Natural Mixed Tocopherol E-400 Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Natural Mixed Tocopherol 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 Mixed Tocopherol E-400 is a dietary supplement by DaVinci Laboratories with 2 active ingredients. 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. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Natural Mixed Tocopherol E-400 by DaVinci Laboratories
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HelloPharmacist Scorecard of Natural Mixed Tocopherol E-400 by DaVinci Laboratories
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
Partial disclosure
Natural Mixed Tocopherol E-400 contains 4 active ingredients, all forms of vitamin E: Vitamin E itself, D-Beta Tocopherol, D-Gamma Tocopherol, and D-Delta Tocopherol. Together they deliver 400 IU of mixed tocopherols per softgel capsule.
The inactive ingredients are microcrystalline cellulose, glycerin, purified water, and soybean oil — standard softgel components.
Does it work?
Couldn't assess
Vitamin E is effective for treating vitamin E deficiency and ataxia with vitamin E deficiency (AVED), a rare genetic disorder. The evidence is possibly effective for Alzheimer disease, beta-thalassemia, glucose-6-phosphate dehydrogenase (G6PD) deficiency, and intracranial hemorrhage — meaning there's some promise, but the data aren't conclusive yet.
How safe is it?
Well-documented data
Vitamin E from food and normal doses is generally well tolerated. High-dose long-term supplements, though, may raise your risk of bleeding and other harms — especially at doses above 400 IU daily.
Serious adverse effects are rare but can include bleeding, hemorrhagic stroke, and cardiovascular complications. There's particular concern about hemorrhagic stroke in male smokers taking synthetic vitamin E for several years, though other studies haven't consistently shown increased stroke risk.
Patients with vitamin K deficiency or those taking blood thinners are at higher bleeding risk.
Meds to double-check
Moderate interaction found
Check with your doctor or pharmacist before taking this if you're on blood thinners (anticoagulants) or antiplatelet drugs like warfarin — vitamin E increases bleeding risk. Also confirm use if you take chemotherapy drugs, CYP3A4 substrates (medications your liver metabolizes through that pathway), cyclosporine, niacin, or selumetinib.
The dose and your specific medications matter.
The bottom line
Scorecard at a glancePartially disclosed formula with no assessable stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
This product is for people who need vitamin E supplementation — those with confirmed deficiency or certain conditions like AVED. If you take blood thinners, blood clotting medications, or chemotherapy, talk with your own doctor or pharmacist before starting it.
High-dose long-term use carries real risks, so confirm the right dose for your situation with your healthcare provider.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 4 of 4 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jun 22, 2023.
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 Mixed Tocopherol E-400, straight from the product label.
| Brand | DaVinci Laboratories |
|---|---|
| Barcode (UPC) | 026664216168 |
| Net contents | 60 Softgel(s) |
| Market status | On market |
| Date entered into DSLD | Jun 22, 2023 |
| DSLD ID | 288324 |
| Product type | Vitamin |
| Supplement form | Softgel Capsule |
| Dietary claims / uses | Nutrient, All Other |
| Intended target group(s) | Adult (18 - 50 Years), Gluten 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 Natural Mixed Tocopherol E-400 by DaVinci Laboratories, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Vitamin E | 268 mg | 1787% |
| Mixed Tocopherols | 67 mg | -- |
| D-Beta Tocopherol | 0 NP | -- |
| D-Delta-Tocopherol + D-Beta-Tocopherol | 11.9 mg | -- |
| D-Gamma Tocopherol | 55 mg | -- |
| D-Delta Tocopherol | 0 NP | -- |
Other ingredients: Microcrystalline Cellulose, Glycerin, Water, Purified, Soybean 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.
General Statements
Truth We pledge total truth in labeling. Our family of products contains only the purest and most potent ingredients. Guaranteed.
Formulation
Color of this product may vary due to color variations of the natural ingredients.
Gluten free
Precautions
Warning: If pregnant or nursing, consult your healthcare practitioner before taking this product.
Keep out of reach of children.
Contains: Soy.
To obtain product information or report a serious adverse event, call 1-800-325-1776.
Storage
Store in a cool, dry place.
