Beta-Carotene

This supplement has been used in connection with the following health conditions:

Used for	Why
3 Stars Leukoplakia 150,000 IU twice per week	Beta-carotene, the most widely used supplement in the treatment of leukoplakia, has been shown in studies to increase remission rate. Caution: Synthetic beta-carotene has been linked to increased risk of lung cancer in smokers. Until more is known, smokers should avoid all beta-carotene supplements. Beta-carotene is the most widely used supplement in the treatment of leukoplakia. In a clinical trial of betel nut chewers with leukoplakia, supplementation with 150,000 IU of beta-carotene twice per week for six months significantly increased the remission rate compared with placebo (14.8% vs. 3.0%).¹ The effectiveness of beta-carotene for treating leukoplakia was also confirmed in a double-blind trial that used 100,000 IU per day for six months.² In one trial, supplementation with 33, 333 IU of beta-carotene per day, alone or combined with 50 IU of vitamin E, was reported not to reduce the incidence of leukoplakia.³ These results have also been observed in smaller trials.⁴ ^{, 5} Drug therapy with a synthetic, prescription form of vitamin A (known as Accutane, isotretinoin, and 13-cis retinoic acid) has been reported to be more effective than treatment with 50,000 IU per day of beta-carotene.⁶ However, because of the potential toxicity of the vitamin A-like drug, it may be preferable to treat leukoplakia with beta-carotene, which is much safer. Before the research on beta-carotene was published, vitamin A was used to treat leukoplakia.⁷ One group of researchers reported that vitamin A (28,500 IU per day) was more effective than beta-carotene in treating people with leukoplakia.⁸ Another trial found that the combination of 150,000 IU per week of beta-carotene plus 100,000 IU per week of vitamin A led to a significant increase in remission time compared to beta carotene alone in betel nut chewers.⁹ Women who are or who could become pregnant should not take 100,000 IU of vitamin A per week without medical supervision.
3 Stars Lung Cancer in Nonsmokers Eat more carrots	Beta-carotene supplementation appears to reduce cancer risk in nonsmokers. Smokers should avoid beta-carotene supplements, including the amounts found in multivitamins. In double-blind trials, synthetic beta-carotene supplementation has led to an increased risk of lung cancer in smokers,¹⁰ ^{, 11} though not in groups consisting primarily of nonsmokers.¹² Smokers should avoid synthetic beta-carotene supplements, including the relatively small amounts found in many multivitamins. The researchers who conducted the lung cancer trials have been criticized for not having used the natural form of beta-carotene.¹³ Preliminary evidence suggests that natural beta-carotene supplementation results in better antioxidant activity¹⁴ and anticancer activity in humans¹⁵ than does supplementation with synthetic beta-carotene. Nonetheless, much less is known about natural beta-carotene and questions remain about its potential efficacy.¹⁶ The effect of natural beta-carotene supplementation on lung cancer risk has yet to be studied. The strong association between increased intake of beta-carotene from food and a reduced risk of lung cancer¹⁷ does not necessarily mean that supplementation with natural beta-carotene supplements would reduce the risk of lung cancer. Dietary beta-carotene may be a marker for diets high in certain fruits and vegetables that contain other anticancer substances that may be responsible for the protective effects. Until more is known, some doctors advise smokers to avoid all forms of beta-carotene supplementation—even natural beta-carotene.
3 Stars Night Blindness If deficient: 10,000 to 25,000 IU daily	Night blindness may be an early sign of vitamin A deficiency. Supplementing with beta-carotene, which the body converts into vitamin A, help correct such a deficiency and improve night blindness. Caution: Synthetic beta-carotene has been linked to increased risk of lung cancer in smokers. Until more is known, smokers should avoid all beta-carotene supplements. Night blindness may be an early sign of vitamin A deficiency. Such a deficiency may result from diets low in animal foods (the main source of vitamin A), such as eggs, dairy products, organ meats, and some fish. Low intake of fruits and vegetables containing beta-carotene, which the body converts into vitamin A, may also contribute to a vitamin A deficiency. Doctors often recommend 10,000 to 25,000 IU of vitamin A per day to correct a deficiency. Beta-carotene is less effective at correcting vitamin A deficiency than is vitamin A itself, because it is not absorbed as well and is only slowly converted by the body into vitamin A.
