Liquid Vitamin E+ Ingredients & Drug Interactions
by Codeage
What is this page for?
First and foremost: checking Liquid Vitamin E+ against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.
Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy
Liquid Vitamin E+ is a dietary supplement by Codeage with 3 active ingredients. Its ingredients are commonly taken for general antioxidant support, skin and hair care, heart health.Based on those ingredients, 861 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Vitamin E, Orange Oil. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Liquid Vitamin E+ by Codeage
Ask about any prescription or over-the-counter medication and we check it for interactions with Liquid Vitamin E+ by Codeage — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of Liquid Vitamin E+ by Codeage
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Full disclosure
Liquid Vitamin E+ contains three ingredients. The two active components are vitamin E and orange oil.
Medium chain triglyceride oil rounds out the formula. This product has no other inactive ingredients listed.
Does it work?
Strong evidence
Vitamin E is effective for treating vitamin E deficiency and a rare inherited disorder called ataxia with vitamin E deficiency (AVED). The evidence suggests it's possibly effective for Alzheimer disease, beta-thalassemia, glucose-6-phosphate dehydrogenase deficiency, and intracranial hemorrhage, though the data isn't as strong.
We don't have effectiveness information on file for orange oil.
How safe is it?
Well-documented data
Vitamin E from food and normal dietary amounts is well-tolerated. High-dose long-term supplements, though, carry caution flags — they may raise your bleeding risk and other potential harms.
Vitamin E is generally well-tolerated when taken by mouth, but rare serious effects include bleeding and hemorrhagic stroke. High doses can interfere with vitamin K-dependent clotting, especially if you already have a vitamin K deficiency or take blood thinners.
Pregnancy and breastfeeding: The safety data advises against high-dose supplements during pregnancy — amounts from food and prenatal vitamins are appropriate. During breastfeeding, normal dietary amounts are fine, but check with your doctor before taking high-dose supplements.
We don't have pregnancy or breastfeeding data on file for medium chain triglyceride oil or orange oil.
Meds to double-check
Major interaction found
Check these medication types before taking Liquid Vitamin E+: blood thinners and antiplatelet drugs (moderate risk of bleeding), medications your liver processes through the CYP3A4 pathway (moderate risk of reduced effectiveness), chemotherapy drugs like alkylating agents and antitumor antibiotics (moderate risk of reduced effectiveness), cyclosporine (moderate risk of increased absorption), warfarin specifically (moderate risk of increased bleeding), selumetinib (moderate risk of exceeding safe vitamin E doses), and niacin (minor risk of reduced cholesterol benefits).
The bottom line
Scorecard at a glanceFully disclosed formula with strong clinical evidence behind its ingredients' uses. Major medication interactions have been identified, and safety information is well characterized.
Vitamin E can help if you have a deficiency, and it's possibly helpful for a few other conditions. If you take blood thinners, anticoagulants, or certain chemotherapy drugs, or if you're pregnant or breastfeeding, talk with your pharmacist or doctor before adding this product — the interactions and safety considerations matter for your situation.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 2 of 3 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jul 24, 2025.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about Liquid Vitamin E+, straight from the product label.
| Brand | Codeage |
|---|---|
| Barcode (UPC) | 850049609142 |
| Net contents | 2 Fluid Ounce(s); 59.2 mL |
| Market status | On market |
| Date entered into DSLD | Jul 24, 2025 |
| DSLD ID | 333437 |
| Product type | Botanical With Nutrients |
| Supplement form | Liquid |
| Dietary claims / uses | Nutrient, All Other, Structure/Function |
| Intended target group(s) | Vegan, Vegetarian, Adult (18 - 50 Years), Organic, Gluten Free, Dairy Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Liquid Vitamin E+ by Codeage, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Medium Chain Triglyceride Oil | 961 mg | -- |
| Vitamin E | 17 mg | 113% |
| Orange Oil | 5 mg | -- |
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Formulation
Organic, Non-GMO, vegan, gluten-free, yeast-free, and soy-free. Contains no artificial coloring.
Organic, Non-GMO, vegan, gluten-free, yeast-free, and soy-free.
Organic USDA Organic
Antioxidant
Certified Organic by MOSA
Precautions
Caution: Do not exceed recommended dose. Discontinue use two weeks prior to surgery.