Formula
100% natural-source Vitamin E
A Vitamin E Supplement with Mixed Tocopherols
FDA Statement of Identity
A Vitamin E Supplement with Mixed Tocopherols
Suggested/Recommended/Usage/Directions
Suggested Use: As a dietary supplement, take 1 softgel daily with a meal or as directed by your healthcare practitioner.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Natural Mixed Tocopherol E-400 by DaVinci Laboratories 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 Mixed Tocopherol E-400 by DaVinci Laboratories
These are the 2 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Softgel(s) Dosage formSoftgel Capsule 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.
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 & interactionsMixed Tocopherols
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...
Mixed Tocopherols monograph & interactionsOther (inactive) ingredients: Microcrystalline Cellulose, Glycerin, Water, Purified, Soybean Oil. These complete the product’s ingredient list but are not active constituents.
Natural Mixed Tocopherol E-400 by DaVinci Laboratories Drug Interactions
HelloPharmacist Interaction Report
Natural Mixed Tocopherol E-400 by DaVinci Laboratories does interact with medications, through its vitamin E components.
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. This effect is dose-dependent, meaning higher doses carry greater risk.
Read the full breakdown — every affected drug type, severity by severity
Vitamin E may also slow how your body metabolizes certain medications processed by CYP3A4 enzymes, potentially changing their levels in your bloodstream. Additionally, if you're on chemotherapy — whether alkylating agents like cyclophosphamide or antitumor antibiotics like doxorubicin — vitamin E's antioxidant properties might theoretically reduce how well those drugs work, though the clinical significance isn't fully established.
The immunosuppressant cyclosporine (Neoral, Sandimmune) is another consideration: one specific vitamin E formulation can increase cyclosporine absorption, though this product's mixed tocopherol blend may not carry that risk to the same degree.
There's also a minor interaction with niacin — vitamin E might decrease niacin's beneficial effects on HDL (good) cholesterol. If you take selumetinib (Koselugo) for cancer, combining it with this supplement could push your total daily vitamin E dose above safe limits and raise bleeding risk.
Altogether, these interactions span 765 individual medications. Before starting this product, run your exact medications through the interaction checker on this page, and discuss any concerns with your own doctor or pharmacist.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Natural Mixed Tocopherol 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 Mixed Tocopherol E-400 interact with 764 drugs. Click any drug to see the details.
1 of the 2 ingredients in Natural Mixed Tocopherol E-400 interact with drugs. Each result below shows which ingredient is responsible. Vitamin E
AxitinibInlyta
How Axitinib interacts with Natural Mixed Tocopherol E-400 — through 1 ingredient. Tap an ingredient for the detail:
D-delta TocopherolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full D-delta Tocopherol + Axitinib interactionAzelastine Hydrochloride, Fluticasone PropionateDymista
How Azelastine Hydrochloride, Fluticasone Propionate interacts with Natural Mixed Tocopherol E-400 — through 1 ingredient. Tap an ingredient for the detail:
D-delta TocopherolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full D-delta Tocopherol + Azelastine Hydrochloride, Fluticasone Propionate interactionBazedoxifene Acetate, Conjugated EstrogensDuavee
How Bazedoxifene Acetate, Conjugated Estrogens interacts with Natural Mixed Tocopherol E-400 — through 1 ingredient. Tap an ingredient for the detail:
D-delta TocopherolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full D-delta Tocopherol + Bazedoxifene Acetate, Conjugated Estrogens interactionBeclometasone DipropionateBecotide
How Beclometasone Dipropionate interacts with Natural Mixed Tocopherol E-400 — through 1 ingredient. Tap an ingredient for the detail:
D-delta TocopherolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full D-delta Tocopherol + Beclometasone Dipropionate interactionBeclomethasoneBeclovent, Vanceril