3 Stars Photosensitivity 100,000 to 300,000 IU daily under medical supervision	Beta-carotene is able to protect against free-radical damage caused by ultraviolet light and may help increase tolerance to sunlight. Caution: Synthetic beta-carotene has been linked to increased risk of lung cancer in smokers. Until more is known, smokers should avoid all beta-carotene supplements. Years ago, researchers theorized that beta-carotene in skin might help protect against sensitivity to ultraviolet light from the sun. Large amounts of beta-carotene (up to 300,000 IU per day for at least several months) have allowed people with photosensitivity to stay out in the sun several times longer than they otherwise could tolerate.¹⁸ ^{, 19} ^{, 20} The protective effect appears to result from beta-carotene’s ability to protect against free-radical damage caused by sunlight.²¹
2 Stars Asthma 64 mg a day of natural supplement	Some researchers have suggested that exercise-related asthma attacks might be caused by free-radical damage caused by the exercise. Supplementing with beta-carotene, an antioxidant, protects against free-radical damage and may prevent these attacks. Caution: Synthetic beta-carotene has been linked to increased risk of lung cancer in smokers. Until more is known, smokers should avoid all beta-carotene supplements. Some researchers have suggested that asthma attacks triggered by exercise might be caused by free-radical damage caused by the exercise. Beta-carotene is an antioxidant that protects against free-radical damage. Israeli researchers reported that 64 mg per day of natural beta-carotene for one week in a double blind trial protected over half of a group of asthmatics who experienced attacks as a result of exercise.²² More research is needed to confirm this promising finding.
2 Stars Immune Function 25,000 to 100,000 IU per day for nonsmokers only	Beta-carotene has been shown to increase immune cell numbers and activity. It has also been shown to enhance cancer-fighting immune functions in healthy people. Caution: Synthetic beta-carotene has been linked to increased risk of lung cancer in smokers. Until more is known, smokers should avoid all beta-carotene supplements. Most,²³ ^{, 24} but not all,²⁵ double-blind studies have shown that elderly people have better immune function and reduced infection rates when taking a multiple vitamin-mineral formula. In one double-blind trial, supplements of 100 mcg per day of selenium and 20 mg per day of zinc, with or without additional vitamin C, vitamin E, and beta-carotene, reduced infections in elderly people, though vitamins without minerals had no effect.²⁶ Burn victims have also experienced fewer infections after receiving trace mineral supplements in double-blind research.²⁷ These studies suggest that trace minerals may be the most important micronutrients for enhancing immunity and preventing infections in the elderly. Beta-carotene and other carotenoids have increased immune cell numbers and activity in animal and human research, an effect that appears to be separate from their role as precursors to vitamin A.²⁸ ^{, 29} Placebo-controlled research has shown positive benefits of beta-carotene supplements in increasing numbers of some white blood cells and enhancing cancer-fighting immune functions in healthy people at 25,000–100,000 IU per day.³⁰ ^{, 31} In double-blind trials in the elderly, supplementation with 40,000–150,000 IU per day of beta-carotene has increased natural killer (NK) cell activity,³² but not several other measures of immunity.³³ Controlled research has found that 50,000 IU per day of beta-carotene boosted immunity in people with colon cancer but in not those with precancerous conditions in the colon.³⁴ Beta-carotene has also prevented immune suppression from ultraviolet light exposure.³⁵ Effects on immunodefiency in HIV-positive people have been inconsistent using beta-carotene.³⁶ ^{, 37}
2 Stars Pancreatic Insufficiency 9,000 IU daily	Taking antioxidant supplements, such as beta-carotene, may lessen pain and prevent recurrences of pancreatitis. Caution: Synthetic beta-carotene has been linked to increased risk of lung cancer in smokers. Until more is known, smokers should avoid all beta-carotene supplements. Free radical damage has been linked to pancreatitis in animal and human studies,³⁸ ^{, 39} ^{, 40} suggesting that antioxidants might be beneficial for this disease. One controlled study found that chronic pancreatitis patients consumed diets significantly lower in several antioxidants due to problems such as appetite loss and abdominal symptoms.⁴¹ Several controlled studies found lower blood levels of antioxidants, such as selenium, vitamin A, vitamin E, vitamin C, glutathione, and several carotenoids, in patients with both acute and chronic pancreatitis.