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Vitamin D Interaction With Prescription Drugs
Vitamin D is essential to maintaining a healthy immune system and strong bones. It might also be useful in preventing many chronic diseases including cancer 1. Vitamin D regulates the amount of minerals such as calcium in the body 1. Because of this, there is a potential for interactions with some common drugs. If you are taking a prescription medication, talk to your doctor or pharmacist before taking vitamin D supplements.
(References 1,2,3)
Water PIlls
If you are taking a diuretic, also called a water pill, your medication can increase your body’s ability to absorb calcium. This can be a problem when combined with vitamin D, which also increases the absorption of calcium. If you absorb too much calcium, you may experience serious side effects including kidney problems. Some common diuretics include:
- thiazide
- chlorothiazide
- hydrochlorothiazide
- indapamide
- metolazone
- chlorthalidone
- If you are taking a diuretic, also called a water pill, your medication can increase your body’s ability to absorb calcium.
- This can be a problem when combined with vitamin D, which also increases the absorption of calcium.
Antacids
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Vitamin D can increase the body’s absorption of aluminum, a common ingredient in many antacids. This can be a problem, particularly if you have kidney disease. To avoid the problem, take vitamin D at least two hours before or four hours after you take an antacid. Also, if you take certain antacids for a long-time, they may impair your body’s ability to absorb vitamin D, according to the University of Maryland Medical Center.
- Vitamin D can increase the body’s absorption of aluminum, a common ingredient in many antacids.
- Also, if you take certain antacids for a long-time, they may impair your body’s ability to absorb vitamin D, according to the University of Maryland Medical Center.
Heart Medications
Calcium affects the heart and because vitamin D increases calcium levels, it can cause problems with a number of common heart medications or drugs that affect the heart. Do not take vitamin D with a heart medication unless you have talked to your doctor first. Some heart medications affected by vitamin D are digoxin and calcium channel blockers like diltiazem, verapamil, nifedipine, nicardipine and amlodipine. Vitamin D can also reduce the effectiveness of some cholesterol lowering drugs known as statins, including atorvastatin and lovastatin, which are used to reduce a major risk factor for heart disease.
- Calcium affects the heart and because vitamin D increases calcium levels, it can cause problems with a number of common heart medications or drugs that affect the heart.
- Vitamin D can also reduce the effectiveness of some cholesterol lowering drugs known as statins, including atorvastatin and lovastatin, which are used to reduce a major risk factor for heart disease.
Other Interactions
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Vitamin D may speed up how fast the liver breaks down certain drugs, which may reduce their effectiveness, according to MedlinePlus. Many drugs fall into this category so be sure to ask your doctor or pharmacist about any medications you are taking before taking a vitamin D supplement. Some common drugs whose effectiveness may be reduced by vitamin D are clarithromycin, cyclosporine, estrogens, indinavir and triazolam. Also, the psoriasis drug calcipotriene is chemically similar to vitamin D and taking the two together may increase the risk of side effects.
- Vitamin D may speed up how fast the liver breaks down certain drugs, which may reduce their effectiveness, according to MedlinePlus.
- Also, the psoriasis drug calcipotriene is chemically similar to vitamin D and taking the two together may increase the risk of side effects.
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References
- American Cancer Society: Vitamin D
- Holick MF, Gordon CM. Patient Guide to Vitamin D Deficiency. The Journal of Clinical Endocrinology & Metabolism. 2011;96(7):1-2. doi:10.1210/jcem.96.7.zeg33a
- Sunyecz JA. The use of calcium and vitamin D in the management of osteoporosis. Ther Clin Risk Manag. 2008;4(4):827-836. doi:10.2147/tcrm.s3552
- Giovannucci E, Liu Y, Hollis BW, Rimm EB. 25-hydroxyvitamin D and risk of myocardial infarction in men: a prospective study. Arch Intern Med. 2008;168(11):1174-1180. doi:10.1001/archinte.168.11.1174
- Gorham ED, Garland CF, Garland FC, et al. Optimal vitamin D status for colorectal cancer prevention: a quantitative meta analysis. Am J Prev Med. 2007;32(3):210-216. doi:10.1016/j.amepre.2006.11.004
- Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. The American Journal of Clinical Nutrition. 2007;85(6):1586-1591. doi:10.1093/ajcn/85.6.1586
- Prentice RL, Pettinger MB, Jackson RD, et al. Health risks and benefits from calcium and vitamin D supplementation: Women’s Health Initiative clinical trial and cohort study. Osteoporos Int. 2013;24(2):567-580. doi:10.1007/s00198-012-2224-2
- Urashima M, Segawa T, Okazaki M, Kurihara M, Wada Y, Ida H. Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr. 2010;91(5):1255-1260. doi:10.3945/ajcn.2009.29094
- Salehpour A, Hosseinpanah F, Shidfar F, et al. A 12-week double-blind randomized clinical trial of vitamin D₃ supplementation on body fat mass in healthy overweight and obese women. Nutr J. 2012;11:78. doi:10.1186/1475-2891-11-78
- Carrillo AE, Flynn MG, Pinkston C, et al. Impact of vitamin D supplementation during a resistance training intervention on body composition, muscle function, and glucose tolerance in overweight and obese adults. Clin Nutr. 2013;32(3):375-381. doi:10.1016/j.clnu.2012.08.014
- Marcinowska-Suchowierska E, Kupisz-Urbańska M, Łukaszkiewicz J, Płudowski P, Jones G. Vitamin D Toxicity-A Clinical Perspective. Front Endocrinol. 2018;9:550. doi:10.3389/fendo.2018.00550
- Ross AC, Manson JE, Abrams SA, et al. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab. 2011;96(1):53-58. doi:10.1210/jc.2010-2704
- Bouillon R, Van Schoor NM, Gielen E, et al. Optimal vitamin D status: a critical analysis on the basis of evidence-based medicine. J Clin Endocrinol Metab. 2013;98(8):E1283-E1304. doi:10.1210/jc.2013-1195
- American Academy of Dermatology. Position Statement of Vitamin D. 2010.