How Beclomethasone interacts with Natural Mixed Tocopherol E-400 — through 1 ingredient. Tap an ingredient for the detail:
D-delta TocopherolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full D-delta Tocopherol + Beclomethasone interactionBeclomethasone DipropionateQNASL, Qvar
How Beclomethasone Dipropionate interacts with Natural Mixed Tocopherol E-400 — through 1 ingredient. Tap an ingredient for the detail:
D-delta TocopherolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full D-delta Tocopherol + Beclomethasone Dipropionate interactionBedaquilineSirturo
How Bedaquiline interacts with Natural Mixed Tocopherol E-400 — through 1 ingredient. Tap an ingredient for the detail:
D-delta TocopherolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full D-delta Tocopherol + Bedaquiline interactionBelladonna Alkaloids, Chlorpheniramine, Phenylephrine, PhenylpropanolamineRespa ARM
How Belladonna Alkaloids, Chlorpheniramine, Phenylephrine, Phenylpropanolamine interacts with Natural Mixed Tocopherol E-400 — through 1 ingredient. Tap an ingredient for the detail:
D-delta TocopherolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full D-delta Tocopherol + Belladonna Alkaloids, Chlorpheniramine, Phenylephrine, Phenylpropanolamine interactionBelladonna Alkaloids, Ergotamine Tartrate, PhenobarbitalBel Tabs, Bellamine-S, Bellaphen-S, Duragal S, Phenarbal S, Spastrin
How Belladonna Alkaloids, Ergotamine Tartrate, Phenobarbital interacts with Natural Mixed Tocopherol E-400 — through 1 ingredient. Tap an ingredient for the detail:
D-delta TocopherolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full D-delta Tocopherol + Belladonna Alkaloids, Ergotamine Tartrate, Phenobarbital interactionBelladonna, Caffeine, Ergotamine, PentobarbitalMicomp PB
How Belladonna, Caffeine, Ergotamine, Pentobarbital interacts with Natural Mixed Tocopherol E-400 — through 1 ingredient. Tap an ingredient for the detail:
D-delta TocopherolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full D-delta Tocopherol + Belladonna, Caffeine, Ergotamine, Pentobarbital interactionBelladonna, Ergotamine Tartrate, Phenobarbital
How Belladonna, Ergotamine Tartrate, Phenobarbital interacts with Natural Mixed Tocopherol E-400 — through 1 ingredient. Tap an ingredient for the detail:
D-delta TocopherolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full D-delta Tocopherol + Belladonna, Ergotamine Tartrate, Phenobarbital interactionBelladonna, Ergotamine, PhenobarbitalBellergal-S
How Belladonna, Ergotamine, Phenobarbital interacts with Natural Mixed Tocopherol E-400 — through 1 ingredient. Tap an ingredient for the detail:
D-delta TocopherolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full D-delta Tocopherol + Belladonna, Ergotamine, Phenobarbital interactionBellafoline, Caffeine, Ergotamine Tartrate, PentobarbitalCafergot PB
How Bellafoline, Caffeine, Ergotamine Tartrate, Pentobarbital interacts with Natural Mixed Tocopherol E-400 — through 1 ingredient. Tap an ingredient for the detail:
D-delta TocopherolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full D-delta Tocopherol + Bellafoline, Caffeine, Ergotamine Tartrate, Pentobarbital interactionBelumosudil MesylateRezurock
How Belumosudil Mesylate interacts with Natural Mixed Tocopherol E-400 — through 1 ingredient. Tap an ingredient for the detail:
D-delta TocopherolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full D-delta Tocopherol + Belumosudil Mesylate interactionBendamustineBelrapzo, Treanda, Vivimusta
How Bendamustine interacts with Natural Mixed Tocopherol E-400 — through 1 ingredient. Tap an ingredient for the detail:
D-delta TocopherolAlkylating Agents Moderate
Interaction Summary
Theoretically, antioxidant effects of vitamin E might reduce the effectiveness of alkylating agents.
Read the full D-delta Tocopherol + Bendamustine interactionBendamustine HydrochlorideBendeka
How Bendamustine Hydrochloride interacts with Natural Mixed Tocopherol E-400 — through 1 ingredient. Tap an ingredient for the detail:
D-delta TocopherolAlkylating Agents Moderate
Interaction Summary
Theoretically, antioxidant effects of vitamin E might reduce the effectiveness of alkylating agents.
