Vitamin E and medications.
Vitamin E is in the Distil supplement database, evidence Grade A. The page below lists every medication we have explicitly assessed it against.
Vitamin E is an essential fat-soluble antioxidant, and while the vitamin itself is Grade A, the evidence for supplementing above dietary levels is mixed and depends heavily on form. Mixed tocopherols and tocotrienols are the sensible choice; tocotrienols specifically show preclinical and early cardiovascular and neuroprotective signals. The important limit is dose. The Miller 2005 meta-analysis of 19 trials and 135,967 people found a dose-response relationship with all-cause mortality that begins above 150 IU per day, and concluded that 400 IU per day or more should be avoided. That signal is not specific to isolated alpha-tocopherol: 10 of the 19 pooled trials used vitamin E combined with other vitamins or minerals, so a mixed product is not a reason to take more. Vitamin E also did not reduce cardiovascular events in the HOPE trial. Keep any supplemental vitamin E at or below 150 IU per day. The interaction angle is bleeding. Vitamin E reduces platelet adhesion, an effect that is modest at 100 to 200 IU but climbs above 400 IU, so it is a hard exclusion with anticoagulants such as warfarin and apixaban and should be stopped before surgery. Vitamin C offers antioxidant network synergy. Keep doses moderate, choose mixed forms, and avoid it entirely if you are on a blood thinner.
Below are the 9 documented pairs we have explicitly assessed for Vitamin E: 9 amber. The pairs cluster around 1 mechanism: Additive antiplatelet effect. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not listed here is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by medication, and the missing-item form at the bottom of the page routes any uncatalogued medication into our next curation pass.
Documented interactions
Last reviewed 14 June 2026. Each interaction below lists the evidence its assessment drew on: some rest on studies of the exact pair, others on mechanism evidence, where a citation may support one part of the reasoning rather than the exact combination. The evidence line on each entry says which.
Additive antiplatelet effect
Amber Does interact with Acenocoumarol?
High-dose vitamin E can mildly reduce blood clotting, which may add to the blood-thinning effect of acenocoumarol and raise bleeding risk. The concern is with high supplemental doses. If you take acenocoumarol, keep vitamin E intake modest and tell your anticoagulant clinic.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Apixaban?
Vitamin E at high doses (above 400 IU per day) can raise bleeding risk in its own right, which could add to apixaban. At low supplement doses (100 to 200 IU) the effect is minimal. Apixaban has no INR test to monitor this, so keep vitamin E modest and tell your GP if you take high-dose vitamin E. Stop it six weeks before planned surgery.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Aspirin?
At low supplement doses (100 to 200 IU) vitamin E adds little to aspirin. At high doses (above 400 IU per day) it can add to aspirin's blood-thinning effect and raise bleeding risk. Use mixed-tocopherol products at modest doses and stop high-dose vitamin E six weeks before any surgery.
Evidence: Limited human data, based on case reports and a known mechanism.
Amber Does interact with Clopidogrel?
At low supplement doses (100 to 200 IU) vitamin E adds little to clopidogrel. At high doses (above 400 IU per day) it can add to clopidogrel's blood-thinning effect and raise bleeding risk. Keep vitamin E to modest mixed-tocopherol doses and stop high-dose vitamin E six weeks before any surgery.
Evidence: Limited human data, based on case reports and a known mechanism.
Amber Does interact with Dabigatran etexilate?
Vitamin E at high doses (above 400 IU per day) can raise bleeding risk in its own right, which may add to dabigatran. At low supplement doses (100 to 200 IU) the effect is minimal. Dabigatran has no routine blood test to monitor this, so keep vitamin E modest and tell your GP if you take high-dose vitamin E. Stop it six weeks before planned surgery.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Edoxaban?
Vitamin E at high doses (above 400 IU per day) can raise bleeding risk in its own right, which may add to edoxaban. At low supplement doses (100 to 200 IU) the effect is minimal. Edoxaban has no routine blood test to monitor this, so keep vitamin E modest and tell your GP if you take high-dose vitamin E. Stop it six weeks before planned surgery.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Rivaroxaban?
Vitamin E at high doses (above 400 IU per day) can raise bleeding risk in its own right, which could add to rivaroxaban. At low supplement doses (100 to 200 IU) the effect is minimal. Rivaroxaban has no INR test to monitor this, so keep vitamin E modest and tell your GP if you take high-dose vitamin E. Stop it six weeks before planned surgery.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Ticagrelor?
Vitamin E at high doses (above 400 IU per day) can raise bleeding risk in its own right, which may add to ticagrelor's blood-thinning effect. At low supplement doses (100 to 200 IU) the effect is minimal. Keep vitamin E to modest mixed-tocopherol doses, tell your GP if you take high-dose vitamin E, and stop it six weeks before any planned surgery.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Warfarin sodium?
Vitamin E at low supplement doses (100 to 200 IU) has little effect on warfarin. At high doses (above 400 IU per day) it can add to bleeding risk and may nudge your INR. Tell your anticoagulant clinic if you take high-dose vitamin E, and stop it six weeks before planned surgery.
Evidence: Limited human data, based on case reports and a known mechanism.
What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope. Use the checker below to surface any medication, and submit a missing item if you take something we have not catalogued.
No affiliates. No commission. We earn nothing on what you buy.
How we grade severity, choose what's in scope, and what we exclude.
Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.
Read the full methodologyA full supplement review, built around you, not a generic stack.
The free checker answers one interaction question at a time. A Distil report reviews the bigger picture: your goals, diet, medications, current supplements and any blood results you provide, then shows what appears worth keeping, changing, adding or leaving out.
- what your diet already covers, so you are not adding a capsule for something food is already handling
- which evidence-graded compounds are worth considering for your goals, and which were considered but left out
- what to keep, change or stop from what you already take, plus the order to introduce anything new
- how your medications and complete supplement stack fit together, with daily timing and a clear point for reassessment
The interaction check is one section of the full report. You also get the reasoning behind each recommendation and the evidence references used.
£49 introductory price for early customers. Standard price £79.
Something missing?
If a supplement or medication you take isn't in our autocomplete, tell us. We go through what people flag every week and add what's missing.