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Drug Nutrient Interactions

Prescription drug listings are not all-inclusive; drugs listed are common examples. For support of overall health in any individual, the appropriate comprehensive age and gender specific multiple formula, flax oil, and multiple antioxidant formula are recommended. However, for a specific potential deficiency, individuals may add single ingredient supplements to assure repletion. It is important to consider the quality and bioavailability of vitamin and mineral supplements used for these purposes.

Top Drug Categories

Interactions

Anti-anxiety  
[Buspar® (buspirone), Ativan®(lorezepam) - see Benzodiazepines]

Kava- For reasons similar to benzodiazepines, it is recommended to avoid taking kava with buspirone unless otherwise directed by a licensed health care professional.
St. John's Wort, Ginkgo Biloba- Concurrent use of St. John's Wort and buspirone and St. John's Wort and Ginkgo Biloba with buspirone  had resulted in mild serotonin syndrome and should be avoided unless directed by a licensed health care professional.
Grapefruit Juice- Concomitant administration of buspirone and grapefruit juice should be avoided as it increased the concentration of buspirone in the blood.

 

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Antibiotics Vitamin K- The use of cefmetazole sodium has been associated with hypoprothrombinrmia and treated with Vitamin K supplementation.

 

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Antibiotics  
(Aminoglycosides, Cephalosporins, Macrolides, Penicillins, Quinolones, Sulfonamides, Tetracyclines) Calcium, Iron, Magnesium, and Zinc- May prevent the absorption of tetracycline, ciproflaxin, and other antibiotics.

 

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Antibiotics   
Gentamycin and Penicillians Potassium Chloride- Concomitant administration of gentamycin with potassium chloride may lower the absorption of potassium chloride.

 

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Antibiotics   
Extended spectrum Macrolides [Biaxin®(clarithromycin), Zithromax®(azithromycin), Erythromycin, and Tetracyclines] Antacids- Antacids containing magnesium and aluminum have been shown to interfere with azithromycin absorption. People can avoid this by taking azithromycin two hours before or after any aluminum or magnesium containing products. Studies show the magnesium typically found in supplements affects absorption of azythromycin.

 

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Anti-Diabetic  
[Glucophage®(metaformin), Actos®, Avandia®(pioglitazone)] DHEA(Dehydroepiandrosterone)- Metaformin has been shown to increase levels of DHEA in blood.

 

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Antihistamines   
[Claratin®(loratadine), Allegra®(fexofenadine)]

St. John's Wort- Concomitant use of St. John's Wort can have an effect on plasma levels of fexofenadine. Fruit Juices- Co-administration of grapefruit, orange, and apple juices decreases the absorption of fexofenadine.

 

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Anti-Psychotics  
[Zyprexa®(olanzapine), Risperdal®(risperidone)]

Vitamin B6 and E- Reported to effectively treat risperidone -related neuroleptic malignant syndrome. Glycine- Glycine in combination with antiphychotic treatment has shown significant effects on the effectiveness of these drugs. While adjunctive glycine treatment has been shown to improve negative symptoms in combination with clozapine, olanzapine, and risperidone. Additional studies have shown it to be ineffective in combination with clozapine.

Supplementation with glycine in combination with an antipsychotic should only be done under the supervision of a health care professional.

 

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Anti-Seizure   
 [Tegretol®(carbamazepine), Dilantin®(phenytoin), phenobarbital and Mysoline®(primidone). Depakene®(valproic acid) and Depakote®(divalproex) are also anticonvulsant drugs.] Magnesium, Black Pepper, and Caffeine- Concomitant administration of phenytoin (Dilantin®) or phenobarbital with magnesium oxide may lower magnesium oxide's absorption. Concomitant administration of Dilantin® and black pepper and/or long pepper may cause the phenytoin to be absorbed more rapidly and eliminated more slowly. Phenytoin also increases the metabolism and loss of caffeine from the body.

 

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Benzodiazepines Kava- Due to the similarity of effects , it is usually recommended to avoid taking Kava with Benzodiazepines unless otherwise directed by a licensed health care professional.
St. John's Wort- Concomitant administration of St. John's Wort with alprazolam and should be avoided unless otherwise directed by a licensed health care professional.

 

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Beta-Blockers Potassium- Concomitant use of certain Beta-Blockers may increase potassium levels.
Pepper (Piper Nigrum, Piper Longum)- In single dose human study, piperine, a chemical found in black pepper and long pepper, was reported to increase blood levels of propranolol, which could increase the activity and risks of the drug's side effects.
Antacids- One study showed a reduction in absorption of Sotalol (Betapace®) when taken concomitantly with an aluminum oxide or magnesium hydroxide antacid. This interaction can be avoided by taking the medication two hours apart.
Magnesium- Magnesium has been effectively used to treat heart arrythmias that have resulted from administration of Sotalol (Betapace®).

 

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Calcium Channel Blockers Calcium- High level calcium supplementation may reverse the blood pressure-lowering actions of some calcium channel blocker drugs.
Vitamin D- Vitamin D may interfere with the effectiveness of verapamil.
St. John's Wort- A recent study showed that St. John's Wort decreased the bioavailability of R- and S-verapamil.
Fruit Juices- Ingestion of grapefruit, grapefruit juice, and grapefruit products has been shown to increase the adverse effects of calcium channel blockers or similar drugs.

 

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Diuretics, Potassium-Sparing   
[Amiloride, Aldactone®(spironolactone), Dytac®(triamterene)] Magnesium- Magnesium tends to be preserved.

 

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HIV Antivirals St. John's Wort- St. John's Wort has been shown to speed up the elimination of indinavir which may result in resistance to the drug. St. John's Wort should not be taken concomitantly with HIV Antivirals.
Sho-Saiko-To- This herbal medicine has been shown to enhance the antiviral activity of lamivudine.
Carnitine- Depletion of Carnitine levels may be responsible for muscle and nerve damage in patients on Antiviral therapies. Canitine supplementation is recommended.
Antioxidants- A small study showed a positive effect of antioxidant supplementation on hyperlactatemia (elevated levels of lactate in the systemic circulation) in patients on long-term Antiviral therapy.
N-Aceylt Cysteine- Studies have shown supplementation a NAC during Antiviral therapy may reduce AZT toxicity.
Vitamins E and C- Supplementation with Vitamin E has shown to improve  the efficacy of AZT and  supplementation with Vitamins E and C may reduce AZT-related cellular damage.  

 

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NSAIDs (non-steroidal anti-inflammatory drugs) Copper- Copper may enhance the anti-inflammatory effects of NSAIDs. Indomethacin may cause sodium and water retention.

 

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Non-Narcotic Pain Relievers  
[Imitrex®(sumitriptan), Ultram®(tramadol)] St. John's Wort- Potential interactions may occur. Concomitant administration is not advised unless prescribed by a health care professional.

 

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Oral Contraceptives St. John's Wort- Concomitant use of St. John's Wort and oral contraceptives may reduce the effectiveness of the contraceptives and cause breakthrough bleeding.
Serum Iron and Copper- Oral contraceptive use has been associated with an increase in iron and copper levels.

 

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Respiratory Corticosteroids Calcium- Calcium absorption was reduced following administration of oral beclomethasone (inhaler), a respiratory steroid similar to Flonase®.

 

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Synthetic Thyroid Iron and Soy- Iron supplements and soy products taken at the same time as thyroid hormone replacement may interfere with absorption. Thyroid hormone absorption is increased when taken on an empty stomach. Thyroid hormones should be taken an hour before eating, at the same time every day.9

 

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