Nutritional Supplement

Vitamin D

  • Negative Interactions

    2
    • Vitamin D

      Verapamil

      Potential Negative Interaction

      Vitamin D may interfere with the effectiveness of verapamil. People taking verapamil should ask their doctor before using vitamin D-containing supplements.

      Verapamil
      Vitamin D
      ×
      1. Threlkeld DS, ed. Diuretics and Cardiovasculars, Calcium Channel Blocking Agents. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Nov 1992, 150-b.
    • Vitamin D

      Warfarin

      Potential Negative Interaction

      In 1975, a single letter to the Journal of the American Medical Association suggested that vitamin D increases the activity of anticoagulants and that this interaction could prove dangerous. However, there have been no other reports of such an interaction, even though tens of millions of people are taking multivitamins that contain vitamin D. Most doctors typically do not tell patients taking anticoagulant medications to avoid vitamin D.

      Warfarin
      Vitamin D
      ×
      1. Schrogie JJ. Coagulopathy and fat soluble vitamins. JAMA 1975;232:19 [letter].
  • Supportive Interactions

    64
    • Vitamin D

      Amphotericin B

      Replenish Depleted Nutrients

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Oral corticosteroids have been found to increase urinary loss of vitamin K, vitamin C, selenium, and zinc. The importance of these losses is unknown.

      Amphotericin B
      Vitamin D
      ×
      1. Buist RA. Drug-nutrient interactions—an overview. Int Clin Nutr Rev 1984;4:114 [review].
      2. Peretz AM, Neve JD, Famaey JP. Selenium in rheumatic diseases. Semin Arthritis Rheum 1991;20:305-16 [review].
    • Vitamin D

      Amphotericin B Chol Sulf Cmplx

      Replenish Depleted Nutrients

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Oral corticosteroids have been found to increase urinary loss of vitamin K, vitamin C, selenium, and zinc. The importance of these losses is unknown.

      Amphotericin B Chol Sulf Cmplx
      Vitamin D
      ×
      1. Buist RA. Drug-nutrient interactions—an overview. Int Clin Nutr Rev 1984;4:114 [review].
      2. Peretz AM, Neve JD, Famaey JP. Selenium in rheumatic diseases. Semin Arthritis Rheum 1991;20:305-16 [review].
    • Vitamin D

      Amphotericin B Lipid Complex

      Replenish Depleted Nutrients

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Oral corticosteroids have been found to increase urinary loss of vitamin K, vitamin C, selenium, and zinc. The importance of these losses is unknown.

      Amphotericin B Lipid Complex
      Vitamin D
      ×
      1. Buist RA. Drug-nutrient interactions—an overview. Int Clin Nutr Rev 1984;4:114 [review].
      2. Peretz AM, Neve JD, Famaey JP. Selenium in rheumatic diseases. Semin Arthritis Rheum 1991;20:305-16 [review].
    • Vitamin D

      Amphotericin B Liposome

      Replenish Depleted Nutrients

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Oral corticosteroids have been found to increase urinary loss of vitamin K, vitamin C, selenium, and zinc. The importance of these losses is unknown.

      Amphotericin B Liposome
      Vitamin D
      ×
      1. Buist RA. Drug-nutrient interactions—an overview. Int Clin Nutr Rev 1984;4:114 [review].
      2. Peretz AM, Neve JD, Famaey JP. Selenium in rheumatic diseases. Semin Arthritis Rheum 1991;20:305-16 [review].
    • Vitamin D

      Carbamazepine

      Replenish Depleted Nutrients

      Though research results vary, long-term use of anticonvulsant drugs appears to interfere with vitamin D activity, which might lead to softening of bones (osteomalacia). One study showed that blood levels of vitamin D in males taking anticonvulsants were lower than those found in men who were not taking seizure medication. In a controlled study, bone strength improved in children taking anticonvulsant drugs who were supplemented with the activated form of vitamin D and 500 mg per day of calcium for nine months. Some research suggests that differences in exposure to sunlight—which normally increases blood levels of vitamin D—might explain why some studies have failed to find a beneficial effect of vitamin D supplementation. In one controlled study, blood vitamin D levels in children taking anticonvulsants were dramatically lower in winter months than in summer months. Another study of 450 people in Florida taking anticonvulsants found that few had drug-induced bone disease. Consequently, people taking anticonvulsant drugs who do not receive adequate sunlight should supplement with 400 IU of vitamin D each day to help prevent osteomalacia.

      Carbamazepine
      Vitamin D
      ×
      1. Nettekoven S, Strohle A, Trunz B, et al. Effects of antiepileptic drug therapy on vitamin D status and biochemical markers of bone turnover in children with epilepsy.Eur J Pediatr 2008;167:1369-77.
      2. Telci A, Cakatay U, Kurt BB, et al. Changes in bone turnover and deoxypyridinoline levels in epileptic patients Clin Chem Lab Med 2000 38:47-50.
      3. Jekovec-Vrhovsek M, Kocijancic A, Prezelj J. Effect of vitamin D and calcium on bone mineral density in children with CP and epilepsy in full-time care. Dev Med Child Neurol 2000;42:403-5.
      4. Riancho JA, Del Arco C, Arteaga R, et al. Influence of solar irradiation on vitamin D levels in children on anticonvulsant drugs. Acta Neurol Scand 1989;79:296-9.
      5. Williams C, Netzloff M, Folkerts L, et al. Vitamin D metabolism and anticonvulsant therapy: effect of sunshine on incidence of osteomalacia. South Med J 1984;77:834.
    • Vitamin D

      Cholestyramine

      Replenish Depleted Nutrients

      Bile acid sequestrants may prevent absorption of folic acid and the fat-soluble vitamins A, D, E, and K. Other medications and vitamin supplements should be taken one hour before or four to six hours after bile acid sequestrants for optimal absorption. Animal studies suggest calcium and zinc may also be depleted by taking cholestyramine.

      Cholestyramine
      Vitamin D
      ×
      1. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 221-2 [review].
      2. Threlkeld DS, ed. Diuretics and Cardiovasculars, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1997, 171i-l.
      3. Watkins DW, Cassidy MM, Khalafi R, Vahouny GV. Calcium and zinc balances in rats chronically fed the bile salt-sequestrant cholestyramine (Questran). Fed Proc 1983;42:819.
    • Vitamin D

      Cimetidine

      Replenish Depleted Nutrients

      Cimetidine may reduce vitamin D activation by the liver. Lab tests can measure activated vitamin D levels in the blood. Forms of vitamin D that do not require liver activation are available, but only by prescription.

      Cimetidine
      Vitamin D
      ×
      1. Anonymous. Cimetidine inhibits the hepatic hydroxylation of vitamin D. Nutr Rev 1985;43:184-5 [review].
    • Vitamin D

      Colesevelam

      Replenish Depleted Nutrients

      Bile acid sequestrants may prevent absorption of folic acid and the fat-soluble vitamins A, D, E, and K. Other medications and vitamin supplements should be taken one hour before or four to six hours after bile acid sequestrants for optimal absorption. Animal studies suggest calcium and zinc may also be depleted by taking cholestyramine.

      Colesevelam
      Vitamin D
      ×
      1. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 221-2 [review].
      2. Threlkeld DS, ed. Diuretics and Cardiovasculars, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1997, 171i-l.
      3. Watkins DW, Cassidy MM, Khalafi R, Vahouny GV. Calcium and zinc balances in rats chronically fed the bile salt-sequestrant cholestyramine (Questran). Fed Proc 1983;42:819.
    • Vitamin D

      Colestipol

      Replenish Depleted Nutrients

      Bile acid sequestrants, including colestipol, may prevent absorption of folic acid and the fat-soluble vitamins A, D, E, K. People taking colestipol should consult with their doctor about vitamin malabsorption and supplementation. People should take other drugs and vitamin supplements one hour before or four to six hours after colestipol to improve absorption.