Read the full D-delta Tocopherol + Bendamustine Hydrochloride interactionBenzhydrocodone, AcetaminophenApadaz
How Benzhydrocodone, Acetaminophen interacts with Natural Mixed Tocopherol E-400 — through 1 ingredient. Tap an ingredient for the detail:
D-delta TocopherolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full D-delta Tocopherol + Benzhydrocodone, Acetaminophen interactionBepridilVascor
How Bepridil interacts with Natural Mixed Tocopherol E-400 — through 1 ingredient. Tap an ingredient for the detail:
D-delta TocopherolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full D-delta Tocopherol + Bepridil interactionBetrixabanBevyxxa
How Betrixaban interacts with Natural Mixed Tocopherol E-400 — through 1 ingredient. Tap an ingredient for the detail:
D-delta TocopherolAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full D-delta Tocopherol + Betrixaban interactionBexaroteneTargretin
How Bexarotene interacts with Natural Mixed Tocopherol E-400 — through 1 ingredient. Tap an ingredient for the detail:
D-delta TocopherolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full D-delta Tocopherol + Bexarotene interactionBictegravir, Emtricitabine, Tenofovir AlafenamideBiktarvy
How Bictegravir, Emtricitabine, Tenofovir Alafenamide interacts with Natural Mixed Tocopherol E-400 — through 1 ingredient. Tap an ingredient for the detail:
D-delta TocopherolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full D-delta Tocopherol + Bictegravir, Emtricitabine, Tenofovir Alafenamide interactionBivalirudinAngiomax, Angiomax Rtu, Angiox
How Bivalirudin interacts with Natural Mixed Tocopherol E-400 — through 1 ingredient. Tap an ingredient for the detail:
D-delta TocopherolAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full D-delta Tocopherol + Bivalirudin interactionBleomycinBlenoxane
How Bleomycin interacts with Natural Mixed Tocopherol E-400 — through 1 ingredient. Tap an ingredient for the detail:
D-delta TocopherolAntitumor Antibiotics Moderate
Interaction Summary
Theoretically, antioxidant effects of vitamin E might reduce the effectiveness of antitumor antibiotics.
Read the full D-delta Tocopherol + Bleomycin interactionBoceprevirVictrelis
How Boceprevir interacts with Natural Mixed Tocopherol E-400 — through 1 ingredient. Tap an ingredient for the detail:
D-delta TocopherolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full D-delta Tocopherol + Boceprevir interactionBosentanTracleer
How Bosentan interacts with Natural Mixed Tocopherol E-400 — through 1 ingredient. Tap an ingredient for the detail:
D-delta TocopherolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full D-delta Tocopherol + Bosentan interactionBosutinibBosulif
How Bosutinib interacts with Natural Mixed Tocopherol E-400 — through 1 ingredient. Tap an ingredient for the detail:
D-delta TocopherolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full D-delta Tocopherol + Bosutinib interactionBrentuximab VedotinAdcetris
How Brentuximab Vedotin interacts with Natural Mixed Tocopherol E-400 — through 1 ingredient. Tap an ingredient for the detail:
D-delta TocopherolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full D-delta Tocopherol + Brentuximab Vedotin interactionBrexpiprazoleRexulti
How Brexpiprazole interacts with Natural Mixed Tocopherol E-400 — through 1 ingredient. Tap an ingredient for the detail:
D-delta TocopherolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full D-delta Tocopherol + Brexpiprazole interactionBrigatinibAlunbrig
How Brigatinib interacts with Natural Mixed Tocopherol E-400 — through 1 ingredient. Tap an ingredient for the detail:
D-delta TocopherolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full D-delta Tocopherol + Brigatinib interactionBromfenac SodiumBromsite, Prolensa
How Bromfenac Sodium interacts with Natural Mixed Tocopherol E-400 — through 1 ingredient. Tap an ingredient for the detail:
D-delta TocopherolAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full D-delta Tocopherol + Bromfenac Sodium interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Natural Mixed Tocopherol 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
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 Mixed Tocopherol E-400, from the product label.
DaVinci Laboratories
See all DaVinci Laboratories products- Name
- DaVinci Laboratories a division of FoodScience LLC
- Street Address
- 929 Harvest Lane
- City
- Williston
- State
- VT
- ZipCode
- 05495
- Phone Number
- 1-800-325-1776
- Web Address
- www.davincilabs.com
Natural Mixed Tocopherol E-400 by DaVinci Laboratories: Common Questions
Does Natural Mixed Tocopherol E-400 by DaVinci Laboratories interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
Is this safe to take if I'm pregnant?
Can I take this while breastfeeding?
What exactly is 'mixed tocopherol' vitamin E?
Will this help with Alzheimer disease?
What's the difference between this 'natural mixed tocopherol' and synthetic vitamin E?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Not sure if Natural Mixed Tocopherol E-400 is safe with your meds?
