Vitamin E (Ester Form, Fat-Soluble Vitamin)

Alpha Tocopheryl Acetate

Brand names: Ephynal (acetate form), various supplement preparations

Adult dose

Dose: Supplementation: 67–1000 mg daily; deficiency: as directed by specialist

Route: Oral

Frequency: Once daily

Clinical pearls

Acetate ester form of vitamin E — more stable in supplements but must be hydrolysed to active alpha-tocopherol in the gut
Used interchangeably with alpha-tocopherol for supplementation in most clinical contexts
Less effective than free tocopherol in conditions with severe fat malabsorption (hydrolysis impaired)
Not recommended for primary prevention of CVD or cancer based on current evidence
RDA for adults: 15 mg/day (22 IU natural; 33 IU synthetic) — most people obtain sufficient from diet

Contraindications

No absolute contraindications at recommended doses

Side effects

Well tolerated at standard doses
High doses: bleeding risk (anti-platelet/anticoagulant effect)
GI disturbance at very high doses

Interactions

Anticoagulants — high-dose may enhance anticoagulation; monitor INR
Vitamin K antagonism at very high doses (rare)

Monitoring

Serum vitamin E levels if treating deficiency
INR if combined with anticoagulants and high-dose supplementation

Reference: BNF; NICE CKS Vitamin deficiency; NHS Vitamins and minerals guidance; https://bnf.nice.org.uk/drugs/alpha-tocopheryl-acetate/. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways