Rice Tocotrienols Ingredients & Drug Interactions
by Bluebonnet
What is this page for?
First and foremost: checking Rice Tocotrienols 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
Rice Tocotrienols is a dietary supplement by Bluebonnet with 4 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 Rice Tocotrienols by Bluebonnet
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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 Rice Tocotrienols by Bluebonnet
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
Rice Tocotrienols by Bluebonnet contains 4 active ingredients: vitamin E along with three tocotrienol forms (alpha-tocotrienol, D-gamma-tocotrienol, and delta tocotrienol). Tocotrienols are a type of vitamin E found naturally in certain plant oils and grains; they work as antioxidants in your body.
The softgel capsule also contains gelatin, glycerin, and purified water as inactive ingredients to form and deliver the capsule.
Does it work?
Strong evidence
The data shows vitamin E is effective for treating vitamin E deficiency and ataxia with vitamin E deficiency (AVED). It's rated possibly effective for Alzheimer disease, beta-thalassemia, glucose-6-phosphate dehydrogenase (G6PD) deficiency, and intracranial hemorrhage.
Because tocotrienols are a form of vitamin E, they share this evidence, though the data doesn't distinguish their effectiveness separately from other vitamin E forms.
How safe is it?
Well-documented data
Vitamin E from food and normal dietary amounts is generally well tolerated. However, high-dose long-term supplements may raise your risk of bleeding and other harms.
Serious side effects are rare but include bleeding, hemorrhagic stroke, and cardiovascular problems. There's also concern that high-dose vitamin E might increase stroke risk, though study results have been mixed.
High doses are particularly risky if you have a vitamin K deficiency or take blood thinners.
Meds to double-check
Moderate interaction found
Check with your doctor or pharmacist before combining this product with blood thinners or antiplatelet drugs (Major risk of bleeding), certain chemotherapy drugs (alkylating agents and antitumor antibiotics), cyclosporine, or selumetinib. Also confirm it's safe with any medications your liver metabolizes via CYP3A4, and let them know if you're taking niacin for cholesterol.
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.
If you're deficient in vitamin E or have AVED, this product could help, and the evidence suggests it might support some other conditions. But if you're on blood thinners, antiplatelet drugs, certain cancer treatments, cyclosporine, niacin, or drugs your liver processes through CYP3A4, talk with your doctor or pharmacist before adding this—the dose and your specific medications matter.
Take time to check your prescriptions against the interaction tool on this page.
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 25, 2018.
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 Rice Tocotrienols, straight from the product label.
| Brand | Bluebonnet |
|---|---|
| Barcode (UPC) | 743715006409 |
| Net contents | 30 Softgel(s) |
| Market status | On market |
| Date entered into DSLD | Jun 25, 2018 |
| DSLD ID | 178226 |
| Product type | Vitamin |
| Supplement form | Softgel Capsule |
| Dietary claims / uses | Nutrient, All Other |
| Intended target group(s) | Adult (18 - 50 Years), Gluten Free, Dairy Free, Sugar 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 Rice Tocotrienols by Bluebonnet, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Vitamin E | 100 IU | 333% |
| Alpha-Tocotrienol | 18 mg | -- |
| D-Gamma-Tocotrienol | 24.2 mg | -- |
| Delta Tocotrienol | 0.3 mg | -- |
Other ingredients: Gelatin, Glycerin, purified Water
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.
Suggested/Recommended/Usage/Directions
Directions: As a dietary supplement, take one softgel daily, preferably with a meal or as directed by a healthcare practitioner.
Formula
Bluebonnet’s Rice Tocotrienols Softgels contain highly advanced lipid-soluble antioxidant nutrients. These naturally occuring vitamin E compounds are extracted from rice and provide alpha, delta and gamma tocotrienols.
100% Natural-Source Vitamin E
Contains: Soybeans
General Statements
Available in easy-to-swallow softgels for maximum assimilation and absorption.