- Taksler GB, Cutler DM, Giovannucci E, Keating NL. Vitamin D deficiency in minority populations. Public Health Nutr. 2015;18(3):379-391. doi:10.1017/S1368980014000457
- Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(7):1911-1930. doi:10.1210/jc.2011-0385
- Cannell JJ, Vieth R, Umhau JC, et al. Epidemic Influenza and Vitamin D. Epidemiol Infect. 2006; 134:1129-40.
- Carrillo AE1, Flynn MG, Pinkston C, Markofski MM, Jiang Y, Donkin SS, Teegarden D. Impact of Vitamin D Supplementation During a Resistance Training Intervention on Body Composition, Muscle Function, and Glucose Tolerance in Overweight and Obese Adults. Clin Nutr. 2013 Jun;32(3):375-81. doi: 10.1016/j.clnu.2012.08.014. Epub 2012 Aug 31.
- Ginde AA, Mansbach JM, Camargo CA, Jr. Association Between Serum 25-Hydroxyvitamin D Level and Upper Respiratory Tract Infection in the Third National Health and Nutrition Examination Survey. Arch Intern Med. 2009; 169:384-90.
- Giovannucci E, Liu Y, Hollis BW, Rimm EB. 25-hydroxyvitamin D and Risk of Myocardial Infarction in Men: a Prospective Study. Arch Intern Med. 2008; 168:1174-80.
- Gorham ED, Garland CF, Garland FC, Grant WB, Mohr SB, Lipkin M, Newmark HL, Giovannucci E, Wei M, Holick MF. Optimal Vitamin D Status for Colorectal Cancer Prevention: a Quantitative Meta-analysis. Am J Prev Med. 2007 Mar;32(3):210-6.
- Heaney, Robert P. “The Vitamin D Requirement in Health and Disease.” The Journal of Steroid Biochemistry & Molecular Biology 97 (2005):13-9.
- Holick MF. Vitamin D. In: Shils M, Olson J, Shike M, Ross AC, ed. Modern Nutrition in Health and Disease, 9th ed. Baltimore: Williams and Wilkins, 1999.
- National Institutes of Health Office of Dietary Supplements. Vitamin D: Dietary Supplement Fact Sheet. University of Ottawa Evidence-based Practice Center. Effectiveness and Safety of Vitamin D in Relation to Bone Health. Agency for Healthcare Research and Quality. Aug 2007: 07-E013.
- Salehpour A1, Hosseinpanah F, Shidfar F, Vafa M, Razaghi M, Dehghani S, Hoshiarrad A, Gohari M. A 12-week Double-blind Randomized Clinical Trial of Vitamin D₃ Supplementation on Body Fat Mass in Healthy Overweight and Obese Women. Nutr J. 2012 Sep 22;11:78. doi: 10.1186/1475-2891-11-78.
- Urashima M, Segawa T, Okazaki M, Kurihara M, Wada Y, Ida H. Randomized Trial of Vitamin D Supplementation to Prevent Seasonal Influenza A in Schoolchildren. Am J Clin Nutr. 2010 91:1255-60. Epub 2010 Mar 10.
- Wilkins, Consuelo H. and Yvette I. Sheline, et al. “Vitamin D Deficiency Is Associated with Low Mood and Worse Cognitive Performance in Older Adults.” American Journal of Geriatric Psychiatry 14 (2006): 1032-40.
Writer Bio
Louise Lyon has been a writer since 1989. Her work has appeared in "Family Doctor," "AARP Bulletin," "Focus on Healthy Aging" and other national publications covering health and science. She holds a Master of Science degree from the Columbia University School of Journalism.