      Animal studies suggest calcium and zinc may be depleted by taking cholestyramine, another bile acid sequestrant. Whether these same interactions would occur with colestipol is not known.

      Colestipol
      Vitamin D
      ×
      1. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 224 [review].
      2. Threlkeld DS, ed. Cardiovascular Drugs, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1999, 171L.
      3. Threlkeld DS(ed). Cardiovascular Drugs, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1999, 171L.
      4. Watkins DW, Cassidy MM, Khalafi R, Vahouny GV. Calcium and zinc balances in rats chronically fed the bile salt-sequestrant cholestyramine (Questran). Fed Proc 1983;42:819.
    • Vitamin D

      Cortisone

      Replenish Depleted Nutrients

      Oral corticosteroids have been found to increase urinary loss of vitamin K, vitamin C, selenium, and zinc. The importance of these losses is unknown.

      Cortisone
      Vitamin D
      ×
      1. Buist RA. Drug-nutrient interactions—an overview. Int Clin Nutr Rev 1984;4:114 [review].
      2. Peretz AM, Neve JD, Famaey JP. Selenium in rheumatic diseases. Semin Arthritis Rheum 1991;20:305-16 [review].
    • Calcium and Vitamin D

      Dexamethasone

      Replenish Depleted Nutrients

      Oral corticosteroids reduce absorption of calcium and interfere with the activation and metabolism of the vitamin, increasing the risk of bone loss. Doctors can measure levels of activated vitamin D (called 1,25 dihydroxycholecalciferol) to determine whether a deficiency exists; if so, activated vitamin D is only available by prescription. A study of rheumatoid arthritis patients treated with low amounts of prednisone found that those who received 1,000 mg of calcium per day plus 500 IU of vitamin D per day for two years experienced no bone loss during that time period. An analysis of properly conducted trials concluded that supplementation with vitamin D and calcium was more effective than placebo or calcium alone in protecting against corticosteroid-induced osteoporosis. Most doctors recommend 1,000 mg of calcium and 400–800 IU vitamin D per day for the prevention of osteoporosis.

      Dexamethasone
      Calcium and Vitamin D
      ×
      1. Hahn TJ, Halstead LR, Baran DT. Effects off short term glucocorticoid administration on intestinal calcium absorption and circulating vitamin D metabolite concentrations in man. J Clin Endocrinol Metab 1981;52:111-5.
      2. Trovato A, Nuhlicek DN, Midtling JE. Drug-nutrient interactions. Am Family Phys 1991;44:1651-8.
      3. Chesney RW, Mazess RB, Hamstra AJ, et al. Reduction of serum-1,25-dihydroxyvitamin-D, in children receiving glucocorticoids. Lancet 1978;ii:1123-5.
      4. Nielsen HK, Eriksen EF, Storm T, Mosekilde K. The effects of short-term, high-dose prednisone on the nuclear uptake of 1,25-dihydroxyvitamin D3 in monocytes from normal human subjects. Metabolism 1988;37:109-14.
      5. Avioli LV. Serum 25-hydroxyvitamin D concentrations in patients receiving chronic corticosteroid therapy. J Lab Clin Med 1977;23:399-404.
      6. Buckley LM, Leib ES, Cartularo KS, et al. Calcium and vitamin D3 supplementation prevents bone loss in the spine secondary to low-dose corticosteroids in patients with rheumatoid arthritis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1996;125:961-8.
      7. Amin S, LaValley PM, Simms RW, Felson DT. The role of vitamin D in corticosteroid-induced osteoporosis. Arthritis Rheum 1999;42:1740-51.
    • Vitamin D

      Diclofenac-Misoprostol

      Replenish Depleted Nutrients

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Elevated calcium and vitamin D blood levels are commonly found in people with sarcoidosis. In one individual with sarcoidosis, taking flubiprofen lowered elevated blood calcium levels, but did not alter the concentration of vitamin D. One controlled study showed that flurbiprofen reduced blood levels of vitamin D in people with frequent calcium kidney stones. Further research is needed to determine whether flurbiprofen reduces blood calcium and vitamin D levels in healthy people.

      Diclofenac-Misoprostol
      Vitamin D
      ×
      1. Brown RC, Heyburn PJ, Littlewood TJ, Beck P. Prostaglandin synthetase inhibition in hypercalcaemia with sarcoidosis. Lancet 1984;2:37.
    • Vitamin D

      Felbamate

      Replenish Depleted Nutrients

      Though research results vary, long-term use of anticonvulsant drugs appears to interfere with vitamin D activity, which might lead to softening of bones (osteomalacia). One study showed that blood levels of vitamin D in males taking anticonvulsants were lower than those found in men who were not taking seizure medication. In a controlled study, bone strength improved in children taking anticonvulsant drugs who were supplemented with the activated form of vitamin D and 500 mg per day of calcium for nine months. Some research suggests that differences in exposure to sunlight—which normally increases blood levels of vitamin D—might explain why some studies have failed to find a beneficial effect of vitamin D supplementation. In one controlled study, blood vitamin D levels in children taking anticonvulsants were dramatically lower in winter months than in summer months. Another study of 450 people in Florida taking anticonvulsants found that few had drug-induced bone disease. Consequently, people taking anticonvulsant drugs who do not receive adequate sunlight should supplement with 400 IU of vitamin D each day to help prevent osteomalacia.

      Felbamate
      Vitamin D
      ×
      1. Nettekoven S, Strohle A, Trunz B, et al. Effects of antiepileptic drug therapy on vitamin D status and biochemical markers of bone turnover in children with epilepsy.Eur J Pediatr 2008;167:1369-77.
      2. Telci A, Cakatay U, Kurt BB, et al. Changes in bone turnover and deoxypyridinoline levels in epileptic patients Clin Chem Lab Med 2000 38:47-50.
      3. Jekovec-Vrhovsek M, Kocijancic A, Prezelj J. Effect of vitamin D and calcium on bone mineral density in children with CP and epilepsy in full-time care. Dev Med Child Neurol 2000;42:403-5.
      4. Riancho JA, Del Arco C, Arteaga R, et al. Influence of solar irradiation on vitamin D levels in children on anticonvulsant drugs. Acta Neurol Scand 1989;79:296-9.
      5. Williams C, Netzloff M, Folkerts L, et al. Vitamin D metabolism and anticonvulsant therapy: effect of sunshine on incidence of osteomalacia. South Med J 1984;77:834.
    • Vitamin D

      Heparin

      Replenish Depleted Nutrients

      Heparin may interfere with activation of vitamin D in the body.Osteoporosis (thinning of the bone) has been reported in patients who received high amounts of heparin for several months. Osteopenia (decreased bone density) has been reported in women who received heparin therapy during pregnancy.

