Medications that interfere with vitamin d absorption
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Medications That Interfere with Vitamin D Absorption
Introduction to Vitamin D and Medication Interactions
Vitamin D is essential for calcium absorption, bone health, and immune function. However, certain medications can interfere with vitamin D metabolism, leading to deficiencies that may impact overall health. This article explores various drugs known to affect vitamin D absorption and metabolism.
Anti-Epileptics and Vitamin D Absorption
Anti-epileptic drugs (AEDs) are commonly associated with reduced vitamin D levels. These medications can induce liver enzymes that accelerate the breakdown of vitamin D, leading to lower serum levels and potential deficiencies1.
Impact of Diuretics on Vitamin D Status
Diuretics, including loop diuretics and thiazide diuretics, can also affect vitamin D metabolism. Loop diuretics may increase the excretion of calcium, indirectly affecting vitamin D status, while thiazide diuretics can increase calcium levels, potentially leading to imbalances in vitamin D metabolism1.
Proton Pump Inhibitors and Histamine H2-Receptor Antagonists
Proton pump inhibitors (PPIs) and histamine H2-receptor antagonists, commonly used to treat acid reflux and peptic ulcers, can interfere with vitamin D absorption by reducing stomach acidity, which is necessary for the absorption of vitamin D1.
Bile Acid Sequestrants and Lipase Inhibitors
Bile acid sequestrants and lipase inhibitors, used to manage cholesterol levels and obesity, respectively, can bind to vitamin D in the gut, preventing its absorption and leading to deficiencies1.
Corticosteroids and Vitamin D Metabolism
Corticosteroids, often prescribed for inflammatory conditions, can impair vitamin D metabolism by reducing calcium absorption in the intestines and increasing calcium excretion in the kidneys, which can lead to lower vitamin D levels1.
Antimicrobials and Antiretroviral Agents
Certain antimicrobials and highly active antiretroviral agents (HAART) used in the treatment of infections and HIV can disrupt vitamin D metabolism. These drugs may induce liver enzymes that metabolize vitamin D, leading to decreased levels1.
Statins and Vitamin D
Statins, widely used to lower cholesterol, have been shown to interfere with vitamin D metabolism. However, some studies suggest that vitamin D supplementation can enhance the pharmacologic action of statins, indicating a complex interaction2 3.
Conclusion
A wide range of medications, including anti-epileptics, diuretics, PPIs, bile acid sequestrants, corticosteroids, antimicrobials, and statins, can interfere with vitamin D absorption and metabolism. Healthcare providers should be aware of these interactions, especially in patients on long-term medication regimens, and consider vitamin D supplementation when necessary to prevent deficiencies and maintain optimal health.
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Most relevant research papers on this topic
A Literature Review of the Potential Impact of Medication on Vitamin D Status
Medication use may affect vitamin D status, highlighting the need for healthcare providers to be aware of potential depletions and provide supplementation if necessary.
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Rigorous JournalInfluence of drugs on vitamin D and calcium metabolism
Drug interactions can disrupt vitamin D metabolism and calcium metabolism, and vitamin D supplementation can enhance the pharmacologic action of certain drugs.
Highly CitedCommon drugs as vitamin D disruptors
Common drugs can disrupt vitamin D metabolism and function, and supplementation with vitamin D can enhance the pharmacologic action of certain drugs.
ED-71, a vitamin D analog, is a more potent inhibitor of bone resorption than alfacalcidol in an estrogen-deficient rat model of osteoporosis.
ED-71 is a more potent inhibitor of bone resorption than alfacalcidol, making it an attractive candidate for an antiosteoporotic drug in an estrogen-deficient rat model of osteoporosis.
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Very Rigorous JournalVitamin D Bioavailability: State of the Art
Ergocalciferol and 25-hydroxyvitamin D are both absorbed similarly, but 25-hydroxyvitamin D is better absorbed, and aging has no effect on vitamin D absorption efficiency.
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Stable Crohn's disease patients can follow calcium and vitamin D guidelines similar to non-CD adults, suggesting that other factors may impair intestinal calcium absorption.
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