Natural E 400 Ingredients & Drug Interactions
by SuperSmart
What is this page for?
First and foremost: checking Natural E 400 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
Natural E 400 is a dietary supplement by SuperSmart with 1 active ingredient. Its ingredients are commonly taken for general antioxidant support, skin and hair care, heart health.Based on those ingredients, 764 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Vitamin E, Natural. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Natural E 400 by SuperSmart
Ask about any prescription or over-the-counter medication and we check it for interactions with Natural E 400 by SuperSmart — 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 Natural E 400 by SuperSmart
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
Natural E 400 is a single-ingredient supplement: vitamin E from natural sources (the RRR form, which is what your body prefers). Each softgel provides 400 IU.
The capsule also contains wheat germ oil as an inactive ingredient to help deliver the vitamin E.
Does it work?
Strong evidence
Vitamin E is effective for preventing and treating actual vitamin E deficiency and a rare genetic condition called AVED (ataxia with vitamin E deficiency). The evidence suggests it may be helpful for Alzheimer disease, beta-thalassemia, G6PD deficiency, and intracranial hemorrhage, though the data is less complete for those uses.
If you're taking this for a reason not on that list, the evidence we hold doesn't establish it.
How safe is it?
Well-documented data
Vitamin E from food and standard prenatal doses are safe. Long-term high-dose supplements, though, raise concerns: the data shows a higher risk of bleeding, and some studies hint at a possible increased risk of hemorrhagic stroke in male smokers taking synthetic vitamin E over several years.
At high doses, vitamin E can interfere with vitamin K-dependent clotting, putting you at greater bleeding risk — especially if you already have a vitamin K deficiency or take blood thinners. There isn't enough data on file about safety in pregnancy or while breastfeeding — the facts note that food amounts and prenatal vitamins are fine, and to check with your doctor before taking high-dose supplements in either situation.
Vitamin E is generally well tolerated when taken by mouth, but serious adverse effects like bleeding and hemorrhagic stroke are rare.
Meds to double-check
Moderate interaction found
Before you take Natural E 400, double-check if you're on any blood thinners or antiplatelet drugs (warfarin, aspirin, clopidogrel, and others) — the moderate bleeding risk is the most serious concern. Also flag any cancer drugs you take, especially selumetinib, alkylating agents, or antitumor antibiotics.
Let your pharmacist know if you take niacin for cholesterol or any drug that your liver processes through the CYP3A4 pathway (a large group that includes many statins, some blood pressure medications, and immunosuppressants like cyclosporine).
The bottom line
Scorecard at a glanceFully disclosed formula with strong clinical evidence behind its ingredients' uses. Moderate medication interactions have been identified, and safety information is well characterized.
Natural E 400 works for vitamin E deficiency and may help a few other rare conditions. If you take any blood thinner, any cancer medication, or heart or cholesterol drugs, talk to your pharmacist before starting this — the interaction risk is real.
High-dose vitamin E supplements carry a small but documented bleeding risk, especially over time.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 1 of 1 active ingredient 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 Natural E 400, straight from the product label.
| Brand | SuperSmart |
|---|---|
| Barcode (UPC) | 5453003820628 |
| Net contents | 100 Softgel(s) |
| Market status | On market |
| Date entered into DSLD | Jul 24, 2025 |
| DSLD ID | 332712 |
| Product type | Vitamin |
| Supplement form | Softgel Capsule |
| Dietary claims / uses | Nutrient, All Other |
| Intended target group(s) | Adult (18 - 50 Years) |
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 Natural E 400 by SuperSmart, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Vitamin E, Natural | 1200 IU | 6700% |
Other ingredients: Wheat Germ Oil
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.
FDA Statement of Identity
Dietary Supplement
Suggested/Recommended/Usage/Directions
Directions: Adults. Take one to three softgels a day at mealtimes.
Formula
Each softgel provides 400 IU of natural vitamin E (d-alpha tocopherol).
Precautions
Precautions: Contains soy and wheat derivatives.
Do not exceed the recommended daily dose. This product is a nutritional supplement and should not replace a varied, balanced diet.
Keep out of childrens' reach.
As with any nutritional supplement, you should consult a health professional before taking this product if you are pregnant, breastfeeding or have a health problem.