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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 Mixed Tocopherol 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 Mixed Tocopherol 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
- Yusuf S, Dagenais G, Pogue J, et al. Vitamin E supplementation and cardiovascular events in high-risk patients. The heart outcomes prevention evaluation study investigators. N Engl J Med 2000;342:154-60. PubMed
- Stephens NG, Parsons A, Schofield PM, et al. Randomised controlled trial of vitamin E in patients with coronary disease: Cambridge Heart Antioxidant Study. Lancet 1996;347:781-6.
- 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
- Takahashi O. Haemorrhagic toxicity of a large dose of alpha-, beta-, gamma- and delta-tocopherols, ubiquinone, beta-carotene, retinol acetate and L-ascorbic acid in the rat. Food Chem Toxicol 1995;33:121-8.
- Briggs GB, Freeman RK, Yaffe SJ. Drugs in Pregnancy and Lactation. 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 1998.
- Sano M, Ernesto C, Thomas RG, et al. A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer's disease. The Alzheimer's Disease Cooperative Study. N Engl J Med 1997;336:1216-22. PubMed
- Liede KE, Haukka JK, Saxen LM, Heinonen OP. Increased tendency towards gingival bleeding caused by joint effect of alpha-tocopherol supplementation and acetylsalicylic acid. Ann Med 1998;30:542-6.
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, DC: National Academy Press, 2000. Available at: http://www.nap.edu/books/0309069351/html/.
- 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
- Liu M, Wallmon A, Olsson-Mortlock C, et al. Mixed tocopherols inhibit platelet aggregation in humans: potential mechanisms. Am J Clin Nutr 2003;77:700-6. PubMed
- 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
- Stein JH, Carlsson CM, Papcke-Benson K, et al. The effects of lipid-lowering and antioxidant vitamin therapies on flow-mediated vasodilation of the brachial artery in older adults with hypercholesterolemia. J Am Coll Cardiol 2001;38:1806-13.. PubMed
- Carlsson CM, Papcke-Benson K, Carnes M, et al. Health-related quality of life and long-term therapy with pravastatin and tocopherol (vitamin E) in older adults. Drugs Aging 2002;19:793-805. . PubMed
- Cheung MC, Zhao XQ, Chait A, et al. Antioxidant supplements block the response of HDL to simvastatin-niacin therapy in patients with coronary artery disease and low HDL. Arterioscler Thromb Vasc Biol 2001;21:1320-6. PubMed
- Schrogie JJ. Coagulopathy and fat-soluble vitamins (letter). JAMA 1975;232:19. DOI
- Celestini A, Pulcinelli FM, Pignatelli P, et al. Vitamin E potentiates the antiplatelet activity of aspirin in collagen-stimulated platelets. Haematologica 2002;87:420-6.
- Stampfer MJ, Jakubowski JA, Faigel D, et al. Vitamin E supplementation effect on human platelet function, arachidonic acid metabolism, and plasma prostacyclin levels. Am J Clin Nutr 1988;47:700-6. PubMed
- Jandak J, Steiner M, Richardson PD. Alpha-tocopherol, an effective inhibitor of platelet adhesion. Blood 1989;73:141-9. DOI
- Freedman JE, Farhat JH, Loscalzo J, Keaney JF. Alpha-tocopherol inhibits aggregation of human platelets by a protein kinase C-dependent mechanism. Circulation 1996;94:2434-40. PubMed
- Steiner M. Vitamin E, a modifier of platelet function: rationale and use in cardiovascular and cerebrovascular disease. Nutr Rev 1999;57:306-9. PubMed
- Brodkin RH, Bleiberg J. Sensitivity to topically applied vitamin E. Arch Dermatol 1965;92:76-7. DOI
- Booth SL, Golly I, Sacheck JM, et al. Effect of vitamin E supplementation on vitamin K status in adults with normal coagulation status. Am J Clin Nutr 2004;80:143-8. PubMed
- Miller ER 3rd, Pastor-Barriuso R, Dalal D, et al. Meta-analysis: High-dosage vitamin E supplementation may increase all-cause mortality. Ann Intern Med 2005;142:60520-53. PubMed
- Lonn E, Bosch J, Yusuf S, et al. HOPE and HOPE-TOO Trial Investigators. Effects of long-term vitamin E supplementation on cardiovascular events and cancer: a randomized controlled trial. JAMA 2005;293:1338-47. PubMed
- Landes N, Pfluger P, Kluth D, et al. Vitamin E activates gene expression via the pregnane X receptor. Biochem Pharmacol 2003;65:269-73. . PubMed
- Brigelius-Flohe R. Vitamin E and drug metabolism. Biochem Biophys Res Commun 2003;305:737-40. PubMed
- Prasad KN. Rationale for using high-dose multiple dietary antioxidants as an adjunct to radiation therapy and chemotherapy. J Nutr 2004;134:3182S-3S. PubMed
- Conklin KA. Cancer chemotherapy and antioxidants. J Nutr 2004;134:3201S-3204S. PubMed
- Schurks M, Glynn RJ, Rist PM, et al. Effects of vitamin E on stroke subtypes: meta-analysis of randomized controlled trials. BMJ 2010;341: c5702. doi: 10.1136/bmj.c5702.
