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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Brand Name
Multitol-m
Generic Name
Multivitamin, Folate
Active Ingredient
.alpha.-tocopherol Acetate, Dl-Category
Vitamin C [EPC]
Variants
1
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| 13.5 mg/1 | TABLET | ORAL | 59088-005 |
Detailed information about Multitol-m
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Multitol-m, you must consult a qualified healthcare professional.
.alpha.-tocopherol Acetate, Dl- is a synthetic form of Vitamin E, a fat-soluble antioxidant essential for protecting cell membranes from oxidative damage. It is used to treat deficiencies and support various physiological functions under medical supervision.
The dosage of .alpha.-tocopherol Acetate, Dl- varies significantly based on whether it is being used for general nutritional support or for the treatment of a specific medical condition.
Pediatric dosing is strictly based on age and the underlying cause of the deficiency. Parents must never give Vitamin E supplements to children without a direct recommendation from a pediatrician.
In cases of pediatric malabsorption, specialists may prescribe much higher doses (e.g., 15-25 IU/kg/day) to ensure adequate systemic levels.
For patients with mild to moderate kidney disease, standard doses of .alpha.-tocopherol Acetate, Dl- generally do not require adjustment. However, in end-stage renal disease (ESRD) or patients on dialysis, the risk-benefit ratio of high-dose antioxidant therapy is still being studied. Consult a nephrologist before starting supplementation.
Because the liver is the primary site for Vitamin E metabolism and the production of alpha-TTP, patients with liver cirrhosis or hepatic failure may have altered Vitamin E status. While adjustments are not standardized, healthcare providers will monitor liver function tests (LFTs) and serum tocopherol levels closely.
Older adults may be at a higher risk for adverse effects from high-dose Vitamin E, particularly regarding bleeding risks and interactions with heart medications. Most geriatricians recommend sticking to the RDA unless a deficiency is clinically proven.
To ensure maximum efficacy and safety, follow these administration guidelines:
If you miss a dose, take it as soon as you remember. If it is almost time for your next scheduled dose, skip the missed dose and resume your regular schedule. Do not double the dose to 'catch up,' as this increases the risk of GI side effects and potential bleeding issues.
Acute overdose of Vitamin E is rarely life-threatening, but chronic 'over-supplementation' can lead to hypervitaminosis E.
> Important: Follow your healthcare provider's dosing instructions exactly. Do not adjust your dose or start new supplements without medical guidance, as Vitamin E can accumulate in the body over time.
When taken at standard RDA levels, .alpha.-tocopherol Acetate, Dl- is generally well-tolerated. However, at higher supplemental doses (typically above 400 IU), patients may experience:
> Warning: Stop taking .alpha.-tocopherol Acetate, Dl- and call your doctor immediately if you experience any of these serious symptoms.
There are currently no FDA black box warnings for .alpha.-tocopherol Acetate, Dl-. However, the lack of a black box warning does not imply absolute safety. The risks of bleeding and the potential for increased mortality at high doses are considered significant clinical concerns that require professional oversight.
Report any unusual symptoms, especially those related to bleeding or vision changes, to your healthcare provider immediately. Regular blood tests may be necessary if you are on long-term, high-dose therapy.
.alpha.-tocopherol Acetate, Dl- is a biologically active compound that can significantly impact blood coagulation and cellular signaling. It is not a 'simple' vitamin when taken in supplemental forms. Patients with a history of heart disease, diabetes, or bleeding disorders must exercise extreme caution. It is vital to disclose all other supplements, including fish oil or garlic, as these can compound the effects of Vitamin E.
No FDA black box warnings for .alpha.-tocopherol Acetate, Dl-. This medication is generally recognized as safe (GRAS) when used within the established Upper Tolerable Intake Level (UL) of 1,000 mg (1,500 IU) per day for adults.
If you are prescribed high-dose .alpha.-tocopherol Acetate, Dl- (e.g., for NASH or malabsorption), your doctor may require the following monitoring:
.alpha.-tocopherol Acetate, Dl- generally does not cause sedation or cognitive impairment. However, if you experience rare side effects like blurred vision or dizziness, you should avoid driving or operating heavy machinery until these symptoms resolve and you have consulted your doctor.
