The short answer
High-dose vitamin E supplements warrant a bleeding precaution with dalteparin, but the size of the exact interaction is uncertain. Dietary vitamin E is a different exposure.
What this answer covers
Oral supplemental vitamin E, mainly alpha-tocopherol evidence, with subcutaneous dalteparin sodium; not vitamin E-coated dialysis devices or topical products.
- Supplement or preparation
- Vitamin E
- Medication ingredient
- dalteparin
Why the precaution applies
NIH guidance cautions that large vitamin E doses may increase bleeding with anticoagulants. Dalteparin’s own label warns about other agents affecting clotting. This supports reviewing high-dose supplementation, without establishing a measured dalteparin-specific risk.
Other anticoagulants provide limited comparisons
A small trial in 21 warfarin-treated patients found no significant INR change with vitamin E. Warfarin and dalteparin work differently, and INR is not a substitute for dalteparin-specific bleeding outcomes. This null result neither proves dalteparin safety nor establishes increased dalteparin potency.
Dose and form matter
The exact supplement amount and form should be reviewed. NIH guidance does not give a certain clinically significant interaction threshold, and dietary vitamin E is not equivalent to concentrated supplements. A suggested threshold should not be treated as a guaranteed safe boundary.
Keep the clinical team informed
Tell the dalteparin team about the exact supplement before starting or changing it. Report unusual bleeding or bruising promptly; serious bleeding, black stools or vomiting blood needs urgent assessment. Do not change prescribed dalteparin yourself. Do not alter dalteparin to accommodate vitamin E, and do not rely on a short gap between doses to prevent a possible clotting effect.
Evidence and practical considerations
Side effects & toxicity
Indirect supplement and anticoagulant precaution, with source-specific null findings and no quantified dalteparin co-use risk.
- Exact scope
- Oral supplemental vitamin E, mainly alpha-tocopherol evidence, with subcutaneous dalteparin sodium; not vitamin E-coated dialysis devices or topical products. with Subcutaneous dalteparin sodium; active ingredient bridge to RxCUI67109 IN. Not UFH or another LMWH.
- Medication form and route
- subcutaneous dalteparin; oral supplement
What remains uncertain
- Source-specific population, preparation and endpoint limits apply; no universal dose or timing rule.
Factors that may matter: Exact preparation; Dose and duration; Kidney function; Other medicines.
Read the supporting source summaries
Source 1: current product label
dailymed.nlm.nih.gov · Source check Sep 10, 2026
Population: Patients receiving subcutaneous dalteparin sodium.
Bleeding risk can increase with platelet inhibitors and other anticoagulants. Hyperkalemia is listed among postmarketing reports, whose frequency and causal relationship cannot reliably be established.
How this applies: Exact dalteparin sodium injection product and route; no silent transfer of unfractionated-heparin dosing or monitoring rules.
Does not specifically name these supplements. Not unfractionated heparin, another LMWH, an oral anticoagulant or topical therapy.
Source 2: regulatory guidance
ods.od.nih.gov · Source check Sep 10, 2026
Population: Users of the specified preparation.
Large supplemental doses may increase bleeding with anticoagulants or antiplatelets; clinically significant dose threshold is uncertain.
How this applies: Exact species, preparation, route and measured endpoints govern applicability; other anticoagulants are not silently treated as dalteparin.
Warfarin-related vitamin K explanation is not a dalteparin absorption mechanism; guidance does not measure this exact pair.
Source 3: original human study
pubmed.ncbi.nlm.nih.gov · Source check Sep 10, 2026
Population: 21 warfarin-treated patients.
No significant INR change with vitamin E versus placebo.
How this applies: Exact species, preparation, route and measured endpoints govern applicability; other anticoagulants are not silently treated as dalteparin.
21 subjects, surrogate INR endpoint, not dalteparin and not proof of no bleeding at any dose. Dose not supplied in inspected abstract.
Research assessment: · Open full citations ↗
Review and change history
- Publication status
- Published research summary
- Clinical review
- Not yet recorded
| Date | Update |
|---|---|
| Article prepared | |
| Prepared exact dalteparin article with independently checked product label and explicit limits on indirect supplement evidence. | |
| Research summary published |
Article revision: b87f345179705cee
This guide brings together the evidence records used by our interaction checker. Each finding retains its own preparation limits, research date, and source summaries.
Full citations require verification. Reading this answer and the source summaries does not.
Taking other supplements or medications?
Use the checker to explore your other combinations. Ask a pharmacist to review the exact products, amounts and medical conditions in your complete list.
Open the interaction checkerInformation, not medical advice. Do not change prescribed treatment based on this guide.