Vitamin c and drug interactions
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Vitamin C and Drug Interactions: A Comprehensive Overview
Introduction to Vitamin C and Drug Interactions
Vitamin C, also known as ascorbic acid, is a vital nutrient known for its antioxidant properties and role in various metabolic processes. However, its interaction with different drugs can influence both the efficacy and safety of these medications. This article explores the interactions between vitamin C and various drugs, highlighting the potential benefits and risks.
Opioids and Vitamin C: Redox-Signaling Crosstalk
Opioids, widely used for pain management, can cause significant side effects such as respiratory depression and systemic hypoxia, leading to free radical generation. Vitamin C, an essential antioxidant, can mitigate some of these negative effects by quenching reactive oxygen and nitrogen species induced by opioids. However, the interaction is complex, involving downstream effects on signaling pathways like STAT3, HIF1α, and NF-κB, which can influence the production of antioxidant proteins 1.
Vitamin C and Drug Metabolism
Vitamin C can influence drug metabolism by affecting the enzymes and cellular compartments involved in these processes. For instance, tetracycline has been shown to reduce leucocyte ascorbic acid concentrations, potentially by competitive blockage of intracellular metabolism. This interaction underscores the need for further research to understand how vitamin C alters the pharmacological effects of various drugs 2.
Aspirin and Vitamin C: Binding Dynamics with Human Serum Albumin
The interaction between aspirin and vitamin C, particularly in the presence of human serum albumin (HSA), reveals that vitamin C can influence the binding process of aspirin. Studies show that taking vitamin C before aspirin does not affect aspirin absorption, but taking it immediately after aspirin can reduce vitamin C absorption. This suggests a timing consideration for co-administration to maximize health benefits 3.
Intravenous Vitamin C: Usage and Safety
High-dose intravenous vitamin C is commonly used by Complementary and Alternative Medicine (CAM) practitioners for conditions like infections, cancer, and fatigue. While generally safe, it can cause minor side effects such as lethargy and vein irritation. However, serious adverse events have been reported in patients with specific conditions like renal impairment, highlighting the importance of monitoring and caution in such cases 4.
Vitamin C and Antineoplastic Drugs
Vitamin C can antagonize the cytotoxic effects of antineoplastic drugs such as doxorubicin, cisplatin, and methotrexate. Pretreatment with vitamin C has been shown to reduce the therapeutic efficacy of these drugs by preserving mitochondrial membrane potential, which is crucial for the drugs' cytotoxic action. This interaction suggests that vitamin C supplementation during cancer treatment may negatively impact therapeutic outcomes 7.
Vitamin C and Kidney Transplantation
Kidney transplant recipients often face vitamin C deficiency, which is associated with higher mortality. Vitamin C supplementation can improve endothelial function and creatinine clearance in these patients. However, it can interact with post-transplant medications like cyclosporine and interfere with creatinine assays, necessitating careful monitoring and dosage adjustments 8.
Vitamin C and Digestive Enzymes
Vitamin C can affect the interaction between drugs like lovastatin and digestive enzymes such as pepsin, trypsin, and α-chymotrypsin. The presence of vitamin C reduces the binding stability of lovastatin to these enzymes, potentially increasing the concentration of free lovastatin in the bloodstream. This interaction highlights the need to consider dietary vitamin C intake when administering certain medications 9.
Conclusion
Vitamin C interacts with various drugs in complex ways that can influence their efficacy and safety. Understanding these interactions is crucial for optimizing therapeutic outcomes and minimizing adverse effects. Further research is needed to elucidate the underlying mechanisms and develop guidelines for the safe co-administration of vitamin C with different medications.
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Most relevant research papers on this topic
Opioids and Vitamin C: Known Interactions and Potential for Redox-Signaling Crosstalk
Vitamin C may reduce negative side effects of opioids by quenching reactive oxygen and nitrogen species, potentially through signaling crosstalk with the opioid receptor.
Rigorous JournalVitamins and drug metabolism with particular reference to vitamin C
Vitamin C interacts with drugs, potentially reducing leucocyte ascorbic acid concentrations, and its interaction with drugs can influence drug metabolism and pharmacological effects.
Interaction between aspirin and vitamin C with human serum albumin as binary and ternary systems.
Taking vitamin C first does not affect aspirin absorption and may be good for health, but taking it after aspirin reduces vitamin C absorption for human body.
In Vitro StudyVitamin C: Intravenous Use by Complementary and Alternative Medicine Practitioners and Adverse Effects
High dose intravenous vitamin C is widely used by Complementary and Alternative Medicine practitioners, with a few minor side effects, but overall appears remarkably safe.
Observational Study
Highly CitedInteractions between vitamins C and E in human subjects.
Vitamin C and E supplementation in humans shows an in vivo interaction, with ascorbic acid increasing and vitamin E enhancing antioxidant properties.
RCTHighly CitedComparing the interactions of nitrendipine with lysozyme or human serum albumin and the effects of vitamin C and naringin on these interactions by spectroscopy and molecular docking methods.
Nitrendipine's interaction with lysozyme and human serum albumin can be disrupted by vitamin C and naringin, potentially increasing free nitrendipine in the bloodstream.
In Vitro StudyVitamin C antagonizes the cytotoxic effects of antineoplastic drugs.
Vitamin C supplementation before antineoplastic agents may reduce the therapeutic efficacy of these drugs in cancer treatment by preserving mitochondrial membrane potential.
In Vitro StudyHighly CitedVitamin C and kidney transplantation: Nutritional status, potential efficacy, safety, and interactions.
Vitamin C supplementation improves endothelial function and creatinine clearance in kidney transplant recipients, but may cause side effects and interact with medications.
Systematic ReviewStudy on the interaction between lovastatin and three digestive enzymes and the effect of naringin and vitamin C on it by spectroscopy and docking methods.
Naringin and vitamin C in fruit juice may increase the blood concentration of lovastatin, potentially reducing the need for lovastatin prescription frequency or dosage.
In Vitro Study