      Heparin
      Vitamin D
      ×
      1. Aarskog D, Aksens L, Markestad TK, et al. Heparin induced inhibition of 1,25-dihydroxyvitamin D formation. Am J Obstet Gynecol 1984;148:1141-2.
      2. Majerus PW, Broze GJ Jr, Miletich JP, Tollefsen DM. Anticoagulant, thrombolytic, and antiplatelet drugs. In Goodman and Gilman's The Pharmacological Basis of Therapeutics, 9th ed. New York: McGraw-Hill 1996, 1346.
      3. Wise PH, Hall AS. Heparin induced osteopenia in pregnancy. BMJ 1980;281:110-1.
      4. Haram K, Hervig T, Thordarson H, Aksnes L. Osteopenia caused by heparin treatment in pregnancy. Acta Obstet Gynecol Scand 1993;72:674-5.
    • Calcium and Vitamin D

      Hydroxychloroquine

      Replenish Depleted Nutrients

      Normally, the active form of vitamin D increases the absorption of calcium into the body. In a 45-year-old woman with sarcoidosis, taking hydroxychloroquine blocked the formation of active vitamin D, which helped normalize elevated blood levels of calcium in this case. Whether hydroxychloroquine has this effect in people who don’t have sarcoidosis or elevated calcium is unknown. Until controlled research explores this interaction more thoroughly, people taking hydroxychloroquine might consider having their vitamin D and/or calcium status monitored by a health practitioner.

      Hydroxychloroquine
      Calcium and Vitamin D
      ×
      1. Barre PE, Gascon-Barre M, Meakins JL, Goltzman D. Hydroxychloroquine treatment of hypercalcemia in a patient with sarcoidosis undergoing hemodialysis. Am J Med 1987;82:1259-62.
    • Vitamin D

      Isoniazid

      Replenish Depleted Nutrients

      Isoniazid may interfere with the activity of other nutrients, including vitamin B3 (niacin), vitamin B12, vitamin D, and vitamin E, folic acid, calcium, and magnesium. People should consider using a daily multivitamin-mineral supplement during isoniazid therapy.

      Isoniazid
      Vitamin D
      ×
      1. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 231-2 [review].
      2. Holt GA. Food & Drug Interactions. Chicago, Precept Press, 1998, 146-7.
    • Vitamin D

      Levetiracetam

      Replenish Depleted Nutrients

      Though research results vary, long-term use of anticonvulsant drugs appears to interfere with vitamin D activity, which might lead to softening of bones (osteomalacia). One study showed that blood levels of vitamin D in males taking anticonvulsants were lower than those found in men who were not taking seizure medication. In a controlled study, bone strength improved in children taking anticonvulsant drugs who were supplemented with the activated form of vitamin D and 500 mg per day of calcium for nine months. Some research suggests that differences in exposure to sunlight—which normally increases blood levels of vitamin D—might explain why some studies have failed to find a beneficial effect of vitamin D supplementation. In one controlled study, blood vitamin D levels in children taking anticonvulsants were dramatically lower in winter months than in summer months. Another study of 450 people in Florida taking anticonvulsants found that few had drug-induced bone disease. Consequently, people taking anticonvulsant drugs who do not receive adequate sunlight should supplement with 400 IU of vitamin D each day to help prevent osteomalacia.

      Levetiracetam
      Vitamin D
      ×
      1. Nettekoven S, Strohle A, Trunz B, et al. Effects of antiepileptic drug therapy on vitamin D status and biochemical markers of bone turnover in children with epilepsy.Eur J Pediatr 2008;167:1369-77.
      2. Telci A, Cakatay U, Kurt BB, et al. Changes in bone turnover and deoxypyridinoline levels in epileptic patients Clin Chem Lab Med 2000 38:47-50.
      3. Jekovec-Vrhovsek M, Kocijancic A, Prezelj J. Effect of vitamin D and calcium on bone mineral density in children with CP and epilepsy in full-time care. Dev Med Child Neurol 2000;42:403-5.
      4. Riancho JA, Del Arco C, Arteaga R, et al. Influence of solar irradiation on vitamin D levels in children on anticonvulsant drugs. Acta Neurol Scand 1989;79:296-9.
      5. Williams C, Netzloff M, Folkerts L, et al. Vitamin D metabolism and anticonvulsant therapy: effect of sunshine on incidence of osteomalacia. South Med J 1984;77:834.
    • Vitamin D

      Mineral Oil

      Replenish Depleted Nutrients

      Mineral oil has interfered with the absorption of many nutrients, including beta-carotene, phosphorus, potassium, and vitamins A, D, K, and E in some, but not all, 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.

      Mineral Oil
      Vitamin D
      ×
      1. Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 176.
      2. Clark JH, Russell GJ, Fitzgerald JF, Nagamori KE. Serum beta-carotene, retinol, and alpha-tocopherol levels during mineral oil therapy for constipation. Am J Dis Child 1987;141:1210-2.
    • Vitamin D

      Naproxen-Esomeprazole Mag

      Replenish Depleted Nutrients

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Elevated calcium and vitamin D blood levels are commonly found in people with sarcoidosis. In one individual with sarcoidosis, taking flubiprofen lowered elevated blood calcium levels, but did not alter the concentration of vitamin D. One controlled study showed that flurbiprofen reduced blood levels of vitamin D in people with frequent calcium kidney stones. Further research is needed to determine whether flurbiprofen reduces blood calcium and vitamin D levels in healthy people.

      Naproxen-Esomeprazole Mag
      Vitamin D
      ×
      1. Brown RC, Heyburn PJ, Littlewood TJ, Beck P. Prostaglandin synthetase inhibition in hypercalcaemia with sarcoidosis. Lancet 1984;2:37.
    • Vitamin D

      Neomycin

      Replenish Depleted Nutrients

      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. 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.

      Neomycin
      Vitamin D
      ×
      1. Roe DA. Drug-Induced Nutritional Deficiencies, 2d ed. Westport, CT: Avi Publishing, 1985, 157-8 [review].
      2. Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998, 183.
    • Vitamin D

      Nystatin

      Replenish Depleted Nutrients

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Oral corticosteroids have been found to increase urinary loss of vitamin K, vitamin C, selenium, and zinc. The importance of these losses is unknown.

      Nystatin
      Vitamin D
      ×
      1. Buist RA. Drug-nutrient interactions—an overview. Int Clin Nutr Rev 1984;4:114 [review].
      2. Peretz AM, Neve JD, Famaey JP. Selenium in rheumatic diseases. Semin Arthritis Rheum 1991;20:305-16 [review].
    • Vitamin D

      Orlistat

      Replenish Depleted Nutrients

      In one well-controlled study, taking orlistat for six months resulted in reduced blood levels of vitamins A and D, though levels for most individuals remained within the normal range. However, a few people developed levels low enough to require supplementation. Other studies have shown that taking orlistat had no affect on blood vitamin A levels. Although additional research is needed, the current evidence suggests that individuals taking orlistat for more than six months should supplement with vitamins A and D.

      Orlistat
      Vitamin D
      ×
      1. Van Gaal LF, Broom JI, Enzi G, Toplak H. Efficacy and tolerability of orlistat in the treatment of obesity: a 6-month dose ranging study. Orlistat Dose-Ranging Study Group. Eur J Clin Pharmacol 1998;54:125-32.
      2. Melia AT, Koss-Twardy SG, Zhi J. The effect of orlistat, an inhibitor of dietary fat absorption, on the absorption of vitamins A and E in healthy volunteers. J Clin Pharmacol 1996;36:647-53.
      3. James WP, Aveell A, Broom J, Whitehead J. A one-year trial to assess the value of orlistat in the management of obesity. Int J Obes Relat Metab Disord 1997;21 Suppl 3:S24-30.
    • Vitamin D

      Oxcarbazepine

      Replenish Depleted Nutrients

      Though research results vary, long-term use of anticonvulsant drugs appears to interfere with vitamin D activity, which might lead to softening of bones (osteomalacia). One study showed that blood levels of vitamin D in males taking anticonvulsants were lower than those found in men who were not taking seizure medication. In a controlled study, bone strength improved in children taking anticonvulsant drugs who were supplemented with the activated form of vitamin D and 500 mg per day of calcium for nine months. Some research suggests that differences in exposure to sunlight—which normally increases blood levels of vitamin D—might explain why some studies have failed to find a beneficial effect of vitamin D supplementation. In one controlled study, blood vitamin D levels in children taking anticonvulsants were dramatically lower in winter months than in summer months. Another study of 450 people in Florida taking anticonvulsants found that few had drug-induced bone disease. Consequently, people taking anticonvulsant drugs who do not receive adequate sunlight should supplement with 400 IU of vitamin D each day to help prevent osteomalacia.