⁴² ^{, 43} ^{, 44} ^{, 45} ^{, 46} ^{, 47} There are few controlled trials of antioxidant supplementation to patients with pancreatitis. One small controlled study of acute pancreatitis patients found that sodium selenite at a dose of 500 micrograms (mcg) daily resulted in decreased levels of a marker of free radical activity, and no patient deaths occurred.⁴⁸ In a small double-blind trial including recurrent acute and chronic pancreatitis patients, supplements providing daily doses of 600 mcg selenium, 9,000 IU beta-carotene, 540 mg vitamin C, 270 IU vitamin E, and 2,000 mg methionine significantly reduced pain, normalized several blood measures of antioxidant levels and free radical activity, and prevented acute recurrences of pancreatitis.⁴⁹ These researchers later reported that continuing antioxidant treatment in these patients for up to five years or more significantly reduced the total number of days spent in the hospital and resulted in 78% of patients becoming pain-free and 88% returning to work.⁵⁰ Another double-blind study using similar amounts of selenium, beta-carotene, vitamin C, vitamin E, and methionine as those in the study mentioned above reported significant improvements in pain and overall health in patients with chronic pancreatitis.⁵¹
2 Stars Sunburn 6 mg daily of natural beta-carotene during periods of high sun exposure	Supplementing with beta-carotene may help protect the skin from ultraviolet rays and sunburn. Caution: Synthetic beta-carotene has been linked to increased risk of lung cancer in smokers. Until more is known, smokers should avoid all beta-carotene supplements. Antioxidants may protect the skin from sunburn due to free radical–producing ultraviolet rays.⁵² Combinations of 1,000 to 2,000 IU per day of vitamin E and 2,000 to 3,000 mg per day of vitamin C, but neither given alone, have a significant protective effect against ultraviolet rays, according to double-blind studies.⁵³ ^{, 54} ^{, 55} Oral synthetic beta-carotene alone was not found to provide effective protection when given in amounts of 15 mg per day or for only a few weeks’ time in larger amounts of 60 to 90 mg per day, but it has been effective either in very large amounts (180 mg per day) or in smaller amounts (30 mg per day) in combination with topical sunscreen.⁵⁶ ^{, 57} ^{, 58} ^{, 59} ^{, 60} Natural sources of beta-carotene or other carotenoids have been more consistently shown to protect against sunburn. One controlled study found that taking a supplement of natural carotenoids (almost all of which was beta-carotene) in daily amounts of 30 mg, 60 mg, and 90 mg gave progressively more protection against ultraviolet rays.⁶¹ In another controlled study, either 24 mg per day of natural beta-carotene or 24 mg per day of a carotenoid combination of equal amounts beta-carotene, lutein, and lycopene helped protect skin from ultraviolet rays.⁶² A preliminary study compared synthetic lycopene (10.1 mg per day), a natural tomato extract containing 9.8 mg of lycopene per day plus additional amounts of other carotenoids, and a solubilized tomato drink (designed to increase lycopene absorption) containing 8.2 mg of lycopene plus additional amounts of other carotenoids. After 12 weeks, only the two tomato-based products were shown to give significant protection against burning by ultraviolet light.⁶³ Still other trials have tested combinations of several antioxidants. One preliminary study found that a daily combination of beta-carotene (6 mg), lycopene (6 mg), vitamin E (15 IU), and selenium for seven weeks protected against ultraviolet light.⁶⁴ However, a double-blind trial of a combination of smaller amounts of several carotenoids, vitamins C and E, selenium, and proanthocyanidins did not find significant UV protection compared with placebo.⁶⁵ Similarly, in a controlled trial, a combination of selenium, copper, and vitamins was found to be ineffective.⁶⁶ It should be noted that while protection from sunburn has been demonstrated with several types of orally administered antioxidants, the degree of protection (typically less than an SPF of 2) is much less than that provided by currently available topical sunscreens. On the other hand, these modest effects will provide some added protection to skin areas where sunscreen is also used and will give a small amount of protection to sun-exposed areas where sunscreen is not applied. However, oral protection from sunburn is not instantaneous; maximum effects are not reached until these antioxidants have been used for about eight to ten weeks.⁶⁷ ^{, 68}
