lPATIENT AND CARER ADVICEPatient or carers should be
given advice on how to administer calcium and
ergocalciferol tablets.
lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Tablet
▶Ergocalciferol with calcium lactate and calcium phosphate (Non-
proprietary)
Ergocalciferol 10 microgram, Calcium phosphate 150 mg, Calcium
lactate 300 mgCalcium and Ergocalciferol tablets| 28 tabletp
£ 22. 38 DT = £ 21. 28
VITAMINS AND TRACE ELEMENTS›VITAMIN E
Alpha tocopherol
(Tocopherol)
lINDICATIONS AND DOSE
Vitamin E deficiency because of malabsorption in
congenital or hereditary chronic cholestasis
▶BY MOUTH USING ORAL SOLUTION
▶Neonate: 17 mg/kg daily, dose to be adjusted as
necessary.▶Child: 17 mg/kg daily, dose to be adjusted as necessarylCONTRA-INDICATIONSPreterm neonates
lCAUTIONSPredisposition to thrombosis
lINTERACTIONS→Appendix 1 : vitamin E substances
lSIDE-EFFECTS
▶Common or very commonDiarrhoea
▶UncommonAlopecia.asthenia.headache.skin reactions
▶Frequency not knownAbdominal pain
lPREGNANCYManufacturer advises caution, no evidence of
harm inanimalstudies.
lBREAST FEEDINGManufacturer advises use only if
potential benefit outweighs risk—no information
available.
lHEPATIC IMPAIRMENTManufacturer advises caution—no
information available.
MonitoringManufacturer advises monitor closely in
hepatic impairment.
lRENAL IMPAIRMENTManufacturer advises caution. Risk of
renal toxicity due to polyethylene glycol content.
MonitoringManufacturer advises monitor closely in renal
impairment.
lPRESCRIBING AND DISPENSING INFORMATION
Tocofersolan is a water-soluble form of D-alpha
tocopherol.
lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Oral solution
▶Vedrop(Orphan Europe (UK) Ltd)A
D-alpha tocopherol (as Tocofersolan) 50 mg per 1 mlVedrop
50 mg/ml oral solution sugar-free| 20 mlP£ 54. 55 sugar-free|
60 mlP£ 163. 65
Alpha tocopheryl acetate
(Tocopherol)
lINDICATIONS AND DOSE
Vitamin E deficiency
▶BY MOUTH
▶Neonate: 10 mg/kg once daily.▶Child: 2 – 10 mg/kg daily, increased if necessary up to
20 mg/kg daily
Malabsorption in cystic fibrosis
▶BY MOUTH
▶Child 1–11 months: 50 mg once daily, dose to be adjusted
as necessary, to be taken with food and pancreatic
enzymes
▶Child 1–11 years: 100 mg once daily, dose to be adjusted
as necessary, to be taken with food and pancreatic
enzymes
▶Child 12–17 years: 100 – 200 mg once daily, dose to be
adjusted as necessary, to be taken with food and
pancreatic enzymes
Vitamin E deficiency in cholestasis and severe liver
disease
▶BY MOUTH
▶Neonate: 10 mg/kg daily.▶Child 1 month–11 years:Initially 100 mg daily, adjusted
according to response, increased if necessary up to
200 mg/kg daily
▶Child 12–17 years:Initially 200 mg daily, adjusted
according to response, increased if necessary up to
200 mg/kg daily
▶BY INTRAMUSCULAR INJECTION
▶Neonate: 10 mg/kg once a month.▶Child: 10 mg/kg once a month (max. per dose 100 mg)
Malabsorption in abetalipoproteinaemia
▶BY MOUTH
▶Neonate: 100 mg/kg once daily.▶Child: 50 – 100 mg/kg once dailylCAUTIONSIncreased risk of necrotising enterocolitis in
neonate weighing less than 1. 5 kg or in a preterm neonate.
predisposition to thrombosis
lINTERACTIONS→Appendix 1 : vitamin E substances
lSIDE-EFFECTSAbdominal pain (more common at high
doses).bleeding tendency.diarrhoea (more common at
high doses).increased risk of thrombosis
lPREGNANCYNo evidence of safety of high doses.
lBREAST FEEDINGExcreted in milk; minimal risk, although
caution with large doses.
lMONITORING REQUIREMENTSIncreased bleeding tendency
in vitamin-K deficient patients or those taking
anticoagulants (prothrombin time and INR should be
monitored).
lDIRECTIONS FOR ADMINISTRATIONConsider dilution of
oral suspension for use in neonates due to high osmolality.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: chewable tablet, solution for injection
Solution for injection
▶E-Vicotrat (Imported (Germany))
Alpha tocopheryl acetate 50 mg per 1 mlE-Vicotrat 100 mg/ 2 ml
solution for injection ampoules| 10 ampoulePs
Oral suspension
EXCIPIENTS:May contain Sucrose
▶Alpha tocopheryl acetate (Non-proprietary)
Alpha tocopheryl acetate 100 mg per 1 mlAlpha tocopheryl
acetate 500 mg/ 5 ml oral suspension| 100 mlG£ 67. 97 DT =
£ 67. 97
Chewable tablet
▶Alpha tocopheryl acetate (Non-proprietary)
Alpha tocopheryl acetate 100 mgAlpha tocopheryl acetate 100 mg
chewable tablets| 30 tablets
▶E-Tabs(Ennogen Healthcare Ltd)
Alpha tocopheryl acetate 100 mgE-Tabs 100 mg chewable tablets
| 30 tablet £ 87. 30BNFC 2018 – 2019 Vitamin deficiency 635
Blood and nutrition9