Myra 400-E Special Precautions

High doses of vitamin E [i.e., doses greater than 100 mg (equivalent to 149 I.U.) daily of d-Alpha Tocopherol] should be used with caution in patients on warfarin. Monitoring of international normalized ratio (INR) and adjusting of warfarin dose (if indicated) are recommended. Likewise, those with vitamin K deficiencies, such as patients with liver failure, should be cautious in taking high doses of vitamin E.
Vitamin E should be used with extreme caution in those with any lesions that have a tendency to bleed (e.g. bleeding peptic ulcers), those with a history of hemorrhagic stroke, and those with inherited bleeding disorders (e.g., hemophilia).
High dose of vitamin E supplementation should be stopped about one month before a surgical procedure and may be resumed following recovery from the procedure, or as directed by a doctor.
Do not use more than the recommended dose.
Consult a doctor: If any undesirable effect occurs.
If the patient is pregnant or thinks may be, or is planning to become pregnant, or is breastfeeding. The effects of high doses of vitamin E during pregnancy and breastfeeding are not known.