1 Star Age-Related Cognitive Decline 50 mg every other day	In one study, long-term beta-carotene supplementation slowed the loss of cognitive function in middle-aged healthy males. Caution: Synthetic beta-carotene has been linked to increased risk of lung cancer in smokers. Until more is known, smokers should avoid all beta-carotene supplements. In a double-blind trial, supplementation with beta-carotene in the amount of 50 mg every other day for 18 years appeared to slow the loss of cognitive function in middle-aged healthy males. Short-term supplementation (one year) was not beneficial.⁶⁹
1 Star Alcohol Withdrawal Refer to label instructions	Though not a treatment for withdrawal, beta-carotene supplementation may be a safe way to correct vitamin A deficiencies common to alcoholics (requires a doctor’s supervision to monitor liver function and avoid damage). Caution: Synthetic beta-carotene has been linked to increased risk of lung cancer in smokers. Until more is known, smokers should avoid all beta-carotene supplements. Although the incidence of B-complex deficiencies is known to be high in alcoholics, the incidence of other vitamin deficiencies remains less clear.⁷⁰ Nonetheless, deficiencies of vitamin A, vitamin D, vitamin E, and vitamin C are seen in many alcoholics. While some reports have suggested it may be safer for alcoholics to supplement with beta-carotene instead of vitamin A,⁷¹ potential problems accompany the use of either vitamin A or beta-carotene in correcting the deficiency induced by alcoholism.⁷² These problems result in part because the combinations of alcohol and vitamin A or alcohol and beta-carotene appear to increase potential damage to the liver. Thus, vitamin A-depleted alcoholics require a doctor’s intervention, including supplementation with vitamin A and beta-carotene accompanied by assessment of liver function. Supplementing with vitamin C, on the other hand, appears to help the body rid itself of alcohol.⁷³ Some doctors recommend 1 to 3 grams per day of vitamin C.
1 Star Cataracts Refer to label instructions	People who eat fruits and vegetables rich in beta-carotene have a lower risk of developing cataracts. Caution: Synthetic beta-carotene has been linked to increased risk of lung cancer in smokers. Until more is known, smokers should avoid all beta-carotene supplements. People with low blood levels of antioxidants and those who eat few antioxidant-rich fruits and vegetables have been reported to be at high risk for cataracts.⁷⁴ ^{, 75} Some,⁷⁶ but not all,⁷⁷ studies have reported that people eating more foods rich in beta-carotene had a lower the risk of developing cataracts. Supplementation with synthetic beta-carotene has not been found to reduce the risk of cataract formation.⁷⁸ It remains unclear whether natural beta-carotene from food or supplements would protect the eye or whether beta-carotene in food is merely a marker for other protective factors in fruits and vegetables high in beta-carotene.
1 Star Gastritis Refer to label instructions	The antioxidant beta-carotene may reduce free radical damage in the stomach, and supplementing with it has led to improvements in people with gastritis in some studies. Caution: Synthetic beta-carotene has been linked to increased risk of lung cancer in smokers. Until more is known, smokers should avoid all beta-carotene supplements. The antioxidant beta-carotene may reduce free radical damage in the stomach,⁷⁹ and eating foods high in beta-carotene has been linked to a decreased risk of developing chronic atrophic gastritis.⁸⁰ Moreover, people with active gastritis have been reported to have low levels of beta-carotene in their stomachs.⁸¹ In a preliminary trial, giving 30,000 IU of beta-carotene per day to people with ulcers or gastritis led to the disappearance of gastric erosions.⁸² In another study, combining vitamin C and beta-carotene also led to improvement in most people with chronic atrophic gastritis.⁸³
1 Star Heart Attack Refer to label instructions	Supplementing with beta-carotene may reduce the likelihood of a heart attack and may improve the outcome for people who have already had a heart attack. Caution: Synthetic beta-carotene has been linked to increased risk of lung cancer in smokers. Until more is known, smokers should avoid all beta-carotene supplements. Blood levels of the antioxidant nutrients vitamins A, C, and E, and beta-carotene are reported to be lower in people with a history of heart attack, compared with healthy individuals.⁸⁴ The number of free radical molecules is also higher, suggesting a need for antioxidants. Streptokinase, a drug therapy commonly used immediately following a heart attack, enhances the need for antioxidants.