Details of the Drug

General Information of Drug (ID: DMZC90K)

• Drug Name: Vitamin E
• Synonyms: Covi-ox; VITAMIN E; E-Vimin; Syntopherol; Profecundin; Evitaminum; Viprimol; Vascuals; Etamican; Viteolin; Tokopharm; Vitayonon; Epsilan; Emipherol; Denamone; Almefrol; Verrol; Ilitia; Etavit; 77171-98-3; Evion; Esorb; alpha-Tokoferol; alpha Tocopherol; Vitaplex E; Vitamin E alpha; Eprolin S; Viterra E; E Prolin; Spavit E; Vita E; Endo E; Med-E; Lan-E; Antisterility vitamin; alpha-Tocopherol acid; Tenox GT 1; (R)-2,5,7,8-tetramethyl-2-((4S,8S)-4,8,12-trimethyltridecyl)chroman-6-ol; Rhenogran Ronotec 50; Vi-E; Covitol F 1000; E 307 (tocopherol)

Indication

Disease Entry	ICD 11	Status	REF
Cardiovascular disease	BA00-BE2Z	Approved	[1]

• Drug Type: Small molecular drug
• #Ro5 Violations (Lipinski): 2:
  Molecular Weight (mw); 430.7
  Topological Polar Surface Area (xlogp); 10.7
  Rotatable Bond Count (rotbonds); 12
  Hydrogen Bond Donor Count (hbonddonor); 1
  Hydrogen Bond Acceptor Count (hbondacc); 2
• Chemical Identifiers:
  Formula: C29H50O2
  IUPAC Name: (2R)-2,5,7,8-tetramethyl-2-[(4R,8R)-4,8,12-trimethyltridecyl]-3,4-dihydrochromen-6-ol
  Canonical SMILES: CC1=C(C2=C(CC[C@@](O2)(C)CCC[C@H](C)CCC[C@H](C)CCCC(C)C)C(=C1O)C)C
  InChI: InChI=1S/C29H50O2/c1-20(2)12-9-13-21(3)14-10-15-22(4)16-11-18-29(8)19-17-26-25(7)27(30)23(5)24(6)28(26)31-29/h20-22,30H,9-19H2,1-8H3/t21-,22-,29-/m1/s1
  InChIKey: GVJHHUAWPYXKBD-IEOSBIPESA-N
• Cross-matching ID:
  PubChem CID: 14985
  ChEBI ID: CHEBI:18145
  CAS Number: 59-02-9
  DrugBank ID: DB00163
  TTD ID: D02TQO
  INTEDE ID: DR1701

Molecular Interaction Atlas of This Drug

Drug-Metabolizing Enzyme (DME)

DME Name	DME ID	UniProt ID	MOA	REF
Cytochrome P450 3A4 (CYP3A4) Main DME	DE4LYSA	CP3A4_HUMAN	Substrate	[2]

Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Disease Different from Vitamin E (Comorbidity)