Pregnant or nursing mothers, children under 18 and individuals with a known medical condition should consult a physician before using this or any dietary supplement.
Pregnant or nursing mothers, children under 18 and individuals with a known medical condition should consult a physician before using this or any dietary supplement. Keep out of reach of children and pets.
Please use caution if you have allergies or sensitivities to any of the listed ingredients.
General Statements
Feel different.
Questions? Codeage.com
Formula
Vitamin E + MCT Oil
Seals/Symbols
USDA Organic
FDA Statement of Identity
Dietary Supplement
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
Suggested/Recommended/Usage/Directions
Suggested use: Take 30 drops (1 mL), immediately follow with purified water or your favorite beverage and swallow. May be added to food or mixed in beverages. Use once daily or as directed by your healthcare provider.
Storage
No refrigeration necessary.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Liquid Vitamin E+ by Codeage label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)The Ingredients in Liquid Vitamin E+ by Codeage
These are the 3 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 mL Dosage formLiquid Servings per container60 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Medium Chain Triglyceride Oil
Vitamin E
Interacts with764 drugs
Vitamin E is an essential fat-soluble vitamin and antioxidant that most people get in adequate amounts from a normal diet. Supplements can help correc...
Vitamin E monograph & interactionsOrange Oil
Interacts with246 drugs
Sweet orange is a common citrus fruit that is a good source of vitamin C, fiber, and antioxidants, and is enjoyed as a food worldwide. Its peel and es...
Orange Oil monograph & interactionsLiquid Vitamin E+ by Codeage Drug Interactions
HelloPharmacist Interaction Report
Liquid Vitamin E+ by Codeage contains vitamin E, which has documented moderate-severity interactions with several medication types.
The most serious concern is with blood thinners (anticoagulants) and antiplatelet drugs — vitamin E can increase bleeding risk by interfering with how your blood clots, especially at higher doses.
Read the full breakdown — every affected drug type, severity by severity
Vitamin E may also affect how your liver processes certain medications through the CYP3A4 pathway, potentially reducing their levels in your blood. It can theoretically lower the effectiveness of chemotherapy drugs, including alkylating agents and antitumor antibiotics that work by generating free radicals.
If you take cyclosporine, a specific form of vitamin E in this product might increase how much of the drug your body absorbs. There's also a minor interaction with niacin where vitamin E might reduce its cholesterol-raising benefits.
We couldn't check two of the three ingredients — medium chain triglyceride oil and orange oil — because we hold no interaction data for them. Altogether, these interactions span 754 individual medications.
Before you start this supplement, run your exact medications through the checker on this page.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Liquid Vitamin E+?
Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in Liquid Vitamin E+ interact with 861 drugs. Click any drug to see the details.
2 of the 3 ingredients in Liquid Vitamin E+ interact with drugs. Each result below shows which ingredient is responsible. Vitamin E Orange Oil
AtorvastatinAtorvaliq
How Atorvastatin interacts with Liquid Vitamin E+ — through 2 ingredients. Tap an ingredient for the detail:
Orange OilOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Oil + Atorvastatin interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Atorvastatin interactionAtorvastatin CalciumLipitor
How Atorvastatin Calcium interacts with Liquid Vitamin E+ — through 2 ingredients. Tap an ingredient for the detail:
Orange OilOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Oil + Atorvastatin Calcium interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Atorvastatin Calcium interactionBosentanTracleer
How Bosentan interacts with Liquid Vitamin E+ — through 2 ingredients. Tap an ingredient for the detail:
Orange OilOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Oil + Bosentan interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Bosentan interactionBrincidofovirTembexa
How Brincidofovir interacts with Liquid Vitamin E+ — through 1 ingredient. Tap an ingredient for the detail:
Orange OilOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Oil + Brincidofovir interactionCeliprololCelicard
How Celiprolol interacts with Liquid Vitamin E+ — through 1 ingredient. Tap an ingredient for the detail:
Orange OilOrganic Anion-transporting Polypeptide Substrates (oatp), Celiprolol (celicard) +1 Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Oil + Celiprolol interactionCerivastatin SodiumBaycol
How Cerivastatin Sodium interacts with Liquid Vitamin E+ — through 1 ingredient. Tap an ingredient for the detail:
Orange OilOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Oil + Cerivastatin Sodium interactionCinoxacinCinobac
How Cinoxacin interacts with Liquid Vitamin E+ — through 1 ingredient. Tap an ingredient for the detail:
Orange OilOrganic Anion-transporting Polypeptide Substrates (oatp), Quinolone Antibiotics Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Oil + Cinoxacin interactionCiprofloxacinCiloxan, Cipro, Cipro IV, Cipro XR, Ciprobay, Otiprio
How Ciprofloxacin interacts with Liquid Vitamin E+ — through 1 ingredient. Tap an ingredient for the detail:
Orange OilQuinolone Antibiotics, Organic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Calcium-fortified sweet orange juice might reduce quinolone absorption.