⁸⁵ Taking antioxidant supplements may improve the outcome for people who have already had a heart attack. In one double-blind trial, people were given 50,000 IU of vitamin A per day, 1,000 mg of vitamin C per day, 600 IU of vitamin E per day, and approximately 41,500 IU of beta-carotene per day or placebo.⁸⁶ After 28 days, the infarct size of those receiving antioxidants was significantly smaller than the infarct size of the placebo group. Low levels of beta-carotene in fatty tissue have been linked to an increased incidence of heart attacks, particularly among smokers.⁸⁷ One population study found that eating a diet high in beta-carotene is associated with a lower rate of nonfatal heart attacks.⁸⁸ However, beta-carotene supplementation may not offer the same protection provided by foods that contain beta-carotene. Most,⁸⁹ ^{, 90} but not all, trials⁹¹ have found that supplemental beta-carotene is not associated with a reduced risk of heart attacks.
1 Star HIV and AIDS Support Refer to label instructions	Beta-carotene levels have been found to be low in HIV-positive people, supplementing with it may be beneficial. Caution: Synthetic beta-carotene has been linked to increased risk of lung cancer in smokers. Until more is known, smokers should avoid all beta-carotene supplements. Beta-carotene levels have been found to be low in HIV-positive people, even in those without symptoms.⁹² However, trials on the effect of beta-carotene supplements have produced conflicting results. In one double-blind trial, supplementing with 300,000 IU per day of beta-carotene significantly increased the number of CD4+ cells in people with HIV infection.⁹³ In a second double-blind study, supplementing with natural mixed carotenoids equivalent to 120,000 IU of beta-carotene per day significantly prolonged survival times in adults with advanced AIDS who were also receiving conventional therapy and a multivitamin.⁹⁴ In another trial, however, 300,000 IU per day of beta-carotene had no effect on CD4+ cell counts or various other measures of immune function in HIV-infected people.⁹⁵
1 Star Macular Degeneration Refer to label instructions	Sunlight triggers oxidative damage in the eye, which can cause macular degeneration. Beta-carotene protects against oxidative damage and may reduce macular degeneration risk. Caution: Synthetic beta-carotene has been linked to increased risk of lung cancer in smokers. Until more is known, smokers should avoid all beta-carotene supplements. Sunlight triggers oxidative damage in the eye, which in turn can cause macular degeneration.⁹⁶ Animals given antioxidants—which protect against oxidative damage—have a lower risk of this vision problem.⁹⁷ People with high blood levels of antioxidants also have a lower risk.⁹⁸ Those with the highest levels (top 20th percentile) of the antioxidants selenium, vitamin C, and vitamin E may have a 70% lower risk of developing macular degeneration, compared with people with the lowest levels of these nutrients (bottom 20th percentile).⁹⁹ People who eat fruits and vegetables high in beta-carotene, another antioxidant, are also at low risk.¹⁰⁰ Some doctors recommend antioxidant supplements to reduce the risk of macular degeneration; reasonable adult levels include 200 mcg of selenium, 1,000 mg of vitamin C, 400 IU of vitamin E, and 25,000 IU of natural beta-carotene per day. However, a preliminary study found no association between age-related macular degeneration and intake of antioxidants, either from the diet, from supplements, or from both combined.¹⁰¹ Moreover, in a double-blind study of male cigarette smokers, supplementing with vitamin E (50 IU per day), synthetic beta-carotene (about 33,000 IU per day), or both did not reduce the incidence of age-related macular degeneration.¹⁰²
1 Star Sickle Cell Anemia Refer to label instructions	Sickle cell anemia patients tend to have low levels of antioxidants, which protect cells from oxygen-related damage. Supplementing with beta-carotene may help correct a deficiency. Caution: Synthetic beta-carotene has been linked to increased risk of lung cancer in smokers. Until more is known, smokers should avoid all beta-carotene supplements. Antioxidant nutrients protect the body’s cells from oxygen-related damage. Many studies show that sickle cell anemia patients tend to have low blood levels of antioxidants, including carotenoids, vitamin A, vitamin E, and vitamin C, despite adequate intake.¹⁰³ ^{, 104} ^{, 105} ^{, 106} ^{, 107} ^{, 108} Low blood levels of vitamin E in particular have been associated with higher numbers of diseased cells in children¹⁰⁹ and with greater frequency of symptoms in adults.¹¹⁰ A small, preliminary trial reported a 44% decrease in the average number of diseased cells in six sickle cell anemia patients given 450 IU vitamin E per day for up to 35 weeks. This effect was maintained as long as supplementation continued.¹¹¹

