PEDIATRICS Vol. 76 No. 4 October 1985, pp. 625-627
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Vitamin E—How Much Is Too Much?

JAMES A. LEMONS MD1 and M. JEFFREY MAISELS MB, BCh2

1 Indiana University School of Medicine, James Whitcomb Riley Hospital for Children, Indianapolis
2 The Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey

For many years a treatment in search of a disease, vitamin E (agr-tocopherol) is now being prescribed widely and in large doses to small premature infants. The possibility of reducing the incidence of severe retrolental fibroplasia,1-4 intraventricular hemorrhage, and even the mortality of these tiny babies5 has, quite understandably, excited the interest of those responsible for their care.

Although concern about potential toxicity has been expressed,6,7 Hittner and co-workers4 recommend that infants weighing less than 1,500 g at birth who require oxygen receive intramuscular injections of a water miscible preparation of d,l-agr-tocopherol on days 1, 2, 4, and 6 of life as well as oral agr-tocopherol in a dosage of 100 mg/kg/d.5 Using this regimen, these workers report that they have not (or have rarely) encountered plasma tocopherol levels in excess of 3.5 mg/dL.8,9