Storage
Store away from direct light, heat and humidity.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Natural E 400 by SuperSmart 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 Natural E 400 by SuperSmart
This is the 1 active ingredient this product is made of. Select it to open its full monograph.
Serving size1 Softgel(s) Dosage formSoftgel Capsule Servings per container33 Amounts shown are per serving.
Vitamin E, Natural
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, Natural monograph & interactionsOther (inactive) ingredients: Wheat Germ Oil. These complete the product’s ingredient list but are not active constituents.
Natural E 400 by SuperSmart Drug Interactions
HelloPharmacist Interaction Report
Natural E 400 by SuperSmart contains vitamin E, which does interact with a number of medications.
The most serious concern is with blood thinners (anticoagulants and antiplatelet drugs) — vitamin E can increase bleeding risk by interfering with clotting factors and platelet function. This effect is dose-dependent, so it matters how much vitamin E you're taking overall.
Read the full breakdown — every affected drug type, severity by severity
Vitamin E also interacts with warfarin specifically at doses above 400 IU daily, raising your INR and bleeding risk. It may slow the metabolism of certain drugs processed by your liver (CYP3A4 substrates), potentially changing their levels in your blood.
There's concern it could reduce the effectiveness of some chemotherapy drugs, including alkylating agents and antitumor antibiotics, by interfering with how they generate free radicals. Additionally, if you take selumetinib (a cancer drug that already contains vitamin E), combining it with this supplement might push your total vitamin E dose into the range where bleeding risk climbs.
Niacin's beneficial effects on HDL cholesterol may also be blunted by vitamin E.
Altogether, these interactions span 754 individual medications. If you take any prescription medication — especially blood thinners, cancer drugs, or heart and cholesterol medications — run it through the checker below before adding this supplement.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Natural E 400?
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 Natural E 400 interact with 764 drugs. Click any drug to see the details.
1 of the 1 ingredient in Natural E 400 interact with drugs. Each result below shows which ingredient is responsible. Vitamin E, Natural
BromocriptineParlodel
How Bromocriptine interacts with Natural E 400 — through 1 ingredient. Tap an ingredient for the detail:
Vitamin E, NaturalCytochrome 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, Natural + Bromocriptine interactionBudenosidePulmicort Flexhaler, Pulmicort Turbuhaler
How Budenoside interacts with Natural E 400 — through 1 ingredient. Tap an ingredient for the detail:
Vitamin E, NaturalCytochrome 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, Natural + Budenoside interactionBudesonideEntocort EC, Eohilia, Pulmicort, Tarpeyo, Uceris
How Budesonide interacts with Natural E 400 — through 1 ingredient. Tap an ingredient for the detail:
Vitamin E, NaturalCytochrome 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, Natural + Budesonide interactionBuprenorphineBrixadi, Butrans, Sublocade, Subutex
How Buprenorphine interacts with Natural E 400 — through 1 ingredient. Tap an ingredient for the detail:
Vitamin E, NaturalCytochrome 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, Natural + Buprenorphine interactionBuprenorphine HydrochlorideBelbuca, Probuphine
How Buprenorphine Hydrochloride interacts with Natural E 400 — through 1 ingredient. Tap an ingredient for the detail:
Vitamin E, NaturalCytochrome 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, Natural + Buprenorphine Hydrochloride interactionBuprenorphine Hydrochloride, Naloxone HydrochlorideBunavail
How Buprenorphine Hydrochloride, Naloxone Hydrochloride interacts with Natural E 400 — through 1 ingredient. Tap an ingredient for the detail:
Vitamin E, NaturalCytochrome 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, Natural + Buprenorphine Hydrochloride, Naloxone Hydrochloride interactionBuprenorphine, NaloxoneCassipa, Zubsolv
How Buprenorphine, Naloxone interacts with Natural E 400 — through 1 ingredient. Tap an ingredient for the detail:
Vitamin E, NaturalCytochrome 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, Natural + Buprenorphine, Naloxone interactionBuprenorphine/naloxoneSuboxone
