The short answer
The added bleeding risk from vitamin E supplements with tolmetin is uncertain. Review the exact product, dose and your bleeding history with your prescriber.
What this answer covers
Oral vitamin E supplements with oral tolmetin sodium capsules. Exact formulation, dose and duration matter; other NSAIDs and other supplement preparations are not interchangeable.
- Supplement or preparation
- Vitamin E
- Medication ingredient
- tolmetin
What the evidence shows
NIH guidance notes that large supplemental vitamin E doses may affect clotting and platelet function. This supports a precaution with medicines affecting bleeding, but it does not provide an exact risk estimate for this NSAID combination or demonstrate added stomach ulceration.
Consider this medicine’s own effects
The inspected capsules contain tolmetin sodium, expressed as a tolmetin-equivalent dose. Tolmetin carries serious GI bleeding and ulcer warnings. These effects make persistent symptoms important to assess, but do not establish that a particular botanical adds to the risk. An antacid should not be used to conceal ongoing pain.
Review the exact product
Bring the dose in mg or IU and formulation to your pharmacist. There is no validated vitamin E cutoff that guarantees safety with this drug. The high-dose supplement concern does not imply that vitamin E in ordinary foods must be avoided.
Know when to get help
oral tolmetin sodium capsules can cause serious GI bleeding even without a supplement. Seek urgent care for vomiting blood or black, tarry stools, and report persistent stomach pain or unusual bleeding. Tell your prescriber about other pain medicines, aspirin and anticoagulants. A few hours of separation has not been shown to prevent an added bleeding effect.
Evidence and practical considerations
Side effects & toxicity
An increased bleeding or GI-injury rate specifically from vitamin E supplements with tolmetin has not been established.
- Exact scope
- Oral vitamin E supplements with oral tolmetin sodium capsules. Exact formulation, dose and duration matter; other NSAIDs and other supplement preparations are not interchangeable. with Exact tolmetin IN 10636 linked by current RxNorm to tolmetin sodium PIN 42935. Capsules contain 246 mg sodium dihydrate equivalent to 200 mg tolmetin. Other NSAIDs are not interchangeable.
- Medication form and route
- Oral
What remains uncertain
- Available supplement-only and other-drug studies do not establish exact-pair clinical harm or exclude rare events. No validated preventive spacing interval.
Factors that may matter: Exact preparation and dose; Fasting versus fed dosing; Bleeding and ulcer history; Other medicines.
Read the supporting source summaries
Source 1: Current prescribing information
dailymed.nlm.nih.gov · Source check Sep 10, 2026
Population: Prescription oral oral tolmetin sodium capsules users; short human pharmacology studies where described.
Serious GI injury and bleeding warnings. Label recommends antacids other than sodium bicarbonate; aluminum/magnesium hydroxide did not change absorption in the cited study.
How this applies: Exact current product label. Exact tolmetin IN 10636 linked by current RxNorm to tolmetin sodium PIN 42935. Capsules contain 246 mg sodium dihydrate equivalent to 200 mg tolmetin. Other NSAIDs are not interchangeable.
Exact oral product label; no measured botanical co-use incidence. Ingredient, route, preparation and comparator differences must be retained.
Source 2: Government nutrient guidance
ods.od.nih.gov · Source check Sep 10, 2026
Population: Supplement users.
High doses may affect platelet/clotting function and increase bleeding concerns with anticoagulant or antiplatelet medicines.
How this applies: General supplement precaution with exact NSAID platelet and GI context.
No exact oral tolmetin sodium capsules trial or safe-dose cutoff; no demonstration of additive GI ulceration. Original guidance body read in captured web open.
Source 3: Medication terminology
rxnav.nlm.nih.gov · Source check Sep 10, 2026
Population: Terminology.
tolmetin is IN. Exact tolmetin IN 10636 linked by current RxNorm to tolmetin sodium PIN 42935. Capsules contain 246 mg sodium dihydrate equivalent to 200 mg tolmetin. Other NSAIDs are not interchangeable.
How this applies: Exact identity.
Not clinical evidence.
Research assessment: · Open full citations ↗
Side effects & toxicity
High-dose vitamin E deserves individualized review with bleeding-risk medicines.
- Exact scope
- Oral vitamin E supplements with oral tolmetin sodium capsules. Exact formulation, dose and duration matter; other NSAIDs and other supplement preparations are not interchangeable. with Exact tolmetin IN 10636 linked by current RxNorm to tolmetin sodium PIN 42935. Capsules contain 246 mg sodium dihydrate equivalent to 200 mg tolmetin. Other NSAIDs are not interchangeable.
- Medication form and route
- Oral
What remains uncertain
- Precaution based on defined supplement evidence and the individual drug label; no exact combination event rate or universal discontinuation rule.
Factors that may matter: Exact preparation and dose; Fasting versus fed dosing; Bleeding and ulcer history; Other medicines.
Read the supporting source summaries
Source 1: Current prescribing information
dailymed.nlm.nih.gov · Source check Sep 10, 2026
Population: Prescription oral oral tolmetin sodium capsules users; short human pharmacology studies where described.
Serious GI injury and bleeding warnings. Label recommends antacids other than sodium bicarbonate; aluminum/magnesium hydroxide did not change absorption in the cited study.
How this applies: Exact current product label. Exact tolmetin IN 10636 linked by current RxNorm to tolmetin sodium PIN 42935. Capsules contain 246 mg sodium dihydrate equivalent to 200 mg tolmetin. Other NSAIDs are not interchangeable.
Exact oral product label; no measured botanical co-use incidence. Ingredient, route, preparation and comparator differences must be retained.
Source 2: Government nutrient guidance
ods.od.nih.gov · Source check Sep 10, 2026
Population: Supplement users.
High doses may affect platelet/clotting function and increase bleeding concerns with anticoagulant or antiplatelet medicines.
How this applies: General supplement precaution with exact NSAID platelet and GI context.
No exact oral tolmetin sodium capsules trial or safe-dose cutoff; no demonstration of additive GI ulceration. Original guidance body read in captured web open.
Research assessment: · Open full citations ↗
Review and change history
- Publication status
- Published research summary
- Clinical review
- Not yet recorded
| Date | Update |
|---|---|
| Article prepared | |
| Sources checked and article drafted. | |
| Research summary published |
Article revision: a576f0e4bf3f7c7e
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.