Ibrutinib
Severe
Database
Clinical effect not specified
Source: DDInter
Drug reference
vitamin e
Fat-soluble vitamin (α-tocopherol, antioxidant) · Vitamin
START
Deficiency 60–75 IU/day PO; cholestasis use water-miscible form
TYPICAL MAX
Upper intake ~1000 mg (~1500 IU)/day — limit chronic high dose
STOP IF
Bleeding/coagulopathy or persistent GI intolerance
WATCH
PT/INR if on warfarin or chronic high-dose
CDSCO approvedATC A11HA03
KDIGO 2024 + manufacturer label
- ONSET
- 1w · repletion
- PEAK
- 4.3w · stores
- t½
- 2d · plasma t½
- DURATION
- 1d · daily dose
EXCRETION
Mainly biliary/faecal; minimal renal
route + CYP
INTERACTIONS
2 major
SEVERE in our sources
PREGNANCY
Safe at recommended intakes.
FDA category + note
Top interactionssee all 5 →
- IbrutinibSevereDatabaseDDInter
- TipranavirSevereDatabaseDDInter
Mechanism
Lipid-soluble chain-breaking antioxidant that scavenges peroxyl radicals in cell membranes, protecting polyunsaturated fatty acids from oxidative damage; essential for nervous-system, retinal and erythrocyte membrane integrity.
Indications
Vitamin E deficiency (e.g., abetalipoproteinaemia, chronic cholestasis, cystic fibrosis)Prevention of haemolytic anaemia in premature infantsSupplementation in malabsorption
Dosing
- Adult
- Deficiency: 60–75 IU/day PO; abetalipoproteinaemia: 100 IU/kg/day. RDA ~15 mg (22 IU) natural d-α-tocopherol/day.
- Pediatric
- RDA per age; deficiency 25–50 IU/day infants, higher for malabsorption.
- Renal adjustment
- No adjustment.
- Hepatic adjustment
- Higher doses may be needed in cholestasis (impaired absorption); use water-miscible formulation.
- Geriatric
- No specific adjustment.
- Max dose
- Upper-intake-limit ~1000 mg/day (~1500 IU) — long-term high-dose discouraged
Pharmacokinetics
Onset
Repletion over weeks–months
Peak effect
Variable (lipid-status dependent)
Duration
Long body stores
Half-life
Variable; long tissue retention
Bioavailability
Requires bile/pancreatic lipase; ~10–50% absorbed
Protein binding
Lipoprotein-bound
Metabolism
Hepatic α-tocopherol transfer protein delivers to lipoproteins; oxidation/excretion
Excretion
Mainly biliary/faecal; minimal renal
Contraindications
- Hypersensitivity (rare)
- Caution: vitamin K deficiency / anticoagulant therapy (bleeding)
Side effects
Common
Generally well tolerated at recommended dosesNausea/diarrhoea at high doses
Serious
- Increased bleeding risk (high-dose, esp. with antiplatelets/anticoagulants)
- Possible increased all-cause mortality at >400 IU/day (meta-analyses)
- Haemorrhagic stroke (high-dose, in selected populations)
Pregnancy & lactation
Pregnancy
Safe at recommended intakes.
Lactation
Compatible at recommended intakes.
Drug interactions
Tipranavir
Severe
Database
Clinical effect not specified
Source: DDInter
Cholestyramine
Moderate
Database
Reduced absorption
Separate dosing; supplement
Source: Kimi deep-research + Cla
Antiplatelets
Moderate
Database
Additive antiplatelet effect
Monitor; avoid chronic high dose
Source: Kimi deep-research + Cla
Warfarin
Moderate
Database
Antagonism of vitamin K / additive bleeding
Monitor INR; avoid >400 IU/day chronic
Source: Kimi deep-research + Cla
7 additional unreviewed or low-confidence interactions hidden because their provenance or source detail is insufficient.
Related guidelines
Iron deficiency anaemia in pregnancy
ICMR · Obstetrics & Gynaecology · 2022
Iron deficiency anaemia in adults
ICMR · Hematology · 2023
Iron deficiency anaemia in pregnancy
FOGSI · Obstetrics & Gynaecology · 2017
Stroke and TIA — secondary prevention
AHA · Neurology · 2021
Tobacco-related cancer prevention
ICMR · Oncology · 2021
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Textbook-sourced·Sources: Goodman & Gilman 14e·Updated: 2026-05-20·Cockpit curated: 2026-05-20