How Buprenorphine/naloxone interacts with Natural E 400 — through 1 ingredient. Tap an ingredient for the detail:
Vitamin E, NaturalCytochrome 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, Natural + Buprenorphine/naloxone interactionBuproprion, DextromethorphanAuvelity
How Buproprion, Dextromethorphan interacts with Natural E 400 — through 1 ingredient. Tap an ingredient for the detail:
Vitamin E, NaturalCytochrome 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, Natural + Buproprion, Dextromethorphan interactionBuspironeBuSpar
How Buspirone interacts with Natural E 400 — through 1 ingredient. Tap an ingredient for the detail:
Vitamin E, NaturalCytochrome 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, Natural + Buspirone interactionBusulfanBusulfex, Myleran
How Busulfan interacts with Natural E 400 — through 1 ingredient. Tap an ingredient for the detail:
Vitamin E, NaturalCytochrome P450 3a4 (cyp3a4) Substrates, Alkylating Agents Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E, Natural + Busulfan interactionCabazitaxelCabazitaxel, Jetvana
How Cabazitaxel interacts with Natural E 400 — through 1 ingredient. Tap an ingredient for the detail:
Vitamin E, NaturalCytochrome 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, Natural + Cabazitaxel interactionCabliviCablivi
How Cablivi interacts with Natural E 400 — through 1 ingredient. Tap an ingredient for the detail:
Vitamin E, NaturalAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Vitamin E, Natural + Cablivi interactionCabotegravir, RilpivirineCabenuva
How Cabotegravir, Rilpivirine interacts with Natural E 400 — through 1 ingredient. Tap an ingredient for the detail:
Vitamin E, NaturalCytochrome 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, Natural + Cabotegravir, Rilpivirine interactionCabozantinibCometriq
How Cabozantinib interacts with Natural E 400 — through 1 ingredient. Tap an ingredient for the detail:
Vitamin E, NaturalCytochrome 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, Natural + Cabozantinib interactionCabozantinib S-malateCabometyx
How Cabozantinib S-malate interacts with Natural E 400 — through 1 ingredient. Tap an ingredient for the detail:
Vitamin E, NaturalCytochrome 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, Natural + Cabozantinib S-malate interactionCaffeine (otc Drug)Molie, Overtime, Vivarin
How Caffeine (otc Drug) interacts with Natural E 400 — through 1 ingredient. Tap an ingredient for the detail:
Vitamin E, NaturalCytochrome 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, Natural + Caffeine (otc Drug) interactionCaffeine (prescription Drug)Caffeine, Dextrophin
How Caffeine (prescription Drug) interacts with Natural E 400 — through 1 ingredient. Tap an ingredient for the detail:
Vitamin E, NaturalCytochrome 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, Natural + Caffeine (prescription Drug) interactionCaffeine , Sodium BenzoateCaffeine and Sodium Benzoate
How Caffeine , Sodium Benzoate interacts with Natural E 400 — through 1 ingredient. Tap an ingredient for the detail:
Vitamin E, NaturalCytochrome 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, Natural + Caffeine , Sodium Benzoate interactionCaffeine, Diphenhydramine, Ergotamine (prescription Drug)Ergodryl
How Caffeine, Diphenhydramine, Ergotamine (prescription Drug) interacts with Natural E 400 — through 1 ingredient. Tap an ingredient for the detail:
Vitamin E, NaturalCytochrome 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, Natural + Caffeine, Diphenhydramine, Ergotamine (prescription Drug) interactionCaffeine, Ergotamine (prescription Drug)Migergot
How Caffeine, Ergotamine (prescription Drug) interacts with Natural E 400 — through 1 ingredient. Tap an ingredient for the detail:
Vitamin E, NaturalCytochrome 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, Natural + Caffeine, Ergotamine (prescription Drug) interactionCaffeine, Ergotamine Tartrate (prescription Drug)Cafergot, Wigraine
How Caffeine, Ergotamine Tartrate (prescription Drug) interacts with Natural E 400 — through 1 ingredient. Tap an ingredient for the detail:
Vitamin E, NaturalCytochrome 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, Natural + Caffeine, Ergotamine Tartrate (prescription Drug) interactionCaffeine, Potassium Salicylate, SalicylamideTrim-Elim
How Caffeine, Potassium Salicylate, Salicylamide interacts with Natural E 400 — through 1 ingredient. Tap an ingredient for the detail:
Vitamin E, NaturalCytochrome 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, Natural + Caffeine, Potassium Salicylate, Salicylamide interactionCalcifediolRayaldee
