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 Release 22.0, Sept. 2008
 
The Medical Algorithms Project
Chapter : ch12. Nutrition Section : Vitamin Assessment
  Replacement Therapy in Vitamin E Deficiency

  Online Excel Reference
Copyright (c) 2008-2010, Institute for Algorithmic Medicine, Houston, TX, USA. All rights reserved.

Overview :

The dose and formulation of vitamin E replacement depends on the severity of the deficiency and the underlying cause.

 

Cause for Vitamin E Deficiency

Special Formulation

Daily Dose and Route

isolated deficiency

 

400 - 1,200 IU po

cystic fibrosis

 

5 - 10 IU per kg po

chronic cholestasis, initial

water-soluble ester

15 - 25 IU per kg po

chronic cholestasis, unresponsive to oral therapy

parenteral (for IM injection)

15 - 25 IU per kg IM

short bowel syndrome

 

200 - 3,600 IU po

 

where:

• Water-soluble ester = d-alpha-tocopherol polyethylene succinate

• The potency of different formulations of vitamin E vary, but this is standardized to International Units (IU) based on activity. 1 mg of all-rac-alpha-tocopheryl acetate has 1 IU activity.

• d,l-alpha-tocopherol (Ephynal) can be used for parenteral administration but is not available in the United States.

 

  References:

Marcus R, Coulston AM. Chapter 64: Fat-soluble vitamins. Vitamins A, K, and E. pages 1773-1791. IN: Hardman JG, Limbird LE (editors). Goodman & Gilman's The Pharmacological Basis of Therapeutics, Tenth Edition. McGraw-Hill. 2001.

Mendell JR, Kissel JT. Chapter 27: Vitamin deficiencies: Cobalamin (Vitamin B12), Vitamin E (Tocopherol), and Thiamine (Vitamin B1). pages 532-550 (Table 27-6, pages 541). IN: Mendell JR, Kissel JT, Cornblath DR (editors). Diagnosis and Management of Peripheral Nerve Disorders. Oxford University Press. 2001.

 

 
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