Read the full Orange Oil + Ciprofloxacin interactionCiprofloxacin, HydrocortisoneCipro HC Otic
How Ciprofloxacin, Hydrocortisone interacts with Liquid Vitamin E+ — through 1 ingredient. Tap an ingredient for the detail:
Orange OilOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Oil + Ciprofloxacin, Hydrocortisone interactionClinafloxacinClinafloxacin
How Clinafloxacin interacts with Liquid Vitamin E+ — through 1 ingredient. Tap an ingredient for the detail:
Orange OilOrganic Anion-transporting Polypeptide Substrates (oatp), Quinolone Antibiotics Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Oil + Clinafloxacin interactionEnoxacinPenetrex
How Enoxacin interacts with Liquid Vitamin E+ — through 1 ingredient. Tap an ingredient for the detail:
Orange OilQuinolone Antibiotics, Organic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Calcium-fortified sweet orange juice might reduce quinolone absorption.
Read the full Orange Oil + Enoxacin interactionEtoposideEtopophos, VePesid, VP16
How Etoposide interacts with Liquid Vitamin E+ — through 2 ingredients. Tap an ingredient for the detail:
Orange OilP-glycoprotein Substrates, Organic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Sweet orange juice seems to modulate P-glycoprotein (P-gp), which might affect the blood levels of P-gp substrates.
Read the full Orange Oil + Etoposide interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Etoposide interactionEzetimibe, AtorvastatinLiptruzet
How Ezetimibe, Atorvastatin interacts with Liquid Vitamin E+ — through 2 ingredients. Tap an ingredient for the detail:
Orange OilOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Oil + Ezetimibe, Atorvastatin interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Ezetimibe, Atorvastatin interactionFexofenadineAllegra
How Fexofenadine interacts with Liquid Vitamin E+ — through 2 ingredients. Tap an ingredient for the detail:
Orange OilP-glycoprotein Substrates, Organic Anion-transporting Polypeptide Substrates (oatp) +1 Major
Interaction Summary
Sweet orange juice seems to modulate P-glycoprotein (P-gp), which might affect the blood levels of P-gp substrates.
Read the full Orange Oil + Fexofenadine interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Fexofenadine interactionFexofenadine, PseudoephedrineAllegra D
How Fexofenadine, Pseudoephedrine interacts with Liquid Vitamin E+ — through 2 ingredients. Tap an ingredient for the detail:
Orange OilFexofenadine (allegra), P-glycoprotein Substrates +1 Major
Interaction Summary
Consuming sweet orange juice with fexofenadine can decrease oral absorption of fexofenadine.
Read the full Orange Oil + Fexofenadine, Pseudoephedrine interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Fexofenadine, Pseudoephedrine interactionFluvastatinLescol, Lescol XL
How Fluvastatin interacts with Liquid Vitamin E+ — through 1 ingredient. Tap an ingredient for the detail:
Orange OilOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Oil + Fluvastatin interactionGatifloxacinTequin, Tequin Injection
How Gatifloxacin interacts with Liquid Vitamin E+ — through 1 ingredient. Tap an ingredient for the detail:
Orange OilOrganic Anion-transporting Polypeptide Substrates (oatp), Quinolone Antibiotics Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Oil + Gatifloxacin interactionGemifloxacinFactive
How Gemifloxacin interacts with Liquid Vitamin E+ — through 1 ingredient. Tap an ingredient for the detail:
Orange OilOrganic Anion-transporting Polypeptide Substrates (oatp), Quinolone Antibiotics Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Oil + Gemifloxacin interactionGlyburideAlbert Glyburide, Diabeta, Glycron, Glynase, Glynase PresTab, Micronase +1 more
How Glyburide interacts with Liquid Vitamin E+ — through 1 ingredient. Tap an ingredient for the detail:
Orange OilOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Oil + Glyburide interactionGlyburide, MetforminGlucovance
How Glyburide, Metformin interacts with Liquid Vitamin E+ — through 1 ingredient. Tap an ingredient for the detail:
Orange OilOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Oil + Glyburide, Metformin interactionGrepafloxacinRaxar
How Grepafloxacin interacts with Liquid Vitamin E+ — through 1 ingredient. Tap an ingredient for the detail:
Orange OilQuinolone Antibiotics, Organic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Calcium-fortified sweet orange juice might reduce quinolone absorption.