      Oxcarbazepine
      Vitamin D
      ×
      1. Nettekoven S, Strohle A, Trunz B, et al. Effects of antiepileptic drug therapy on vitamin D status and biochemical markers of bone turnover in children with epilepsy.Eur J Pediatr 2008;167:1369-77.
      2. Telci A, Cakatay U, Kurt BB, et al. Changes in bone turnover and deoxypyridinoline levels in epileptic patients Clin Chem Lab Med 2000 38:47-50.
      3. Jekovec-Vrhovsek M, Kocijancic A, Prezelj J. Effect of vitamin D and calcium on bone mineral density in children with CP and epilepsy in full-time care. Dev Med Child Neurol 2000;42:403-5.
      4. Riancho JA, Del Arco C, Arteaga R, et al. Influence of solar irradiation on vitamin D levels in children on anticonvulsant drugs. Acta Neurol Scand 1989;79:296-9.
      5. Williams C, Netzloff M, Folkerts L, et al. Vitamin D metabolism and anticonvulsant therapy: effect of sunshine on incidence of osteomalacia. South Med J 1984;77:834.
    • Vitamin D

      Phenobarbital

      Replenish Depleted Nutrients

      Though research results vary, long-term use of anticonvulsant drugs appears to interfere with vitamin D activity, which might lead to softening of bones (osteomalacia). One study showed that blood levels of vitamin D in males taking anticonvulsants were lower than those found in men who were not taking seizure medication. In a controlled study, bone strength improved in children taking anticonvulsant drugs who were supplemented with the activated form of vitamin D and 500 mg per day of calcium for nine months. Some research suggests that differences in exposure to sunlight—which normally increases blood levels of vitamin D—might explain why some studies have failed to find a beneficial effect of vitamin D supplementation. In one controlled study, blood vitamin D levels in children taking anticonvulsants were dramatically lower in winter months than in summer months. Another study of 450 people in Florida taking anticonvulsants found that few had drug-induced bone disease. Consequently, people taking anticonvulsant drugs who do not receive adequate sunlight should supplement with 400 IU of vitamin D each day to help prevent osteomalacia.

      Phenobarbital
      Vitamin D
      ×
      1. Telci A, Cakatay U, Kurt BB, et al. Changes in bone turnover and deoxypyridinoline levels in epileptic patients Clin Chem Lab Med 2000 38:47-50.
      2. Jekovec-Vrhovsek M, Kocijancic A, Prezelj J. Effect of vitamin D and calcium on bone mineral density in children with CP and epilepsy in full-time care. Dev Med Child Neurol 2000;42:403-5.
      3. Riancho JA, Del Arco C, Arteaga R, et al. Influence of solar irradiation on vitamin D levels in children on anticonvulsant drugs. Acta Neurol Scand 1989;79:296-9.
      4. Williams C, Netzloff M, Folkerts L, et al. Vitamin D metabolism and anticonvulsant therapy: effect of sunshine on incidence of osteomalacia. South Med J 1984;77:834.
    • Vitamin D

      Phenytoin

      Replenish Depleted Nutrients

      Though research results vary, long-term use of anticonvulsant drugs appears to interfere with vitamin D activity, which might lead to softening of bones (osteomalacia). One study showed that blood levels of vitamin D in males taking anticonvulsants were lower than those found in men who were not taking seizure medication. In a controlled study, bone strength improved in children taking anticonvulsant drugs who were supplemented with the activated form of vitamin D and 500 mg per day of calcium for nine months. Some research suggests that differences in exposure to sunlight—which normally increases blood levels of vitamin D—might explain why some studies have failed to find a beneficial effect of vitamin D supplementation. In one controlled study, blood vitamin D levels in children taking anticonvulsants were dramatically lower in winter months than in summer months. Another study of 450 people in Florida taking anticonvulsants found that few had drug-induced bone disease. Consequently, people taking anticonvulsant drugs who do not receive adequate sunlight should supplement with 400 IU of vitamin D each day to help prevent osteomalacia.

      Phenytoin
      Vitamin D
      ×
      1. Nettekoven S, Strohle A, Trunz B, et al. Effects of antiepileptic drug therapy on vitamin D status and biochemical markers of bone turnover in children with epilepsy.Eur J Pediatr 2008;167:1369-77.
      2. Telci A, Cakatay U, Kurt BB, et al. Changes in bone turnover and deoxypyridinoline levels in epileptic patients Clin Chem Lab Med 2000 38:47-50.
      3. Jekovec-Vrhovsek M, Kocijancic A, Prezelj J. Effect of vitamin D and calcium on bone mineral density in children with CP and epilepsy in full-time care. Dev Med Child Neurol 2000;42:403-5.
      4. Riancho JA, Del Arco C, Arteaga R, et al. Influence of solar irradiation on vitamin D levels in children on anticonvulsant drugs. Acta Neurol Scand 1989;79:296-9.
      5. Williams C, Netzloff M, Folkerts L, et al. Vitamin D metabolism and anticonvulsant therapy: effect of sunshine on incidence of osteomalacia. South Med J 1984;77:834.
    • Vitamin D

      Prednisolone

      Replenish Depleted Nutrients

      Oral corticosteroids reduce absorption of calcium and interfere with the activation and metabolism of the vitamin, increasing the risk of bone loss. Doctors can measure levels of activated vitamin D (called 1,25 dihydroxycholecalciferol) to determine whether a deficiency exists; if so, activated vitamin D is only available by prescription. A study of rheumatoid arthritis patients treated with low amounts of prednisone found that those who received 1,000 mg of calcium per day plus 500 IU of vitamin D per day for two years experienced no bone loss during that time period. An analysis of properly conducted trials concluded that supplementation with vitamin D and calcium was more effective than placebo or calcium alone in protecting against corticosteroid-induced osteoporosis. Most doctors recommend 1,000 mg of calcium and 400–800 IU vitamin D per day for the prevention of osteoporosis.