- Lawson KA, Wright ME, Subar A, et al. Multivitamin use and risk of prostate cancer in the National Institutes of Health-AARP Diet and Health Study. J Natl Cancer Inst 2007;99:754-64. PubMed
- Gaziano JM, Glynn RJ, Christen WG, et al. Vitamins E and C in the prevention of prostate total cancer in men: the physicians' health study II randomised controlled trial. JAMA 2009;301:52-62.
- Hayden KM, Welsh-Bohmer KA, Wengreen HJ, et al; Cache County Investigators. Risk of mortality with vitamin E supplements: the Cache County study. Am L Med 2007;120:180-4. PubMed
- 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
- Sesso, H. D., Buring, J. E., Christen, W. G., Kurth, T., Belanger, C., MacFadyen, J., Bubes, V., Manson, J. E., Glynn, R. J., and Gaziano, J. M. Vitamins E and C in the prevention of cardiovascular disease in men: the Physicians' Health Study II randomiz
- Papaioannou, D., Cooper, K. L., Carroll, C., Hind, D., Squires, H., Tappenden, P., and Logan, R. F. Antioxidants in the chemoprevention of colorectal cancer and colorectal adenomas in the general population: a systematic review and meta-analysis. Colorec PubMed
- Cooper, K., Squires, H., Carroll, C., Papaioannou, D., Booth, A., Logan, R. F., Maguire, C., Hind, D., and Tappenden, P. Chemoprevention of colorectal cancer: systematic review and economic evaluation. Health Technol.Assess. 2010;14(32):1-206. PubMed
- 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
- Musso, G., Cassader, M., Rosina, F., and Gambino, R. Impact of current treatments on liver disease, glucose metabolism and cardiovascular risk in non-alcoholic fatty liver disease (NAFLD): a systematic review and meta-analysis of randomised trials. Diabe PubMed
- Bell, E. F. Upper limit of vitamin E in infant formulas. J.Nutr. 1989;119(12 Suppl):1829-1831. PubMed
- 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.
- Chae CU, Albert CM, Moorthy MV, et al. Vitamin E supplementation and the risk of heart failure in women. Circ Heart Fail. 2012;5(2):176-82. PubMed
- Rumbold A, Ota E, Hori H, Miyazaki C, Crowther CA. Vitamin E supplementation in pregnancy. Cochrane Database Syst Rev. 2015;(9):CD004069. PubMed
- Prescribing information: KOSELUGO (selumetinib) capsules. U.S. Food and Drug Administration. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/213756s000lbl.pdf.
- Warshaw EM, Ruggiero JL, DeKoven JG, et al. Patch testing with tocopherol and tocopherol acetate: the North American Contact Dermatitis Group experience, 2001 to 2016. Dermatitis. 2021;32(5):308-18. PubMed
- US Preventive Services Task Force, Mangione CM, Barry MJ, et al. Vitamin, Mineral, and Multivitamin Supplementation to Prevent Cardiovascular Disease and Cancer: US Preventive Services Task Force Recommendation Statement. JAMA 2022;327(23):2326-2333. PubMed
- Abrol R, Kaushik R, Goel D, Sama S, Kaushik RM, Kala M. Vitamin E-induced coagulopathy in a young patient: a case report. J Med Case Rep 2023;17(1):107. PubMed
- Abtahi-Naeini B, Rastegarnasab F, Saffaei A. Liquid vitamin E injection for cosmetic facial rejuvenation: A disaster report of lipogranuloma. J Cosmet Dermatol 2022;21(11):5549-5554. PubMed
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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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