Read the full Orange Oil + Grepafloxacin interactionIrinotecanCamptosar, Onivyde
How Irinotecan interacts with Liquid Vitamin E+ — through 2 ingredients. Tap an ingredient for the detail:
Orange OilOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Oil + Irinotecan interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Irinotecan interactionIrinotecan Hydrochloride
How Irinotecan Hydrochloride interacts with Liquid Vitamin E+ — through 2 ingredients. Tap an ingredient for the detail:
Orange OilOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Oil + Irinotecan Hydrochloride interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Irinotecan Hydrochloride interactionIsoniazid, Pyrazinamide, RifampinRifater
How Isoniazid, Pyrazinamide, Rifampin interacts with Liquid Vitamin E+ — through 1 ingredient. Tap an ingredient for the detail:
Orange OilOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Oil + Isoniazid, Pyrazinamide, Rifampin interactionIsoniazid, RifampinRifamate
How Isoniazid, Rifampin interacts with Liquid Vitamin E+ — through 1 ingredient. Tap an ingredient for the detail:
Orange OilOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Oil + Isoniazid, Rifampin interactionIvermectinMectizan, Sklice, Soolantra, Stromectol
How Ivermectin interacts with Liquid Vitamin E+ — through 1 ingredient. Tap an ingredient for the detail:
Orange OilIvermectin (stromectol, Others), P-glycoprotein Substrates Major
Interaction Summary
Consuming sweet orange juice with ivermectin can decrease the oral absorption of ivermectin.
Read the full Orange Oil + Ivermectin interactionLevofloxacinLeva-pak, Levaquin, Levaquin Injection
How Levofloxacin interacts with Liquid Vitamin E+ — through 1 ingredient. Tap an ingredient for the detail:
Orange OilOrganic Anion-transporting Polypeptide Substrates (oatp), Quinolone Antibiotics Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Oil + Levofloxacin interactionLevofloxacin (ophthalmic)Levofloxacin
How Levofloxacin (ophthalmic) interacts with Liquid Vitamin E+ — through 1 ingredient. Tap an ingredient for the detail:
Orange OilOrganic Anion-transporting Polypeptide Substrates (oatp), Quinolone Antibiotics Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Oil + Levofloxacin (ophthalmic) interactionLomefloxacinMaxaquin
How Lomefloxacin interacts with Liquid Vitamin E+ — through 1 ingredient. Tap an ingredient for the detail:
Orange OilOrganic Anion-transporting Polypeptide Substrates (oatp), Quinolone Antibiotics Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Oil + Lomefloxacin interactionLovastatinAltocor, Mevacor
How Lovastatin interacts with Liquid Vitamin E+ — through 2 ingredients. Tap an ingredient for the detail:
Orange OilOrganic Anion-transporting Polypeptide Substrates (oatp) Major
Interaction Summary
Consuming sweet orange juice can decrease oral absorption of OATP substrates.
Read the full Orange Oil + Lovastatin interactionVitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Lovastatin interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Liquid Vitamin E+ with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.
Vitamin E
Alkylating Agents
Theoretically, antioxidant effects of vitamin E might reduce the effectiveness of alkylating agents.
There's concern that antioxidants could reduce the activity of chemotherapy drugs which generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin E have on chemotherapy. Advise patients to consult their oncologist before using vitamin E supplements, especially in high doses.