      Prednisolone
      Vitamin D
      ×
      1. Hahn TJ, Halstead LR, Baran DT. Effects off short term glucocorticoid administration on intestinal calcium absorption and circulating vitamin D metabolite concentrations in man. J Clin Endocrinol Metab 1981;52:111-5.
      2. Trovato A, Nuhlicek DN, Midtling JE. Drug-nutrient interactions. Am Family Phys 1991;44:1651-8.
      3. Chesney RW, Mazess RB, Hamstra AJ, et al. Reduction of serum-1,25-dihydroxyvitamin-D, in children receiving glucocorticoids. Lancet 1978;ii:1123-5.
      4. Nielsen HK, Eriksen EF, Storm T, Mosekilde K. The effects of short-term, high-dose prednisone on the nuclear uptake of 1,25-dihydroxyvitamin D3 in monocytes from normal human subjects. Metabolism 1988;37:109-14.
      5. Avioli LV. Serum 25-hydroxyvitamin D concentrations in patients receiving chronic corticosteroid therapy. J Lab Clin Med 1977;23:399-404.
      6. Buckley LM, Leib ES, Cartularo KS, et al. Calcium and vitamin D3 supplementation prevents bone loss in the spine secondary to low-dose corticosteroids in patients with rheumatoid arthritis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1996;125:961-8.
      7. Amin S, LaValley PM, Simms RW, Felson DT. The role of vitamin D in corticosteroid-induced osteoporosis. Arthritis Rheum 1999;42:1740-51.
    • Vitamin D

      Primidone

      Replenish Depleted Nutrients

      Though research results vary, long-term use of anticonvulsant drugs appears to interfere with vitamin D activity, which might lead to softening of bones (osteomalacia). One study showed that blood levels of vitamin D in males taking anticonvulsants were lower than those found in men who were not taking seizure medication. In a controlled study, bone strength improved in children taking anticonvulsant drugs who were supplemented with the activated form of vitamin D and 500 mg per day of calcium for nine months. Some research suggests that differences in exposure to sunlight—which normally increases blood levels of vitamin D—might explain why some studies have failed to find a beneficial effect of vitamin D supplementation. In one controlled study, blood vitamin D levels in children taking anticonvulsants were dramatically lower in winter months than in summer months. Another study of 450 people in Florida taking anticonvulsants found that few had drug-induced bone disease. Consequently, people taking anticonvulsant drugs who do not receive adequate sunlight should supplement with 400 IU of vitamin D each day to help prevent osteomalacia.

      Primidone
      Vitamin D
      ×
      1. Nettekoven S, Strohle A, Trunz B, et al. Effects of antiepileptic drug therapy on vitamin D status and biochemical markers of bone turnover in children with epilepsy.Eur J Pediatr 2008;167:1369-77.
      2. Telci A, Cakatay U, Kurt BB, et al. Changes in bone turnover and deoxypyridinoline levels in epileptic patients Clin Chem Lab Med 2000 38:47-50.
      3. Jekovec-Vrhovsek M, Kocijancic A, Prezelj J. Effect of vitamin D and calcium on bone mineral density in children with CP and epilepsy in full-time care. Dev Med Child Neurol 2000;42:403-5.
      4. Riancho JA, Del Arco C, Arteaga R, et al. Influence of solar irradiation on vitamin D levels in children on anticonvulsant drugs. Acta Neurol Scand 1989;79:296-9.
      5. Williams C, Netzloff M, Folkerts L, et al. Vitamin D metabolism and anticonvulsant therapy: effect of sunshine on incidence of osteomalacia. South Med J 1984;77:834.
    • Vitamin D

      Topiramate

      Replenish Depleted Nutrients

      Though research results vary, long-term use of anticonvulsant drugs appears to interfere with vitamin D activity, which might lead to softening of bones (osteomalacia). One study showed that blood levels of vitamin D in males taking anticonvulsants were lower than those found in men who were not taking seizure medication. In a controlled study, bone strength improved in children taking anticonvulsant drugs who were supplemented with the activated form of vitamin D and 500 mg per day of calcium for nine months. Some research suggests that differences in exposure to sunlight—which normally increases blood levels of vitamin D—might explain why some studies have failed to find a beneficial effect of vitamin D supplementation. In one controlled study, blood vitamin D levels in children taking anticonvulsants were dramatically lower in winter months than in summer months. Another study of 450 people in Florida taking anticonvulsants found that few had drug-induced bone disease. Consequently, people taking anticonvulsant drugs who do not receive adequate sunlight should supplement with 400 IU of vitamin D each day to help prevent osteomalacia.

      Topiramate
      Vitamin D
      ×
      1. Nettekoven S, Strohle A, Trunz B, et al. Effects of antiepileptic drug therapy on vitamin D status and biochemical markers of bone turnover in children with epilepsy.Eur J Pediatr 2008;167:1369-77.
      2. Telci A, Cakatay U, Kurt BB, et al. Changes in bone turnover and deoxypyridinoline levels in epileptic patients Clin Chem Lab Med 2000 38:47-50.
      3. Jekovec-Vrhovsek M, Kocijancic A, Prezelj J. Effect of vitamin D and calcium on bone mineral density in children with CP and epilepsy in full-time care. Dev Med Child Neurol 2000;42:403-5.
      4. Riancho JA, Del Arco C, Arteaga R, et al. Influence of solar irradiation on vitamin D levels in children on anticonvulsant drugs. Acta Neurol Scand 1989;79:296-9.
      5. Williams C, Netzloff M, Folkerts L, et al. Vitamin D metabolism and anticonvulsant therapy: effect of sunshine on incidence of osteomalacia. South Med J 1984;77:834.
    • Vitamin D

      Zonisamide

      Replenish Depleted Nutrients

      Though research results vary, long-term use of anticonvulsant drugs appears to interfere with vitamin D activity, which might lead to softening of bones (osteomalacia). One study showed that blood levels of vitamin D in males taking anticonvulsants were lower than those found in men who were not taking seizure medication. In a controlled study, bone strength improved in children taking anticonvulsant drugs who were supplemented with the activated form of vitamin D and 500 mg per day of calcium for nine months. Some research suggests that differences in exposure to sunlight—which normally increases blood levels of vitamin D—might explain why some studies have failed to find a beneficial effect of vitamin D supplementation. In one controlled study, blood vitamin D levels in children taking anticonvulsants were dramatically lower in winter months than in summer months. Another study of 450 people in Florida taking anticonvulsants found that few had drug-induced bone disease. Consequently, people taking anticonvulsant drugs who do not receive adequate sunlight should supplement with 400 IU of vitamin D each day to help prevent osteomalacia.

      Zonisamide
      Vitamin D
      ×
      1. Nettekoven S, Strohle A, Trunz B, et al. Effects of antiepileptic drug therapy on vitamin D status and biochemical markers of bone turnover in children with epilepsy.Eur J Pediatr 2008;167:1369-77.
      2. Telci A, Cakatay U, Kurt BB, et al. Changes in bone turnover and deoxypyridinoline levels in epileptic patients Clin Chem Lab Med 2000 38:47-50.
      3. Jekovec-Vrhovsek M, Kocijancic A, Prezelj J. Effect of vitamin D and calcium on bone mineral density in children with CP and epilepsy in full-time care. Dev Med Child Neurol 2000;42:403-5.
      4. Riancho JA, Del Arco C, Arteaga R, et al. Influence of solar irradiation on vitamin D levels in children on anticonvulsant drugs. Acta Neurol Scand 1989;79:296-9.
      5. Williams C, Netzloff M, Folkerts L, et al. Vitamin D metabolism and anticonvulsant therapy: effect of sunshine on incidence of osteomalacia. South Med J 1984;77:834.
    • Vitamin D

      Estradiol

      Support Medicine

      In controlled studies, the addition of 300 IU per day of vitamin D3 (cholecalciferol) did not improve the bone-preserving or fracture-preventing effects of hormone replacement with estradiol plus a progestin (a synthetic form of progesterone) in postmenopausal women without osteoporosis. However, in a controlled study of osteoporotic women, only those receiving both hormone replacement and vitamin D had increases in bone density of the hip; no improvement occurred in the hip with hormones alone. More research is needed to determine conclusively when vitamin D is important to add to hormone replacement.

