confirmed deficiency or specific medical conditions. 1

Recommended Dosages

• The Dietary Reference Intake (DRI) for vitamin E for adult men and women is set at a daily Estimated Average Requirement (EAR) of 12 mg α-tocopherol and a Recommended Dietary Allowance (RDA) of 15 mg for both men and women 1
• European Food Safety Authority (EFSA) recommends an Adequate Intake (AI) of 13 mg/day for men and 11 mg/day for women 1
• During pregnancy, the RDA is 15 mg, and during lactation, it increases to 19 mg/day 1
• For older adults, while absorption doesn't decrease with age, intakes as high as 200 mg/day may be needed for optimal immune function 1

Administration Guidelines

• Vitamin E supplements should be taken with food containing fat to enhance absorption 1
• For liquid formulations: use the provided syringe marked with dose lines for accurate administration 2
• Liquid vitamin E can be mixed with formula, juice, cereal, or other food and should be consumed within 1 hour of mixing 2

Indications for Supplementation

• Supplementation is indicated when plasma α-tocopherol levels are below 12 μmol/L 1
• For patients with fat malabsorption conditions (such as short bowel syndrome), a dose of 200 mg/day is recommended 1
• In cases of confirmed vitamin E deficiency, start with 100 mg per day, adjusting based on the cause of depletion/deficiency 1

Special Populations and Considerations

• Patients with cystic fibrosis, abetalipoproteinemia, or thrombotic thrombocytopenic purpura (TTP) should have vitamin E levels monitored 1
• For non-diabetic, non-cirrhotic patients with biopsy-confirmed nonalcoholic steatohepatitis (NASH), 800 IU of vitamin E may be beneficial 1
• Patients on weight management diets with reduced fat intake may experience up to 50% reduction in vitamin E intake and might need supplementation 1

Safety and Precautions

• Caution for patients on anticoagulants: Vitamin E has anticoagulant effects and may increase bleeding risk when combined with warfarin or aspirin 1, 3, 4
• Vitamin E supplements should be discontinued in the perioperative period for any patient requiring surgery 3
• Smokers should avoid vitamin E supplementation due to potential negative effects on vitamin C 3
• Patients requiring vitamin A therapy or having retinitis pigmentosa should avoid vitamin E supplementation 3
• Keep vitamin E supplements out of reach of children to prevent excessive dosage 2

Toxicity and Upper Limits

• The Upper Limit (UL) for adults is set at 1000 mg (2325 μmol) 1
• Toxic effects from high doses are rare even after high intake for several years 1
• High-dose supplementation (1000 IU/670 mg daily for 12 weeks) may decrease γ-carboxylation of prothrombin, affecting coagulation 1
• Long-term high-dose supplementation has been associated with increased risks of all-cause mortality, hemorrhagic stroke, and certain cancers in some studies 4

Monitoring

• Routine monitoring of vitamin E concentrations is not generally recommended except in cases of long-term supplementation or specific clinical indications 1
• When measuring vitamin E status, it should be expressed as a ratio to lipids (cholesterol and triglycerides) for accurate assessment 1

Vitamin E supplementation at recommended doses (15 mg/day) appears safe for most individuals, but higher doses should be used only under medical supervision and for specific indications 5.