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Comorbidity	REF
Cilostazol	DMZMSCT	Moderate	Increased risk of bleeding by the combination of Vitamin E and Cilostazol.	Arterial occlusive disease [BD40]	[12]
Anisindione	DM2C48U	Moderate	Increased risk of bleeding by the combination of Vitamin E and Anisindione.	Coagulation defect [3B10]	[12]
Ardeparin	DMYRX8B	Moderate	Increased risk of bleeding by the combination of Vitamin E and Ardeparin.	Coronary thrombosis [BA43]	[12]
Danaparoid	DM6CLBN	Moderate	Increased risk of bleeding by the combination of Vitamin E and Danaparoid.	Deep vein thrombosis [BD71]	[12]
Rivaroxaban	DMQMBZ1	Moderate	Increased risk of bleeding by the combination of Vitamin E and Rivaroxaban.	Deep vein thrombosis [BD71]	[12]
Sulfinpyrazone	DMEV954	Moderate	Increased risk of bleeding by the combination of Vitamin E and Sulfinpyrazone.	Gout [FA25]	[12]
Tipranavir	DM8HJX6	Major	Increased risk of bleeding by the combination of Vitamin E and Tipranavir.	Human immunodeficiency virus disease [1C60-1C62]	[13]
Dipyridamole	DMXY30O	Moderate	Increased risk of bleeding by the combination of Vitamin E and Dipyridamole.	Hypertension [BA00-BA04]	[12]
Ticlopidine	DMO946V	Moderate	Increased risk of bleeding by the combination of Vitamin E and Ticlopidine.	Ischaemic/haemorrhagic stroke [8B20]	[12]
Ibrutinib	DMHZCPO	Major	Increased risk of bleeding by the combination of Vitamin E and Ibrutinib.	Mature B-cell lymphoma [2A85]	[14]
Prasugrel	DM7MT6E	Moderate	Increased risk of bleeding by the combination of Vitamin E and Prasugrel.	Myocardial infarction [BA41-BA43]	[12]
Vorapaxar	DMA16BR	Moderate	Increased risk of bleeding by the combination of Vitamin E and Vorapaxar.	Myocardial infarction [BA41-BA43]	[12]
Tirofiban	DMQG17S	Moderate	Increased risk of bleeding by the combination of Vitamin E and Tirofiban.	Myocardial infarction [BA41-BA43]	[12]
Orlistat	DMRJSP8	Minor	Decreased absorption of Vitamin E caused by Orlistat.	Obesity [5B80-5B81]	[15]
Aspirin	DM672AH	Moderate	Increased risk of bleeding by the combination of Vitamin E and Aspirin.	Pain [MG30-MG3Z]	[16]
Treprostinil	DMTIQF3	Moderate	Increased risk of bleeding by the combination of Vitamin E and Treprostinil.	Pulmonary hypertension [BB01]	[12]
Epoprostenol	DMUTYR2	Moderate	Increased risk of bleeding by the combination of Vitamin E and Epoprostenol.	Pulmonary hypertension [BB01]	[12]
Iloprost	DMVPZBE	Moderate	Increased risk of bleeding by the combination of Vitamin E and Iloprost.	Pulmonary hypertension [BB01]	[12]
Warfarin	DMJYCVW	Moderate	Increased risk of bleeding by the combination of Vitamin E and Warfarin.	Supraventricular tachyarrhythmia [BC81]	[12]
Caplacizumab	DMPUKA7	Moderate	Increased risk of bleeding by the combination of Vitamin E and Caplacizumab.	Thrombocytopenia [3B64]	[12]
Apixaban	DM89JLN	Moderate	Increased risk of bleeding by the combination of Vitamin E and Apixaban.	Thrombosis [DB61-GB90]	[12]
Cangrelor	DM8JRH0	Moderate	Increased risk of bleeding by the combination of Vitamin E and Cangrelor.	Thrombosis [DB61-GB90]	[12]
Brilinta	DMBR01X	Moderate	Increased risk of bleeding by the combination of Vitamin E and Brilinta.	Thrombosis [DB61-GB90]	[12]
Argatroban	DMFI46A	Moderate	Increased risk of bleeding by the combination of Vitamin E and Argatroban.	Thrombosis [DB61-GB90]	[12]
Dicumarol	DMFQCB1	Moderate	Increased risk of bleeding by the combination of Vitamin E and Dicumarol.	Thrombosis [DB61-GB90]	[16]
Clopidogrel	DMOL54H	Moderate	Increased risk of bleeding by the combination of Vitamin E and Clopidogrel.	Thrombosis [DB61-GB90]	[12]
Betrixaban	DM2C4RF	Moderate	Increased risk of bleeding by the combination of Vitamin E and Betrixaban.	Venous thromboembolism [BD72]	[12]

References

• [1] Drugs@FDA. U.S. Food and Drug Administration. U.S. Department of Health & Human Services. 2015
• [2] Adverse effects of vitamin E by induction of drug metabolism. Genes Nutr. 2007 Dec;2(3):249-56.
• [3] Expression levels and activation of a PXR variant are directly related to drug resistance in osteosarcoma cell lines. Cancer. 2007 Mar 1;109(5):957-65.
• [4] Contribution of human hepatic cytochrome P450 isoforms to regioselective hydroxylation of steroid hormones. Xenobiotica. 1998 Jun;28(6):539-47.
• [5] Comprehensive evaluation of tamoxifen sequential biotransformation by the human cytochrome P450 system in vitro: prominent roles for CYP3A and CYP2D6. J Pharmacol Exp Ther. 2004 Sep;310(3):1062-75.
• [6] Isoform-specific regulation of cytochromes P450 expression by estradiol and progesterone. Drug Metab Dispos. 2013 Feb;41(2):263-9.
• [7] Metabolic interactions between acetaminophen (paracetamol) and two flavonoids, luteolin and quercetin, through in-vitro inhibition studies. J Pharm Pharmacol. 2017 Dec;69(12):1762-1772.
• [8] Potent mechanism-based inhibition of CYP3A4 by imatinib explains its liability to interact with CYP3A4 substrates. Br J Pharmacol. 2012 Apr;165(8):2787-98.
• [9] Effects of morin on the pharmacokinetics of etoposide in rats. Biopharm Drug Dispos. 2007 Apr;28(3):151-6.
• [10] The metabolism of zidovudine by human liver microsomes in vitro: formation of 3'-amino-3'-deoxythymidine. Biochem Pharmacol. 1994 Jul 19;48(2):267-76.
• [11] Substrates, inducers, inhibitors and structure-activity relationships of human Cytochrome P450 2C9 and implications in drug development. Curr Med Chem. 2009;16(27):3480-675.
• [12] Booth SL, Golly I, Sacheck JM, Roubenoff R, Dallal GE, et al "Effect of vitamin E supplementation on vitamin K status in adults with normal coagulation status." Am J Clin Nutr 80 (2004): 143-8. [PMID: 15213041]
• [13] Product Information. Aptivus (tipranavir). Boehringer-Ingelheim, Ridgefield, CT.
• [14] Agencia Espaola de Medicamentos y Productos Sanitarios Healthcare "Centro de informacion online de medicamentos de la AEMPS - CIMA.".
• [15] Product Information. Xenical (orlistat). Roche Laboratories, Nutley, NJ.
• [16] Gonzalez-Correa JA, Arrebola MM, Guerrero A, et al. "Influence of vitamin E on the antiplatelet effect of acetylsalicylic acid in human blood." Platelets 16(3-4) (2005): 171-9. [PMID: 16011961]