      Estradiol
      Vitamin D
      ×
      1. Komulainen M, Kroger H, Tuppurainen MT, et al. Prevention of femoral and lumbar bone loss with hormone replacement therapy and vitamin D3 in early postmenopausal women: a population-based 5-year randomized trial. J Clin Endocrinol Metab 1999;84:546-52.
      2. Komulainen MH, Kroger H, Tuppurainen MT, et al. HRT and Vit D in prevention of non-vertebral fractures in postmenopausal women; a 5 year randomized trial. Maturitas 1998;31:45-54.
      3. Tuppurainen MT, Komulainen M, Kroger H, et al. Does vitamin D strengthen the increase in femoral neck BMD in osteoporotic women treated with estrogen? Osteoporos Int 1998;8:32-8.
    • Vitamin D

      Sodium Fluoride

      Support Medicine

      Collagen is a protein that is used in many areas of the body for structural support. One test tube study showed that the active form of vitamin D, 1,25 dihydroxycholecalciferol, increased the production of a certain type of collagen when it was combined with fluoride. Controlled research is needed to determine whether taking 1,25 dihydroxycholecalciferol with sodium fluoride might promote beneficial collagen growth.

      Sodium Fluoride
      Vitamin D
      ×
      1. Kassem M, Mosekilde L, Eriksen EF. 1,25-dihydroxy-vitamin D3 potentiates fluoride-stimulated collagen Type I production in cultures of human bone marrow stromal osteoblast-like cells. J Bone Miner Res 1993;8:1453-8.
    • Vitamin D

      Anastrozole

      Reduce Side Effects
      In a double-blind study, vitamin D supplementation relieved drug-induced musculoskeletal symptoms in women with breast cancer who were taking anastrozole. The amount of vitamin D used was relatively large (up to 50,000 IU of vitamin D2 once a week) and is potentially toxic. Vitamin D therapy in people taking anastrozole should therefore be prescribed and monitored by a doctor.
      Anastrozole
      Vitamin D
      ×
      1. Rastelli AL, Taylor ME, Gao F, et al. Vitamin D and aromatase inhibitor-induced musculoskeletal symptoms (AIMSS): a phase II, double-blind, placebo-controlled, randomized trial. Breast Cancer Res Treat 2011;129:107-16.
    • Vitamin D

      Atorvastatin

      Reduce Side Effects
      In a preliminary trial, supplementation with vitamin D appeared to prevent muscle-related side effects in patients taking statin drugs. The amount of vitamin D used in this study was very large (up to 50,000 IU twice a week) and potentially toxic. People taking statin drugs should consult with their doctor regarding how much vitamin D can be taken.
      Atorvastatin
      Vitamin D
      ×
      1. Glueck CJ, Budhani SB, Masineni SS, et al. Vitamin D deficiency, myositis-myalgia, and reversible statin intolerance. Curr Med Res Opin 2011;27:1683-90.
    • Calcium and Vitamin D

      Betamethasone

      Reduce Side Effects

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Oral corticosteroids reduce absorption of calcium and interfere with the activation and metabolism of the vitamin, increasing the risk of bone loss. Doctors can measure levels of activated vitamin D (called 1,25 dihydroxycholecalciferol) to determine whether a deficiency exists; if so, activated vitamin D is only available by prescription. A study of rheumatoid arthritis patients treated with low amounts of prednisone found that those who received 1,000 mg of calcium per day plus 500 IU of vitamin D per day for two years experienced no bone loss during that time period. An analysis of properly conducted trials concluded that supplementation with vitamin D and calcium was more effective than placebo or calcium alone in protecting against corticosteroid-induced osteoporosis. Most doctors recommend 1,000 mg of calcium and 400–800 IU vitamin D per day for the prevention of osteoporosis.

      Betamethasone
      Calcium and Vitamin D
      ×
      1. Hahn TJ, Halstead LR, Baran DT. Effects off short term glucocorticoid administration on intestinal calcium absorption and circulating vitamin D metabolite concentrations in man. J Clin Endocrinol Metab 1981;52:111-5.
      2. Trovato A, Nuhlicek DN, Midtling JE. Drug-nutrient interactions. Am Family Phys 1991;44:1651-8.
      3. Chesney RW, Mazess RB, Hamstra AJ, et al. Reduction of serum-1,25-dihydroxyvitamin-D, in children receiving glucocorticoids. Lancet 1978;ii:1123-5.
      4. Nielsen HK, Eriksen EF, Storm T, Mosekilde K. The effects of short-term, high-dose prednisone on the nuclear uptake of 1,25-dihydroxyvitamin D3 in monocytes from normal human subjects. Metabolism 1988;37:109-14.
      5. Avioli LV. Serum 25-hydroxyvitamin D concentrations in patients receiving chronic corticosteroid therapy. J Lab Clin Med 1977;23:399-404.
      6. Buckley LM, Leib ES, Cartularo KS, et al. Calcium and vitamin D3 supplementation prevents bone loss in the spine secondary to low-dose corticosteroids in patients with rheumatoid arthritis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1996;125:961-8.
      7. Amin S, LaValley PM, Simms RW, Felson DT. The role of vitamin D in corticosteroid-induced osteoporosis. Arthritis Rheum 1999;42:1740-51.
    • Vitamin D

      Carbamazepine

      Reduce Side Effects

      Though research results vary, long-term use of anticonvulsant drugs appears to interfere with vitamin D activity, which might lead to softening of bones (osteomalacia). One study showed that blood levels of vitamin D in males taking anticonvulsants were lower than those found in men who were not taking seizure medication. In a controlled study, bone strength improved in children taking anticonvulsant drugs who were supplemented with the activated form of vitamin D and 500 mg per day of calcium for nine months. Some research suggests that differences in exposure to sunlight—which normally increases blood levels of vitamin D—might explain why some studies have failed to find a beneficial effect of vitamin D supplementation. In one controlled study, blood vitamin D levels in children taking anticonvulsants were dramatically lower in winter months than in summer months. Another study of 450 people in Florida taking anticonvulsants found that few had drug-induced bone disease. Consequently, people taking anticonvulsant drugs who do not receive adequate sunlight should supplement with 400 IU of vitamin D each day to help prevent osteomalacia.

      Carbamazepine
      Vitamin D
      ×
      1. Nettekoven S, Strohle A, Trunz B, et al. Effects of antiepileptic drug therapy on vitamin D status and biochemical markers of bone turnover in children with epilepsy.Eur J Pediatr 2008;167:1369-77.
      2. Telci A, Cakatay U, Kurt BB, et al. Changes in bone turnover and deoxypyridinoline levels in epileptic patients Clin Chem Lab Med 2000 38:47-50.
      3. Jekovec-Vrhovsek M, Kocijancic A, Prezelj J. Effect of vitamin D and calcium on bone mineral density in children with CP and epilepsy in full-time care. Dev Med Child Neurol 2000;42:403-5.
      4. Riancho JA, Del Arco C, Arteaga R, et al. Influence of solar irradiation on vitamin D levels in children on anticonvulsant drugs. Acta Neurol Scand 1989;79:296-9.
      5. Williams C, Netzloff M, Folkerts L, et al. Vitamin D metabolism and anticonvulsant therapy: effect of sunshine on incidence of osteomalacia. South Med J 1984;77:834.
    • Calcium and Vitamin D

      Cortisone

      Reduce Side Effects

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Oral corticosteroids reduce absorption of calcium and interfere with the activation and metabolism of the vitamin, increasing the risk of bone loss. Doctors can measure levels of activated vitamin D (called 1,25 dihydroxycholecalciferol) to determine whether a deficiency exists; if so, activated vitamin D is only available by prescription. A study of rheumatoid arthritis patients treated with low amounts of prednisone found that those who received 1,000 mg of calcium per day plus 500 IU of vitamin D per day for two years experienced no bone loss during that time period. An analysis of properly conducted trials concluded that supplementation with vitamin D and calcium was more effective than placebo or calcium alone in protecting against corticosteroid-induced osteoporosis. Most doctors recommend 1,000 mg of calcium and 400–800 IU vitamin D per day for the prevention of osteoporosis.