Anticoagulant/Antiplatelet Drugs
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Vitamin E seems to inhibit of platelet aggregation and antagonize the effects of vitamin K-dependent clotting factors. These effects appear to be dose-dependent, and are probably only likely to be clinically significant with doses of at least 800 units daily. Mixed tocopherols, such as those found in food, might have a greater antiplatelet effect than alpha-tocopherol. RRR alpha-tocopherol (natural vitamin E) 1000 IU daily antagonizes vitamin K-dependent clotting factors. Advise patients to avoid high doses of vitamin E, especially in people with low vitamin K intake or other risk factors for bleeding.
Antitumor Antibiotics
Theoretically, antioxidant effects of vitamin E might reduce the effectiveness of antitumor antibiotics.
There's concern that antioxidants could reduce the activity of antitumor antibiotic drugs such as doxorubicin, which generate free radicals. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin E have on chemotherapy involving antitumor antibiotics. Advise patients to consult their oncologist before using vitamin E supplements, especially in high doses.
Cyclosporine (Neoral, Sandimmune)
A specific form of vitamin E might increase absorption and levels of cyclosporine.
There is some evidence that one specific formulation of vitamin E (D-alpha-tocopheryl-polyethylene glycol-1000 succinate, TPGS, tocophersolan, Liqui-E) might increase absorption of cyclosporine. This vitamin E formulation forms micelles which seems to increase absorption of cyclosporine by 40% to 72% in some patients. However, this interaction is unlikely to occur with the usual forms of vitamin E.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Vitamin E appears to bind with the nuclear receptor, pregnane X receptor (PXR), which results in increased expression of CYP3A4. Although the clinical significance of this is not known, use caution when considering concomitant use of vitamin E and other drugs affected by these enzymes.
Selumetinib (Koselugo)
Taking selumetinib with vitamin E can result in a total daily dose of vitamin E that exceeds safe limits and therefore might increase the risk of bleeding.
Selumetinib contains 48-54 IU vitamin E per capsule. The increased risk of bleeding with vitamin E appears to be dose-dependent. Be cautious when using selumetinib in combination with supplemental vitamin E, especially in patients at higher risk of bleed, such as those with chronic conditions and those taking antiplatelet drugs.
Warfarin (Coumadin)
Using vitamin E with warfarin might increase the risk of bleeding.
Due to interference with production of vitamin K-dependent clotting factors, use of more than 400 IU of vitamin E daily with warfarin might increase prothrombin time (PT), INR, and the risk of bleeding,. At a dose of 1000 IU per day, vitamin E can antagonize vitamin K-dependent clotting factors even in people not taking warfarin. Limited clinical evidence suggests that doses up to 1200 IU daily may be used safely by patients taking warfarin, but this may not be applicable in all patient populations.
Niacin
Vitamin E might decrease the beneficial effects of niacin on high-density lipoprotein (HDL) cholesterol levels.
A combination of niacin and simvastatin (Zocor) effectively raises high-density lipoprotein (HDL) cholesterol levels in people with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50%. Vitamin E alone combined with a statin does not seem to decrease HDL levels. It is not known whether the adverse effect on HDL is due to one of the other antioxidants or to the combination. It also is not known whether it will occur in other patient populations.
Orange Oil
Celiprolol (Celicard)
Consuming sweet orange with celiprolol can decrease oral absorption of celiprolol.
A pharmacokinetic study in healthy volunteers shows that celiprolol levels, after a single dose of 100 mg, are decreased by up to 90% in people who drink sweet orange juice 200 mL three times daily. It's not known if lower consumption of sweet orange juice will have the same effect. Theoretically, this occurs due to short-term inhibition of organic anion transporting polypeptide (OATP). Recommend separating drug administration and consumption of sweet orange by at least 4 hours.
Ivermectin (Stromectol, Others)
Consuming sweet orange juice with ivermectin can decrease the oral absorption of ivermectin.
A pharmacokinetic study in healthy volunteers shows that taking ivermectin orally with sweet orange juice 750 mL over 4 hours reduces the bioavailability of ivermectin. This effect does not seem to be related to effects on P-glycoprotein. The effect on ivermectin is more pronounced in males compared to females.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Consuming sweet orange juice can decrease oral absorption of OATP substrates. Separate administration by at least 4 hours.