How It Works

Interactions

Interactions with Medicines

Certain medicines interact with this supplement.

What Are Drug Interactions

Types of interactions: Beneficial Adverse Check

Replenish Depleted Nutrients

Cholestyramine

Use of colestipol for six months has been shown to significantly lower blood levels of carotenoids including beta-carotene.¹⁶²

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Colchicine

Colchicine has been associated with impaired absorption of beta-carotene, fat, lactose (milk sugar), potassium, and sodium.¹⁷⁷

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Colesevelam

Use of colestipol for six months has been shown to significantly lower blood levels of carotenoids including beta-carotene.¹⁷⁸

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Colestipol

Use of colestipol for six months has been shown to significantly lower blood levels of carotenoids including beta-carotene.¹⁷⁹
Lansoprazole

Omeprazole , a drug closely related to lansoprazole, taken for seven days led to a near-total loss of stomach acid in healthy people and interfered with the absorption of a single administration of 120 mg of beta-carotene.²⁴⁸ It is unknown whether repeated administration of beta-carotene would overcome this problem or if absorption of carotenoids from food would be impaired. Persons taking omeprazole and related acid-blocking drugs for long periods may want to have carotenoid blood levels checked, eat plenty of fruits and vegetables, and consider supplementing with carotenoids.

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Mineral Oil

Mineral oil has interfered with the absorption of many nutrients, including beta-carotene, calcium, phosphorus, potassium, and vitamins A, D, K, and E in some,²⁸² but not all,²⁸³ research. Taking mineral oil on an empty stomach may reduce this interference. It makes sense to take a daily multivitamin-mineral supplement two hours before or after mineral oil. It is important to read labels, because many multivitamins do not contain vitamin K or contain inadequate (less than 100 mcg per day) amounts.
Neomycin

Neomycin can decrease absorption or increase elimination of many nutrients, including calcium, carbohydrates, beta-carotene, fats, folic acid, iron, magnesium, potassium, sodium, and vitamin A, vitamin B12, vitamin D, and vitamin K.²⁸⁴ ^{, 285} Surgery preparation with oral neomycin is unlikely to lead to deficiencies. It makes sense for people taking neomycin for more than a few days to also take a multivitamin-mineral supplement.
Orlistat

One well-controlled study showed that taking orlistat greatly reduces the absorption of beta-carotene.²⁸⁶ Therefore, individuals taking orlistat for long periods of time should probably supplement with beta-carotene.

Reduce Side Effects

Busulfan

Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.¹²⁷ Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.¹²⁸ Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.¹²⁹ Applying vitamin E only once per day was helpful to only some groups of patients in another trial,¹³⁰ and not all studies have found vitamin E to be effective.¹³¹ Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).¹³² A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.¹³³

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Capecitabine

Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.¹³⁴ Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.¹³⁵ Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.¹³⁶ Applying vitamin E only once per day was helpful to only some groups of patients in another trial,¹³⁷ and not all studies have found vitamin E to be effective.¹³⁸ Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).¹³⁹ A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.¹⁴⁰

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Carboplatin

Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.¹⁴¹ Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.¹⁴² Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.¹⁴³ Applying vitamin E only once per day was helpful to only some groups of patients in another trial,¹⁴⁴ and not all studies have found vitamin E to be effective.¹⁴⁵ Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).¹⁴⁶ A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.¹⁴⁷

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Carmustine

Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.¹⁴⁸ Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.¹⁴⁹ Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.¹⁵⁰ Applying vitamin E only once per day was helpful to only some groups of patients in another trial,¹⁵¹ and not all studies have found vitamin E to be effective.¹⁵² Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).¹⁵³ A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.¹⁵⁴

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Chlorambucil

Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.¹⁵⁵ Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.¹⁵⁶ Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.¹⁵⁷ Applying vitamin E only once per day was helpful to only some groups of patients in another trial,¹⁵⁸ and not all studies have found vitamin E to be effective.¹⁵⁹ Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).¹⁶⁰ A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.¹⁶¹

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Cisplatin

Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.¹⁶³ Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.¹⁶⁴ Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.¹⁶⁵ Applying vitamin E only once per day was helpful to only some groups of patients in another trial,¹⁶⁶ and not all studies have found vitamin E to be effective.¹⁶⁷ Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).¹⁶⁸ A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.¹⁶⁹

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Cladribine

Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.¹⁷⁰ Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.¹⁷¹ Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.¹⁷² Applying vitamin E only once per day was helpful to only some groups of patients in another trial,¹⁷³ and not all studies have found vitamin E to be effective.¹⁷⁴ Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).¹⁷⁵ A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.¹⁷⁶

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Cyclophosphamide

Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.¹⁸⁰ Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Cytarabine

Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.¹⁸¹ Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.¹⁸² Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.¹⁸³ Applying vitamin E only once per day was helpful to only some groups of patients in another trial,¹⁸⁴ and not all studies have found vitamin E to be effective.¹⁸⁵ Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).¹⁸⁶ A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.¹⁸⁷

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Docetaxel

Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.¹⁸⁸ Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.¹⁸⁹ Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.¹⁹⁰ Applying vitamin E only once per day was helpful to only some groups of patients in another trial,¹⁹¹ and not all studies have found vitamin E to be effective.¹⁹² Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Erlotinib

Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.¹⁹³ Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.¹⁹⁴ Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.¹⁹⁵ Applying vitamin E only once per day was helpful to only some groups of patients in another trial,¹⁹⁶ and not all studies have found vitamin E to be effective.¹⁹⁷ Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).¹⁹⁸ A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.¹⁹⁹

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Etoposide

Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.²⁰⁰ Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.²⁰¹ Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.²⁰² Applying vitamin E only once per day was helpful to only some groups of patients in another trial,²⁰³ and not all studies have found vitamin E to be effective.²⁰⁴ Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).²⁰⁵ A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.²⁰⁶

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Floxuridine

Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.²⁰⁷ Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.²⁰⁸ Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.²⁰⁹ Applying vitamin E only once per day was helpful to only some groups of patients in another trial,²¹⁰ and not all studies have found vitamin E to be effective.²¹¹ Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).²¹² A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.²¹³

