Interactions with Drugs
Vitamin E may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
Vitamin E may interfere with the way the body processes certain drugs using the liver's "cytochrome P450" enzyme system. As a result, the levels of these drugs may be altered in the blood, and may cause altered effects or potentially serious adverse reactions. People using any medications should check the package insert, and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.
Vitamin E may also interact with agents that cause abortion, Alzheimer's agents, amprenavir, anesthetics, anti-androgens, anti-arthritis agents, anti-asthma agents, anticancer agents, antidiabetic agents, anti-estrogens, anti-seizure agents, anti-tuberculosis agents, aromatase inhibitors, cholesterol-lowering agents, cholestyramine, colestipol, cyclosporine, gefinitib, gemfibrozil, heart agents, hormonal agents, hydrophilic agents, iron, isoniazid, letrozole, nervous system agents, orlistat, paclitaxel, propofol, remifentanil, sucralfate, and vancomycin.
Interactions with Herbs and Dietary Supplements
Vitamin E may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.
Vitamin E may interfere with the way the body processes certain herbs or supplements using the liver's "cytochrome P450" enzyme system. As a result, the levels of other herbs or supplements may be altered in the blood. It may also alter the effects that other herbs or supplements possibly have on the P450 system.
Vitamin E may also interact with aloe, Alzheimer's herbs and supplements, anesthetics, anti-androgens, anti-arthritis herbs and supplements, anti-asthma herbs and supplements, anticancer herbs and supplements, antidiabetic agents, anti-estrogens, antioxidants, anti-seizure herbs and supplements, cholesterol-lowering herbs and supplements, cigarettes, copper, fish oil, heart herbs and supplements, herbs and supplements that cause abortion, hormonal herbs and supplements, hydrophilic herbs and supplements, iron, mineral oil, nervous system herbs and supplements, omega-6 fatty acids, stanyl esters, vitamin A, vitamin C, vitamin K, and zinc.
This evidence-based monograph was prepared by The Natural Standard Research Collaboration