Clinical research shows that consuming sweet orange juice inhibits OATP, which reduces bioavailability of oral drugs that are substrates of OATP. For example, sweet orange juice decreases bioavailability of fexofenadine, a substrate of OATP, by about 72% and of celiprolol, another OATP substrate, by up to 90%. Since sweet orange juice seems to affect OATP for a short time, recommend separating drug administration and consumption of sweet orange juice by at least 4 hours.
Pravastatin (Pravachol)
Consuming sweet orange juice with pravastatin can increase the absorption of pravastatin.
A small pharmacokinetic study in healthy volunteers shows that consuming sweet orange juice 800 mL over 3 hours, including before, during, and after taking pravastatin 10 mg, increases pravastatin levels by about 149%, without affecting pravastatin elimination. Theoretically this effect might be due to modulation of organic anion transporting polypeptides (OATPs) by sweet orange juice. Sweet orange juice does not seem to affect simvastatin levels, but it is not known if sweet orange affects any of the other statins.
Fexofenadine (Allegra)
Consuming sweet orange juice with fexofenadine can decrease oral absorption of fexofenadine.
Clinical research shows that coadministration of sweet orange juice 1200 mL decreases bioavailability of fexofenadine by about 72%. In an animal model, sweet orange juice decreased bioavailability of fexofenadine by 31%. Fexofenadine manufacturer data indicates that concomitant administration of sweet orange juice and fexofenadine results in larger wheal and flare sizes in research models. This suggests that sweet orange reduces the clinical response to fexofenadine. Theoretically, this occurs due to short-term inhibition of organic anion transporting polypeptide (OATP). Recommend separating drug administration and consumption of sweet orange by at least 4 hours.
P-Glycoprotein Substrates
Sweet orange juice seems to modulate P-glycoprotein (P-gp), which might affect the blood levels of P-gp substrates.
Animal and in vitro research suggest that orange juice extract inhibits drug efflux by P-gp, increasing absorption and levels of P-gp substrates. In contrast, pharmacokinetic research in humans shows that drinking large amounts of sweet orange juice decreases absorption and levels of the P-gp substrate celiprolol. This suggests that orange juice actually induces drug efflux by P-gp or affects drug levels by another mechanism such as inhibiting the gut drug transporter called organic anion transporting polypeptide (OATP). Until more is known, sweet orange juice should be used cautiously in people taking P-gp substrates.
Quinolone Antibiotics
Calcium-fortified sweet orange juice might reduce quinolone absorption.
Calcium binds to quinolones in the gut. Theoretically, the calcium in certain fortified orange juices can also bind to quinolone antibiotics and reduce their absorption and levels.
Brand information
Manufacturer and brand details for Liquid Vitamin E+, from the product label.
Codeage
See all Codeage products- Name
- Codeage LLC
- Street Address
- 5628 Washington Blvd
- City
- Los Angeles
- State
- CA
- ZipCode
- 90016
- Web Address
- www.codeage.com
Liquid Vitamin E+ by Codeage: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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The Full Monographs Behind Liquid Vitamin E+’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Vitamin E
Interacts with 764 drugsVitamin E is an essential fat-soluble vitamin and antioxidant that most people get in adequate amounts from a normal diet. Supplements can help correct a true deficiency, but high-dose vitam...
Read the full Vitamin E monograph → Herb & supplement monographSweet Orange
Interacts with 246 drugsSweet orange is a common citrus fruit that is a good source of vitamin C, fiber, and antioxidants, and is enjoyed as a food worldwide. Its peel and essential oil are used in aromatherapy and...
Read the full Sweet Orange monograph →Sources & How We Checked
Liquid Vitamin E+'s label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
The 81 references behind this product’s interaction data
Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.