How Calcifediol interacts with Natural E 400 — through 1 ingredient. Tap an ingredient for the detail:
Vitamin E, NaturalCytochrome 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, Natural + Calcifediol interactionCangrelorKengreal
How Cangrelor interacts with Natural E 400 — through 1 ingredient. Tap an ingredient for the detail:
Vitamin E, NaturalAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Vitamin E, Natural + Cangrelor interactionCannabidiol (prescription Drug)Epidiolex
How Cannabidiol (prescription Drug) interacts with Natural E 400 — through 1 ingredient. Tap an ingredient for the detail:
Vitamin E, NaturalCytochrome 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, Natural + Cannabidiol (prescription Drug) interactionCapivasertibTruqap
How Capivasertib interacts with Natural E 400 — through 1 ingredient. Tap an ingredient for the detail:
Vitamin E, NaturalCytochrome 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, Natural + Capivasertib interactionCapmatinib HydrochlorideTabrecta
How Capmatinib Hydrochloride interacts with Natural E 400 — through 1 ingredient. Tap an ingredient for the detail:
Vitamin E, NaturalCytochrome 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, Natural + Capmatinib Hydrochloride interactionCarbamazepineCarbatrol, Carnexiv, Equetro, Tegretol, Tegretol XR
How Carbamazepine interacts with Natural E 400 — through 1 ingredient. Tap an ingredient for the detail:
Vitamin E, NaturalCytochrome 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, Natural + Carbamazepine interactionCarbetapentane Tannate, Chlorpheniramine TannateTussi-12
How Carbetapentane Tannate, Chlorpheniramine Tannate interacts with Natural E 400 — through 1 ingredient. Tap an ingredient for the detail:
Vitamin E, NaturalCytochrome 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, Natural + Carbetapentane Tannate, Chlorpheniramine Tannate interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Natural E 400 with known interactions, here are the types of medications it can affect. Open any type for the detail — or search your exact drug in the checker above.
Vitamin E, Natural
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.
Brand information
Manufacturer and brand details for Natural E 400, from the product label.
SuperSmart
See all SuperSmart products- Name
- SN Worldwide Unipessoal, LDA
- Street Address
- Avenida Do Infante 66 Edificio Quinta Avenida 1 C
- City
- Funchal
- ZipCode
- 9000-015
Natural E 400 by SuperSmart: Common Questions
Does Natural E 400 by SuperSmart interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
Is this natural vitamin E different from synthetic?
Will vitamin E help my heart or prevent cancer?
What are the side effects?
Can I take this while pregnant or breastfeeding?
How much vitamin E is too much?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Not sure if Natural E 400 is safe with your meds?
Our pharmacists answer your medication & supplement questions — free.
Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind Natural E 400’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Sources & How We Checked
Natural E 400'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 64 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
- Kim JM, White RH. Effect of vitamin E on the anticoagulant response to warfarin. Am J Cardiol 1996;77:545-6. PubMed
- Corrigan JJ Jr. The effect of vitamin E on warfarin-induced vitamin K deficiency. Ann N Y Acad Sci 1982;393:361-8. PubMed
- Corrigan JJ Jr. Coagulation problems relating to vitamin E. Am J Pediatr Hematol Oncol 1979;1:169-73.
- Corrigan JJ Jr, Marcus FI. Coagulopathy associated with vitamin E ingestion. JAMA 1974;230:1300-1. DOI
- Labriola D, Livingston R. Possible interactions between dietary antioxidants and chemotherapy. Oncology 1999;13:1003-8.
- Chang T, Benet LZ, Hebert MF. The effect of water-soluble vitamin E on cyclosporine pharmacokinetics in healthy volunteers. Clin Pharmacol Ther 1996;59:297-303. PubMed
- Pan SH, Lopez RR Jr, Sher LS, et al. Enhanced oral cyclosporine absorption with water-soluble vitamin E early after liver transplantation. Pharmacother 1996;16:59-65. DOI
- 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
- Chappell LC, Seed PT, Briley AL, et al. Effect of antioxidants on the occurrence of pre-eclampsia in women at increased risk: a randomised trial. Lancet 1999;354:810-6. DOI
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