There is no direct contraindication between moderate alcohol consumption and Vitamin E. However, chronic heavy alcohol use can damage the liver and interfere with the absorption of fat-soluble vitamins, potentially worsening a Vitamin E deficiency while also increasing the risk of GI bleeding.
For most patients, Vitamin E can be stopped without a tapering schedule. However, if you have been taking very high doses for a long period, your doctor may suggest a gradual reduction to prevent any rebound oxidative stress, although this is more theoretical than clinically documented.
> Important: Discuss all your medical conditions, especially any history of stroke or bleeding problems, with your healthcare provider before starting .alpha.-tocopherol Acetate, Dl-.
While there are few absolute contraindications, .alpha.-tocopherol Acetate, Dl- should generally not be used in high doses alongside:
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking. A complete medication review is the only way to prevent dangerous interactions.
.alpha.-tocopherol Acetate, Dl- must NEVER be used in the following circumstances:
Conditions requiring a careful risk-benefit analysis by a healthcare professional include:
Patients who are allergic to soybean products should be cautious, as many Vitamin E softgels use soybean oil as a carrier. While the tocopherol itself may be pure, the 'dl-alpha-tocopherol acetate' is often suspended in oils that could trigger a reaction in highly sensitive individuals. Always check the label for 'inactive ingredients' or 'contains' statements.
> Important: Your healthcare provider will evaluate your complete medical history, including any history of bleeding or upcoming surgeries, before prescribing .alpha.-tocopherol Acetate, Dl-.
> Important: Special populations require individualized medical assessment. Never start a supplement for a child, pregnant woman, or elderly person without professional consultation.
.alpha.-tocopherol Acetate, Dl- is a synthetic ester of alpha-tocopherol. Once the acetate group is cleaved by intestinal esterases, the free alpha-tocopherol acts as a primary antioxidant. It specifically targets the lipid peroxidation cycle. When a lipid radical (L•) or a lipid peroxyl radical (LOO•) is formed in the cell membrane, alpha-tocopherol (TOH) reacts with it faster than the radical can react with an adjacent fatty acid. This results in a stable lipid hydroperoxide and a tocopheroxyl radical (TO•). The tocopheroxyl radical is relatively unreactive and can be 'recycled' back into active tocopherol by other antioxidants like Vitamin C (ascorbic acid) or glutathione.
| Parameter | Value |
|---|---|
| Bioavailability | 20% to 50% (highly dependent on fat intake) |
| Protein Binding | 95% to 99% (bound to lipoproteins like LDL/VLDL) |
| Half-life | 48 to 72 hours (systemic circulation) |
| Tmax | 3 to 6 hours after oral ingestion |
| Metabolism | Hepatic; metabolized to alpha-CEHC |
| Excretion | Fecal (>70%), Renal (<30% as metabolites) |
.alpha.-tocopherol Acetate, Dl- is classified as a Fat-Soluble Vitamin. It is often grouped with other essential vitamins like A, D, and K. Related compounds include tocotrienols, though alpha-tocopherol is the form with the highest biological activity in humans.
Common questions about Multitol-m
.alpha.-tocopherol Acetate, Dl- is primarily used to treat or prevent Vitamin E deficiency, particularly in individuals with fat malabsorption disorders like cystic fibrosis or certain genetic conditions. It acts as a powerful antioxidant that protects cells from oxidative stress and damage caused by free radicals. Healthcare providers also use it as a supplement for patients receiving long-term intravenous nutrition. In some specialized cases, it is used off-label to support liver health in patients with non-alcoholic steatohepatitis (NASH). It is essential to use this medication only under medical supervision to ensure the correct dosage for your specific health needs.
At standard doses, .alpha.-tocopherol Acetate, Dl- is usually well-tolerated with few side effects. However, when taken in higher supplemental doses, the most common issues include gastrointestinal symptoms such as nausea, stomach cramps, and diarrhea. Some patients also report feeling unusually tired or experiencing mild headaches and blurred vision. These side effects often resolve if the dose is lowered or taken with a larger meal. If you experience persistent or severe digestive upset, you should contact your healthcare provider to discuss adjusting your intake.