      Cortisone
      Calcium and Vitamin D
      ×
      1. Hahn TJ, Halstead LR, Baran DT. Effects off short term glucocorticoid administration on intestinal calcium absorption and circulating vitamin D metabolite concentrations in man. J Clin Endocrinol Metab 1981;52:111-5.
      2. Trovato A, Nuhlicek DN, Midtling JE. Drug-nutrient interactions. Am Family Phys 1991;44:1651-8.
      3. Chesney RW, Mazess RB, Hamstra AJ, et al. Reduction of serum-1,25-dihydroxyvitamin-D, in children receiving glucocorticoids. Lancet 1978;ii:1123-5.
      4. Nielsen HK, Eriksen EF, Storm T, Mosekilde K. The effects of short-term, high-dose prednisone on the nuclear uptake of 1,25-dihydroxyvitamin D3 in monocytes from normal human subjects. Metabolism 1988;37:109-14.
      5. Avioli LV. Serum 25-hydroxyvitamin D concentrations in patients receiving chronic corticosteroid therapy. J Lab Clin Med 1977;23:399-404.
      6. Buckley LM, Leib ES, Cartularo KS, et al. Calcium and vitamin D3 supplementation prevents bone loss in the spine secondary to low-dose corticosteroids in patients with rheumatoid arthritis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1996;125:961-8.
      7. Amin S, LaValley PM, Simms RW, Felson DT. The role of vitamin D in corticosteroid-induced osteoporosis. Arthritis Rheum 1999;42:1740-51.
    • Calcium and Vitamin D

      Dexamethasone

      Reduce Side Effects

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Oral corticosteroids reduce absorption of calcium and interfere with the activation and metabolism of the vitamin, increasing the risk of bone loss. Doctors can measure levels of activated vitamin D (called 1,25 dihydroxycholecalciferol) to determine whether a deficiency exists; if so, activated vitamin D is only available by prescription. A study of rheumatoid arthritis patients treated with low amounts of prednisone found that those who received 1,000 mg of calcium per day plus 500 IU of vitamin D per day for two years experienced no bone loss during that time period. An analysis of properly conducted trials concluded that supplementation with vitamin D and calcium was more effective than placebo or calcium alone in protecting against corticosteroid-induced osteoporosis. Most doctors recommend 1,000 mg of calcium and 400–800 IU vitamin D per day for the prevention of osteoporosis.

      Dexamethasone
      Calcium and Vitamin D
      ×
      1. Hahn TJ, Halstead LR, Baran DT. Effects off short term glucocorticoid administration on intestinal calcium absorption and circulating vitamin D metabolite concentrations in man. J Clin Endocrinol Metab 1981;52:111-5.
      2. Trovato A, Nuhlicek DN, Midtling JE. Drug-nutrient interactions. Am Family Phys 1991;44:1651-8.
      3. Chesney RW, Mazess RB, Hamstra AJ, et al. Reduction of serum-1,25-dihydroxyvitamin-D, in children receiving glucocorticoids. Lancet 1978;ii:1123-5.
      4. Nielsen HK, Eriksen EF, Storm T, Mosekilde K. The effects of short-term, high-dose prednisone on the nuclear uptake of 1,25-dihydroxyvitamin D3 in monocytes from normal human subjects. Metabolism 1988;37:109-14.
      5. Avioli LV. Serum 25-hydroxyvitamin D concentrations in patients receiving chronic corticosteroid therapy. J Lab Clin Med 1977;23:399-404.
      6. Buckley LM, Leib ES, Cartularo KS, et al. Calcium and vitamin D3 supplementation prevents bone loss in the spine secondary to low-dose corticosteroids in patients with rheumatoid arthritis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1996;125:961-8.
      7. Amin S, LaValley PM, Simms RW, Felson DT. The role of vitamin D in corticosteroid-induced osteoporosis. Arthritis Rheum 1999;42:1740-51.
    • Calcium and Vitamin D

      Dexamethasone Sod Phosphate-PF

      Reduce Side Effects

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Oral corticosteroids reduce absorption of calcium and interfere with the activation and metabolism of the vitamin, increasing the risk of bone loss. Doctors can measure levels of activated vitamin D (called 1,25 dihydroxycholecalciferol) to determine whether a deficiency exists; if so, activated vitamin D is only available by prescription. A study of rheumatoid arthritis patients treated with low amounts of prednisone found that those who received 1,000 mg of calcium per day plus 500 IU of vitamin D per day for two years experienced no bone loss during that time period. An analysis of properly conducted trials concluded that supplementation with vitamin D and calcium was more effective than placebo or calcium alone in protecting against corticosteroid-induced osteoporosis. Most doctors recommend 1,000 mg of calcium and 400–800 IU vitamin D per day for the prevention of osteoporosis.

      Dexamethasone Sod Phosphate-PF
      Calcium and Vitamin D
      ×
      1. Hahn TJ, Halstead LR, Baran DT. Effects off short term glucocorticoid administration on intestinal calcium absorption and circulating vitamin D metabolite concentrations in man. J Clin Endocrinol Metab 1981;52:111-5.
      2. Trovato A, Nuhlicek DN, Midtling JE. Drug-nutrient interactions. Am Family Phys 1991;44:1651-8.
      3. Chesney RW, Mazess RB, Hamstra AJ, et al. Reduction of serum-1,25-dihydroxyvitamin-D, in children receiving glucocorticoids. Lancet 1978;ii:1123-5.
      4. Nielsen HK, Eriksen EF, Storm T, Mosekilde K. The effects of short-term, high-dose prednisone on the nuclear uptake of 1,25-dihydroxyvitamin D3 in monocytes from normal human subjects. Metabolism 1988;37:109-14.
      5. Avioli LV. Serum 25-hydroxyvitamin D concentrations in patients receiving chronic corticosteroid therapy. J Lab Clin Med 1977;23:399-404.
      6. Buckley LM, Leib ES, Cartularo KS, et al. Calcium and vitamin D3 supplementation prevents bone loss in the spine secondary to low-dose corticosteroids in patients with rheumatoid arthritis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1996;125:961-8.
      7. Amin S, LaValley PM, Simms RW, Felson DT. The role of vitamin D in corticosteroid-induced osteoporosis. Arthritis Rheum 1999;42:1740-51.
    • Calcium and Vitamin D

      Dexamethasone Sodium Phosphate

      Reduce Side Effects

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Oral corticosteroids reduce absorption of calcium and interfere with the activation and metabolism of the vitamin, increasing the risk of bone loss. Doctors can measure levels of activated vitamin D (called 1,25 dihydroxycholecalciferol) to determine whether a deficiency exists; if so, activated vitamin D is only available by prescription. A study of rheumatoid arthritis patients treated with low amounts of prednisone found that those who received 1,000 mg of calcium per day plus 500 IU of vitamin D per day for two years experienced no bone loss during that time period. An analysis of properly conducted trials concluded that supplementation with vitamin D and calcium was more effective than placebo or calcium alone in protecting against corticosteroid-induced osteoporosis. Most doctors recommend 1,000 mg of calcium and 400–800 IU vitamin D per day for the prevention of osteoporosis.