The chemotherapy drug cisplatin may cause kidney damage, resulting in depletion of calcium and phosphate.²¹⁴

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Fludarabine

Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.²¹⁵ Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.²¹⁶ Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.²¹⁷ Applying vitamin E only once per day was helpful to only some groups of patients in another trial,²¹⁸ and not all studies have found vitamin E to be effective.²¹⁹ Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).²²⁰ A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.²²¹

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Fluorouracil

Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.²²² Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.²²³ Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.²²⁴ Applying vitamin E only once per day was helpful to only some groups of patients in another trial,²²⁵ and not all studies have found vitamin E to be effective.²²⁶ Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Hydroxyurea

Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.²²⁷ Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.²²⁸ Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.²²⁹ Applying vitamin E only once per day was helpful to only some groups of patients in another trial,²³⁰ and not all studies have found vitamin E to be effective.²³¹ Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).²³² A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.²³³

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Ifosfamide

Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.²³⁴ Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.²³⁵ Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.²³⁶ Applying vitamin E only once per day was helpful to only some groups of patients in another trial,²³⁷ and not all studies have found vitamin E to be effective.²³⁸ Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).²³⁹ A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.²⁴⁰

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Irinotecan

Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.²⁴¹ Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.²⁴² Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.²⁴³ Applying vitamin E only once per day was helpful to only some groups of patients in another trial,²⁴⁴ and not all studies have found vitamin E to be effective.²⁴⁵ Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).²⁴⁶ A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.²⁴⁷

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Lomustine

Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.²⁴⁹ Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.²⁵⁰ Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.²⁵¹ Applying vitamin E only once per day was helpful to only some groups of patients in another trial,²⁵² and not all studies have found vitamin E to be effective.²⁵³ Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).²⁵⁴ A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.²⁵⁵

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Mechlorethamine

Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.²⁵⁶ Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.²⁵⁷ Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.²⁵⁸ Applying vitamin E only once per day was helpful to only some groups of patients in another trial,²⁵⁹ and not all studies have found vitamin E to be effective.²⁶⁰ Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).²⁶¹ A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.²⁶²

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Melphalan

Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.²⁶³ Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.²⁶⁴ Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.²⁶⁵ Applying vitamin E only once per day was helpful to only some groups of patients in another trial,²⁶⁶ and not all studies have found vitamin E to be effective.²⁶⁷ Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).²⁶⁸ A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.²⁶⁹

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Mercaptopurine

Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.²⁷⁰ Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.²⁷¹ Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.²⁷² Applying vitamin E only once per day was helpful to only some groups of patients in another trial,²⁷³ and not all studies have found vitamin E to be effective.²⁷⁴ Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).²⁷⁵ A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.²⁷⁶

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Methotrexate

Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.²⁷⁷ Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.²⁷⁸ Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.²⁷⁹ Applying vitamin E only once per day was helpful to only some groups of patients in another trial,²⁸⁰ and not all studies have found vitamin E to be effective.²⁸¹ Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Paclitaxel

Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.²⁸⁷ Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.²⁸⁸ Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.²⁸⁹ Applying vitamin E only once per day was helpful to only some groups of patients in another trial,²⁹⁰ and not all studies have found vitamin E to be effective.²⁹¹ Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form. In another study, supplementation with vitamin E orally (600 IU per day) reduced the incidence of paclitaxel-induced nerve damage.²⁹²

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Polifeprosan 20 with Carmustine

Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.²⁹³ Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.²⁹⁴ Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.²⁹⁵ Applying vitamin E only once per day was helpful to only some groups of patients in another trial,²⁹⁶ and not all studies have found vitamin E to be effective.²⁹⁷ Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).²⁹⁸ A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.²⁹⁹

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Quinidine

Some people taking quinidine develop sensitivity to ultraviolet radiation from the sun. In a preliminary study, three people with quinidine-induced skin inflammation were able to tolerate intense sun exposure without recurrence of the rash after supplementing with 90–180 mg of beta-carotene each day.³⁰⁰ Further research is needed to confirm that people taking quinidine can prevent side effects by supplementing with beta-carotene.
Thioguanine

Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.³⁰¹ Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.³⁰² Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.³⁰³ Applying vitamin E only once per day was helpful to only some groups of patients in another trial,³⁰⁴ and not all studies have found vitamin E to be effective.³⁰⁵ Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).³⁰⁶ A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.³⁰⁷

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Thiotepa

Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.³⁰⁸ Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.³⁰⁹ Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.³¹⁰ Applying vitamin E only once per day was helpful to only some groups of patients in another trial,³¹¹ and not all studies have found vitamin E to be effective.³¹² Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).³¹³ A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.³¹⁴

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Uracil Mustard

Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.³¹⁵ Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.³¹⁶ Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.³¹⁷ Applying vitamin E only once per day was helpful to only some groups of patients in another trial,³¹⁸ and not all studies have found vitamin E to be effective.³¹⁹ Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).³²⁰ A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.³²¹