While there is no direct chemical interaction that makes alcohol strictly prohibited, caution is advised. Chronic heavy alcohol consumption can damage the liver and interfere with the body's ability to absorb fat-soluble vitamins like Vitamin E, potentially making the supplement less effective. Furthermore, both high-dose Vitamin E and heavy alcohol use can increase the risk of internal bleeding and GI irritation. It is best to discuss your alcohol consumption habits with your doctor to ensure the supplement is safe and effective for you. Moderate drinking is generally not considered a major risk for those taking standard RDA doses.
.alpha.-tocopherol Acetate, Dl- is considered safe and is actually essential during pregnancy when taken at the Recommended Dietary Allowance (RDA) of 15 mg per day. It is a standard component of most prenatal vitamins and supports the development of the fetus. However, pregnant women should avoid taking high-dose Vitamin E supplements (above the RDA) unless specifically instructed by their obstetrician. Some research has suggested that excessive intake could potentially lead to complications, so it is vital to stick to the doses recommended by your healthcare professional. Always inform your doctor of all supplements you are taking during pregnancy.
The time it takes for .alpha.-tocopherol Acetate, Dl- to work depends on the condition being treated. As an antioxidant, it begins working at the molecular level within hours of being absorbed into the cell membranes. However, if you are taking it to correct a clinical deficiency that has caused neurological symptoms or muscle weakness, it may take several weeks or even months of consistent dosing to notice an improvement. Your doctor will likely monitor your blood levels to ensure the supplement is reaching the therapeutic range. Consistency in taking the medication with food is the best way to ensure it works as quickly as possible.
For the majority of patients, .alpha.-tocopherol Acetate, Dl- can be stopped suddenly without experiencing withdrawal symptoms. Unlike some medications that affect the central nervous system, Vitamin E does not create a physical dependence. However, if you were taking it to treat a specific medical condition or a severe deficiency, stopping the supplement could cause your Vitamin E levels to drop, potentially leading to a return of symptoms over time. You should always consult with your healthcare provider before stopping any prescribed supplement to ensure it is safe for your specific health situation. They can advise if a gradual reduction is necessary for your particular case.
If you miss a dose of .alpha.-tocopherol Acetate, Dl-, you should take it as soon as you remember, provided it is not almost time for your next scheduled dose. If you are close to the time of your next dose, simply skip the missed one and continue with your regular schedule. Never take two doses at the same time to make up for a missed one, as this can increase the risk of stomach upset and other side effects. Because Vitamin E is stored in the body's fat tissues, missing a single dose is unlikely to have a significant impact on your overall health. If you frequently forget your doses, consider using a pill organizer or a reminder app.
There is no clinical evidence to suggest that .alpha.-tocopherol Acetate, Dl- causes weight gain. It is a micronutrient and does not contain a significant number of calories. However, because Vitamin E must be taken with dietary fat for proper absorption, some patients may inadvertently increase their caloric intake if they significantly change their diet to include more fatty foods. If you notice unexpected weight changes while taking this supplement, it is more likely related to other factors such as diet, activity level, or an underlying medical condition. Discuss any concerns about weight with your healthcare provider.
.alpha.-tocopherol Acetate, Dl- can interact with several types of medications, some of which can be serious. It is particularly dangerous when taken with blood thinners like Warfarin, as it can significantly increase the risk of bleeding. It may also interfere with the effectiveness of certain chemotherapy drugs and cholesterol medications like statins. Because of these potential interactions, it is crucial to provide your doctor with a complete list of all prescription drugs, over-the-counter medicines, and herbal supplements you are using. Your pharmacist can also perform a drug interaction check to ensure your combination of medications is safe.
Yes, .alpha.-tocopherol Acetate, Dl- is widely available as a generic medication and as an over-the-counter supplement. The generic versions are biologically equivalent to brand-name versions and are typically much more cost-effective. When purchasing, you may see it labeled simply as 'Vitamin E' or 'Synthetic Vitamin E.' It is important to check the label to see if it is the 'dl' (synthetic) or 'd' (natural) form, as the natural form is more potent and may require a different dose. Always choose a reputable brand that follows Good Manufacturing Practices (GMP) to ensure the purity and accuracy of the dosage.
Other drugs with the same active ingredient (.alpha.-tocopherol Acetate, Dl-)