Vitamin E 64 references
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- Anon. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Soprawivenza nell'Infarto miocardico. Lancet 1999;354:447-55. DOI
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- The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med 1994;330:1029-35. PubMed
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- Brown BG, Zhao XQ, Chait A, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med 2001;345:1583-93. DOI
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- Sokol RJ, Johnson KE, Karrer FM, et al. Improvement of cyclosporin absorption in children after liver transplantation by means of water-soluble vitamin E. Lancet 1991;338:212-4.. PubMed
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- Jandak J, Steiner M, Richardson PD. Alpha-tocopherol, an effective inhibitor of platelet adhesion. Blood 1989;73:141-9. DOI
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- Smedts HP, de Vries JH, Rakhshandehroo M, et al. High maternal vitamin E intake by diet or supplements is associated with congenital heart defects in the offspring. BJOG 2009;116:416-23. PubMed
- Klein EA, Thompson IM Jr, Tangen CM, et al. Vitamin E and the risk of prostate cancer: the Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA 2011;306:1549-56. PubMed
- Huang, H. Y., Caballero, B., Chang, S., Alberg, A. J., Semba, R. D., Schneyer, C. R., Wilson, R. F., Cheng, T. Y., Vassy, J., Prokopowicz, G., Barnes, G. J., and Bass, E. B. The efficacy and safety of multivitamin and mineral supplement use to prevent ca
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- Mathew, M. C., Ervin, A. M., Tao, J., and Davis, R. M. Antioxidant vitamin supplementation for preventing and slowing the progression of age-related cataract. Cochrane.Database.Syst.Rev. 2012;6:CD004567. PubMed
- Rahimi, R., Nikfar, S., Rezaie, A., and Abdollahi, M. A meta-analysis on the efficacy and safety of combined vitamin C and E supplementation in preeclamptic women. Hypertens.Pregnancy. 2009;28(4):417-434. PubMed
- Soares, K. V. and McGrath, J. J. Vitamin E for neuroleptic-induced tardive dyskinesia. Cochrane.Database.Syst.Rev. 2001;(4):CD000209. DOI
- Roed-Petersen, J. and Hjorth, N. Contact dermatitis from antioxidants. Br.J.Dermatol. 1976;94(3):233-241. PubMed
- Brion, L. P., Bell, E. F., Raghuveer, T. S., and Soghier, L. What is the appropriate intravenous dose of vitamin E for very-low-birth-weight infants? J.Perinatol. 2004;24(4):205-207. PubMed
- Manny, T., Pettus, J., Hemal, A., Marks, M., and Mirzazadeh, M. Penile sclerosing lipogranulomas and disfigurement from use of "1Super Extenze" among Laotian immigrants. J.Sex Med. 2011;8(12):3505-3510. PubMed
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- Manzano, D., Aguirre, A., Gardeazabal, J., Eizaguirre, X., and Diaz Perez, J. L. Allergic contact dermatitis from tocopheryl acetate (vitamin E) and retinol palmitate (vitamin A) in a moisturizing cream. Contact Dermatitis 1994;31(5):324.
- Barak, Y., Swartz, M., Shamir, E., Stein, D., and Weizman, A. Vitamin E (alpha-tocopherol) in the treatment of tardive dyskinesia: a statistical meta-analysis. Ann.Clin.Psychiatry 1998;10(3):101-105.
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Sweet Orange 17 references
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- Kurowska EM, Spence JD, Jordan J, et al. HDL-cholesterol-raising effect of orange juice in subjects with hypercholesterolemia. Am J Clin Nutr 2000;72:1095-100. PubMed
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- Bailey DG, Dresser GK, Munoz C, et al. Reduction of fexofenadine bioavailability by fruit juices. Clin Pharmacol Ther 2001;69:P21.
- Pletz MW, Petzold P, Allen A, et al. Effect of calcium carbonate on bioavailability of orally administered gemifloxacin. Antimicrob Agents Chemother 2003;47:2158-60.. PubMed
- Lilja JJ, Juntti-Patinen L, Neuvonen PJ. Orange juice substantially reduces the bioavailability of the beta-adrenergic-blocking agent celiprolol. Clin Pharmacol Ther 2004;75:184-90.
- Tian R, Koyabu N, Takanaga H, et al. Effects of grapefruit juice and orange juice on the intestinal efflux of P-glycoprotein substrates. Pharm Res 2002;19:802-9. PubMed
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- Neuhofel, A. L., Wilton, J. H., Victory, J. M., Hejmanowsk, L. G., and Amsden, G. W. Lack of bioequivalence of ciprofloxacin when administered with calcium-fortified orange juice: a new twist on an old interaction. J Clin Pharmacol. 2002;42(4):461-466. DOI
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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
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