General
0640B
FDA Statement of Identity
Dietary Supplement
Seals/Symbols
Gluten free
Precautions
Contains: Soybeans
Formulation
Free of milk, egg, fish, crustacean shellfish, tree nuts, peanuts and wheat. Also free of corn, yeast, gluten, barley, sodium and sugar.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Rice Tocotrienols by Bluebonnet 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 Rice Tocotrienols by Bluebonnet
These are the 4 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Softgel(s) Dosage formSoftgel Capsule 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 & interactionsAlpha-Tocotrienol
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...
Alpha-Tocotrienol monograph & interactionsD-Gamma-Tocotrienol
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...
D-Gamma-Tocotrienol monograph & interactionsDelta Tocotrienol
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...
Delta Tocotrienol monograph & interactionsOther (inactive) ingredients: Gelatin, Glycerin, Purified Water. These complete the product’s ingredient list but are not active constituents.
Rice Tocotrienols by Bluebonnet Drug Interactions
HelloPharmacist Interaction Report
Bluebonnet Rice Tocotrienols interacts with medications through its vitamin E content—all four tocotrienol forms (vitamin E, alpha-tocotrienol, D-gamma-tocotrienol, and delta tocotrienol) carry the same interaction profile.
The most serious concern is with blood thinners (anticoagulants) and antiplatelet drugs: vitamin E can increase bleeding risk by interfering with how your body forms clots and preventing platelets from clumping together. This effect is dose-dependent.
Read the full breakdown — every affected drug type, severity by severity
Vitamin E may also speed up how your liver breaks down certain medications (CYP3A4 substrates), potentially lowering their effectiveness, and could theoretically reduce how well some chemotherapy drugs (alkylating agents and antitumor antibiotics) work by interfering with their ability to generate free radicals. It may increase cyclosporine levels in your bloodstream, and taking it alongside the cancer drug selumetinib could push your total vitamin E intake into unsafe territory.
A minor concern: vitamin E might blunt niacin's beneficial effects on HDL cholesterol.
Altogether, these interactions span 765 individual medications. Use the search tool below to check your exact prescriptions before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Rice Tocotrienols?
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 Rice Tocotrienols interact with 764 drugs. Click any drug to see the details.
1 of the 4 ingredients in Rice Tocotrienols interact with drugs. Each result below shows which ingredient is responsible. Vitamin E
AxitinibInlyta
How Axitinib interacts with Rice Tocotrienols — through 1 ingredient. Tap an ingredient for the detail:
Delta TocotrienolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Delta Tocotrienol + Axitinib interactionAzelastine Hydrochloride, Fluticasone PropionateDymista
How Azelastine Hydrochloride, Fluticasone Propionate interacts with Rice Tocotrienols — through 1 ingredient. Tap an ingredient for the detail:
Delta TocotrienolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Delta Tocotrienol + Azelastine Hydrochloride, Fluticasone Propionate interactionBazedoxifene Acetate, Conjugated EstrogensDuavee
How Bazedoxifene Acetate, Conjugated Estrogens interacts with Rice Tocotrienols — through 1 ingredient. Tap an ingredient for the detail:
Delta TocotrienolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Delta Tocotrienol + Bazedoxifene Acetate, Conjugated Estrogens interactionBeclometasone DipropionateBecotide
How Beclometasone Dipropionate interacts with Rice Tocotrienols — through 1 ingredient. Tap an ingredient for the detail:
Delta TocotrienolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Delta Tocotrienol + Beclometasone Dipropionate interactionBeclomethasoneBeclovent, Vanceril
How Beclomethasone interacts with Rice Tocotrienols — through 1 ingredient. Tap an ingredient for the detail:
Delta TocotrienolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Delta Tocotrienol + Beclomethasone interactionBeclomethasone DipropionateQNASL, Qvar
How Beclomethasone Dipropionate interacts with Rice Tocotrienols — through 1 ingredient. Tap an ingredient for the detail:
Delta TocotrienolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Delta Tocotrienol + Beclomethasone Dipropionate interactionBedaquilineSirturo
How Bedaquiline interacts with Rice Tocotrienols — through 1 ingredient. Tap an ingredient for the detail:
Delta TocotrienolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Delta Tocotrienol + Bedaquiline interactionBelladonna Alkaloids, Chlorpheniramine, Phenylephrine, PhenylpropanolamineRespa ARM
How Belladonna Alkaloids, Chlorpheniramine, Phenylephrine, Phenylpropanolamine interacts with Rice Tocotrienols — through 1 ingredient. Tap an ingredient for the detail:
Delta TocotrienolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Delta Tocotrienol + 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 Rice Tocotrienols — through 1 ingredient. Tap an ingredient for the detail:
Delta TocotrienolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Delta Tocotrienol + Belladonna Alkaloids, Ergotamine Tartrate, Phenobarbital interactionBelladonna, Caffeine, Ergotamine, PentobarbitalMicomp PB
How Belladonna, Caffeine, Ergotamine, Pentobarbital interacts with Rice Tocotrienols — through 1 ingredient. Tap an ingredient for the detail:
Delta TocotrienolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Delta Tocotrienol + Belladonna, Caffeine, Ergotamine, Pentobarbital interactionBelladonna, Ergotamine Tartrate, Phenobarbital
How Belladonna, Ergotamine Tartrate, Phenobarbital interacts with Rice Tocotrienols — through 1 ingredient. Tap an ingredient for the detail:
Delta TocotrienolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Delta Tocotrienol + Belladonna, Ergotamine Tartrate, Phenobarbital interactionBelladonna, Ergotamine, PhenobarbitalBellergal-S
How Belladonna, Ergotamine, Phenobarbital interacts with Rice Tocotrienols — through 1 ingredient. Tap an ingredient for the detail:
Delta TocotrienolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Delta Tocotrienol + Belladonna, Ergotamine, Phenobarbital interactionBellafoline, Caffeine, Ergotamine Tartrate, PentobarbitalCafergot PB
How Bellafoline, Caffeine, Ergotamine Tartrate, Pentobarbital interacts with Rice Tocotrienols — through 1 ingredient. Tap an ingredient for the detail:
Delta TocotrienolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Delta Tocotrienol + Bellafoline, Caffeine, Ergotamine Tartrate, Pentobarbital interactionBelumosudil MesylateRezurock
How Belumosudil Mesylate interacts with Rice Tocotrienols — through 1 ingredient. Tap an ingredient for the detail:
Delta TocotrienolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Delta Tocotrienol + Belumosudil Mesylate interactionBendamustineBelrapzo, Treanda, Vivimusta
How Bendamustine interacts with Rice Tocotrienols — through 1 ingredient. Tap an ingredient for the detail:
Delta TocotrienolAlkylating Agents Moderate
Interaction Summary
Theoretically, antioxidant effects of vitamin E might reduce the effectiveness of alkylating agents.
Read the full Delta Tocotrienol + Bendamustine interactionBendamustine HydrochlorideBendeka
How Bendamustine Hydrochloride interacts with Rice Tocotrienols — through 1 ingredient. Tap an ingredient for the detail:
Delta TocotrienolAlkylating Agents Moderate
Interaction Summary
Theoretically, antioxidant effects of vitamin E might reduce the effectiveness of alkylating agents.