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Vinblastine

Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.³²² Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.³²³ Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.³²⁴ Applying vitamin E only once per day was helpful to only some groups of patients in another trial,³²⁵ and not all studies have found vitamin E to be effective.³²⁶ Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).³²⁷ A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.³²⁸

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Vincristine

Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.³²⁹ Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.³³⁰ Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.³³¹ Applying vitamin E only once per day was helpful to only some groups of patients in another trial,³³² and not all studies have found vitamin E to be effective.³³³ Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).³³⁴ A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.³³⁵

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

Support Medicine

none

Reduces Effectiveness

none

Potential Negative Interaction

none

Explanation Required

none

Side Effects

Related Information

References

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132. Pace A, Savarese A, Picardo M, et al. Neuroprotective effect of vitamin E supplementation in patients treated with cisplatin chemotherapy. J Clin Oncol2003;21:927–31.

133. Argyriou AA, Chroni E, Koutras A, et al. Vitamin E for prophylaxis against chemotherapy-induced neuropathy: a randomized controlled trial. Neurology2005;64:26–31.

134. Mills EED. The modifying effect of beta-carotene on radiation and chemotherapy induced oral mucositis. Br J Cancer 1988;57:416–7.

135. Wadleigh RG, Redman RS, Graham ML, et al. Vitamin E in the treatment of chemotherapy-induced mucositis. Am J Med 1992;92:481–4.

136. Lopez I, Goudou C, Ribrag V, et al. Treatment of mucositis with vitamin E during administration of neutropenic antineoplastic agents. Ann Med Intern[Paris] 1994;145:405–8.

137. Lopez I, Goudou C, Ribrag V, et al. Traitement des mucites par la vitamine E lors de l’administration d’anti-neoplasiques neutropeniants. Ann Med Interne 1994;145:405–8.

138. Legha SS, Wang YM, Mackay B, et al. Clinical and pharmacologic investigation of the effects of alpha-tocopherol on Adriamycin cardiotoxicity. Ann NY Acad Sci 1982;393:411–8.

139. Pace A, Savarese A, Picardo M, et al. Neuroprotective effect of vitamin E supplementation in patients treated with cisplatin chemotherapy. J Clin Oncol2003;21:927–31.

140. Argyriou AA, Chroni E, Koutras A, et al. Vitamin E for prophylaxis against chemotherapy-induced neuropathy: a randomized controlled trial. Neurology2005;64:26–31.

141. Mills EED. The modifying effect of beta-carotene on radiation and chemotherapy induced oral mucositis. Br J Cancer 1988;57:416–7.

142. Wadleigh RG, Redman RS, Graham ML, et al. Vitamin E in the treatment of chemotherapy-induced mucositis. Am J Med 1992;92:481–4.

143. Lopez I, Goudou C, Ribrag V, et al. Treatment of mucositis with vitamin E during administration of neutropenic antineoplastic agents. Ann Med Intern[Paris] 1994;145:405–8.

144. Lopez I, Goudou C, Ribrag V, et al. Traitement des mucites par la vitamine E lors de l’administration d’anti-neoplasiques neutropeniants. Ann Med Interne 1994;145:405–8.

145. Legha SS, Wang YM, Mackay B, et al. Clinical and pharmacologic investigation of the effects of alpha-tocopherol on Adriamycin cardiotoxicity. Ann NY Acad Sci 1982;393:411–8.

146. Pace A, Savarese A, Picardo M, et al. Neuroprotective effect of vitamin E supplementation in patients treated with cisplatin chemotherapy. J Clin Oncol2003;21:927–31.

147. Argyriou AA, Chroni E, Koutras A, et al. Vitamin E for prophylaxis against chemotherapy-induced neuropathy: a randomized controlled trial. Neurology2005;64:26–31.

148. Mills EED. The modifying effect of beta-carotene on radiation and chemotherapy induced oral mucositis. Br J Cancer 1988;57:416–7.

149. Wadleigh RG, Redman RS, Graham ML, et al. Vitamin E in the treatment of chemotherapy-induced mucositis. Am J Med 1992;92:481–4.

150. Lopez I, Goudou C, Ribrag V, et al. Treatment of mucositis with vitamin E during administration of neutropenic antineoplastic agents. Ann Med Intern[Paris] 1994;145:405–8.

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326. Legha SS, Wang YM, Mackay B, et al. Clinical and pharmacologic investigation of the effects of alpha-tocopherol on Adriamycin cardiotoxicity. Ann NY Acad Sci 1982;393:411–8.

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Beta-Carotene

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