Read the full Delta Tocotrienol + Bendamustine Hydrochloride interactionBenzhydrocodone, AcetaminophenApadaz
How Benzhydrocodone, Acetaminophen interacts with Rice Tocotrienols — through 1 ingredient. Tap an ingredient for the detail:
Delta TocotrienolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Delta Tocotrienol + Benzhydrocodone, Acetaminophen interactionBepridilVascor
How Bepridil interacts with Rice Tocotrienols — through 1 ingredient. Tap an ingredient for the detail:
Delta TocotrienolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Delta Tocotrienol + Bepridil interactionBetrixabanBevyxxa
How Betrixaban interacts with Rice Tocotrienols — through 1 ingredient. Tap an ingredient for the detail:
Delta TocotrienolAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Delta Tocotrienol + Betrixaban interactionBexaroteneTargretin
How Bexarotene interacts with Rice Tocotrienols — through 1 ingredient. Tap an ingredient for the detail:
Delta TocotrienolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Delta Tocotrienol + Bexarotene interactionBictegravir, Emtricitabine, Tenofovir AlafenamideBiktarvy
How Bictegravir, Emtricitabine, Tenofovir Alafenamide interacts with Rice Tocotrienols — through 1 ingredient. Tap an ingredient for the detail:
Delta TocotrienolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Delta Tocotrienol + Bictegravir, Emtricitabine, Tenofovir Alafenamide interactionBivalirudinAngiomax, Angiomax Rtu, Angiox
How Bivalirudin interacts with Rice Tocotrienols — through 1 ingredient. Tap an ingredient for the detail:
Delta TocotrienolAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Delta Tocotrienol + Bivalirudin interactionBleomycinBlenoxane
How Bleomycin interacts with Rice Tocotrienols — through 1 ingredient. Tap an ingredient for the detail:
Delta TocotrienolAntitumor Antibiotics Moderate
Interaction Summary
Theoretically, antioxidant effects of vitamin E might reduce the effectiveness of antitumor antibiotics.
Read the full Delta Tocotrienol + Bleomycin interactionBoceprevirVictrelis
How Boceprevir interacts with Rice Tocotrienols — through 1 ingredient. Tap an ingredient for the detail:
Delta TocotrienolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Delta Tocotrienol + Boceprevir interactionBosentanTracleer
How Bosentan interacts with Rice Tocotrienols — through 1 ingredient. Tap an ingredient for the detail:
Delta TocotrienolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Delta Tocotrienol + Bosentan interactionBosutinibBosulif
How Bosutinib interacts with Rice Tocotrienols — through 1 ingredient. Tap an ingredient for the detail:
Delta TocotrienolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Delta Tocotrienol + Bosutinib interactionBrentuximab VedotinAdcetris
How Brentuximab Vedotin interacts with Rice Tocotrienols — through 1 ingredient. Tap an ingredient for the detail:
Delta TocotrienolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Delta Tocotrienol + Brentuximab Vedotin interactionBrexpiprazoleRexulti
How Brexpiprazole interacts with Rice Tocotrienols — through 1 ingredient. Tap an ingredient for the detail:
Delta TocotrienolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Delta Tocotrienol + Brexpiprazole interactionBrigatinibAlunbrig
How Brigatinib interacts with Rice Tocotrienols — through 1 ingredient. Tap an ingredient for the detail:
Delta TocotrienolCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Delta Tocotrienol + Brigatinib interactionBromfenac SodiumBromsite, Prolensa
How Bromfenac Sodium interacts with Rice Tocotrienols — through 1 ingredient. Tap an ingredient for the detail:
Delta TocotrienolAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Delta Tocotrienol + Bromfenac Sodium interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Rice Tocotrienols 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 Rice Tocotrienols, from the product label.
Bluebonnet
- Name
- Bluebonnet Nutrition Corporation
- Street Address
- 12915 Dairy Ashford
- City
- Sugar Land
- State
- TX
- ZipCode
- 77478
- Web Address
- www.bluebonnetnutrition.com
Rice Tocotrienols by Bluebonnet: Common Questions
Does Rice Tocotrienols by Bluebonnet interact with any medications?
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What are tocotrienols and why are they in this product?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Not sure if Rice Tocotrienols 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 Rice Tocotrienols’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Sources & How We Checked
Rice Tocotrienols'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
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