      Dexamethasone Sodium Phosphate
      Calcium and Vitamin D
      ×
      1. Hahn TJ, Halstead LR, Baran DT. Effects off short term glucocorticoid administration on intestinal calcium absorption and circulating vitamin D metabolite concentrations in man. J Clin Endocrinol Metab 1981;52:111-5.
      2. Trovato A, Nuhlicek DN, Midtling JE. Drug-nutrient interactions. Am Family Phys 1991;44:1651-8.
      3. Chesney RW, Mazess RB, Hamstra AJ, et al. Reduction of serum-1,25-dihydroxyvitamin-D, in children receiving glucocorticoids. Lancet 1978;ii:1123-5.
      4. Nielsen HK, Eriksen EF, Storm T, Mosekilde K. The effects of short-term, high-dose prednisone on the nuclear uptake of 1,25-dihydroxyvitamin D3 in monocytes from normal human subjects. Metabolism 1988;37:109-14.
      5. Avioli LV. Serum 25-hydroxyvitamin D concentrations in patients receiving chronic corticosteroid therapy. J Lab Clin Med 1977;23:399-404.
      6. Buckley LM, Leib ES, Cartularo KS, et al. Calcium and vitamin D3 supplementation prevents bone loss in the spine secondary to low-dose corticosteroids in patients with rheumatoid arthritis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1996;125:961-8.
      7. Amin S, LaValley PM, Simms RW, Felson DT. The role of vitamin D in corticosteroid-induced osteoporosis. Arthritis Rheum 1999;42:1740-51.
    • Vitamin D

      Felbamate

      Reduce Side Effects

      Though research results vary, long-term use of anticonvulsant drugs appears to interfere with vitamin D activity, which might lead to softening of bones (osteomalacia). One study showed that blood levels of vitamin D in males taking anticonvulsants were lower than those found in men who were not taking seizure medication. In a controlled study, bone strength improved in children taking anticonvulsant drugs who were supplemented with the activated form of vitamin D and 500 mg per day of calcium for nine months. Some research suggests that differences in exposure to sunlight—which normally increases blood levels of vitamin D—might explain why some studies have failed to find a beneficial effect of vitamin D supplementation. In one controlled study, blood vitamin D levels in children taking anticonvulsants were dramatically lower in winter months than in summer months. Another study of 450 people in Florida taking anticonvulsants found that few had drug-induced bone disease. Consequently, people taking anticonvulsant drugs who do not receive adequate sunlight should supplement with 400 IU of vitamin D each day to help prevent osteomalacia.

      Felbamate
      Vitamin D
      ×
      1. Nettekoven S, Strohle A, Trunz B, et al. Effects of antiepileptic drug therapy on vitamin D status and biochemical markers of bone turnover in children with epilepsy.Eur J Pediatr 2008;167:1369-77.
      2. Telci A, Cakatay U, Kurt BB, et al. Changes in bone turnover and deoxypyridinoline levels in epileptic patients Clin Chem Lab Med 2000 38:47-50.
      3. Jekovec-Vrhovsek M, Kocijancic A, Prezelj J. Effect of vitamin D and calcium on bone mineral density in children with CP and epilepsy in full-time care. Dev Med Child Neurol 2000;42:403-5.
      4. Riancho JA, Del Arco C, Arteaga R, et al. Influence of solar irradiation on vitamin D levels in children on anticonvulsant drugs. Acta Neurol Scand 1989;79:296-9.
      5. Williams C, Netzloff M, Folkerts L, et al. Vitamin D metabolism and anticonvulsant therapy: effect of sunshine on incidence of osteomalacia. South Med J 1984;77:834.
    • Vitamin D

      Fluvastatin

      Reduce Side Effects
      In a preliminary trial, supplementation with vitamin D appeared to prevent muscle-related side effects in patients taking statin drugs. The amount of vitamin D used in this study was very large (up to 50,000 IU twice a week) and potentially toxic. People taking statin drugs should consult with their doctor regarding how much vitamin D can be taken.
      Fluvastatin
      Vitamin D
      ×
      1. Glueck CJ, Budhani SB, Masineni SS, et al. Vitamin D deficiency, myositis-myalgia, and reversible statin intolerance. Curr Med Res Opin 2011;27:1683-90.
    • Calcium and Vitamin D

      Hydrocortisone

      Reduce Side Effects

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Oral corticosteroids reduce absorption of calcium and interfere with the activation and metabolism of the vitamin, increasing the risk of bone loss. Doctors can measure levels of activated vitamin D (called 1,25 dihydroxycholecalciferol) to determine whether a deficiency exists; if so, activated vitamin D is only available by prescription. A study of rheumatoid arthritis patients treated with low amounts of prednisone found that those who received 1,000 mg of calcium per day plus 500 IU of vitamin D per day for two years experienced no bone loss during that time period. An analysis of properly conducted trials concluded that supplementation with vitamin D and calcium was more effective than placebo or calcium alone in protecting against corticosteroid-induced osteoporosis. Most doctors recommend 1,000 mg of calcium and 400–800 IU vitamin D per day for the prevention of osteoporosis.

      Hydrocortisone
      Calcium and Vitamin D
      ×
      1. Hahn TJ, Halstead LR, Baran DT. Effects off short term glucocorticoid administration on intestinal calcium absorption and circulating vitamin D metabolite concentrations in man. J Clin Endocrinol Metab 1981;52:111-5.
      2. Trovato A, Nuhlicek DN, Midtling JE. Drug-nutrient interactions. Am Family Phys 1991;44:1651-8.
      3. Chesney RW, Mazess RB, Hamstra AJ, et al. Reduction of serum-1,25-dihydroxyvitamin-D, in children receiving glucocorticoids. Lancet 1978;ii:1123-5.
      4. Nielsen HK, Eriksen EF, Storm T, Mosekilde K. The effects of short-term, high-dose prednisone on the nuclear uptake of 1,25-dihydroxyvitamin D3 in monocytes from normal human subjects. Metabolism 1988;37:109-14.
      5. Avioli LV. Serum 25-hydroxyvitamin D concentrations in patients receiving chronic corticosteroid therapy. J Lab Clin Med 1977;23:399-404.
      6. Buckley LM, Leib ES, Cartularo KS, et al. Calcium and vitamin D3 supplementation prevents bone loss in the spine secondary to low-dose corticosteroids in patients with rheumatoid arthritis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1996;125:961-8.
      7. Amin S, LaValley PM, Simms RW, Felson DT. The role of vitamin D in corticosteroid-induced osteoporosis. Arthritis Rheum 1999;42:1740-51.
    • Calcium and Vitamin D

      Hydrocortisone Acetate

      Reduce Side Effects

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Oral corticosteroids reduce absorption of calcium and interfere with the activation and metabolism of the vitamin, increasing the risk of bone loss. Doctors can measure levels of activated vitamin D (called 1,25 dihydroxycholecalciferol) to determine whether a deficiency exists; if so, activated vitamin D is only available by prescription. A study of rheumatoid arthritis patients treated with low amounts of prednisone found that those who received 1,000 mg of calcium per day plus 500 IU of vitamin D per day for two years experienced no bone loss during that time period. An analysis of properly conducted trials concluded that supplementation with vitamin D and calcium was more effective than placebo or calcium alone in protecting against corticosteroid-induced osteoporosis. Most doctors recommend 1,000 mg of calcium and 400–800 IU vitamin D per day for the prevention of osteoporosis.

      Hydrocortisone Acetate
      Calcium and Vitamin D
      ×
      1. Hahn TJ, Halstead LR, Baran DT. Effects off short term glucocorticoid administration on intestinal calcium absorption and circulating vitamin D metabolite concentrations in man. J Clin Endocrinol Metab 1981;52:111-5.
      2. Trovato A, Nuhlicek DN, Midtling JE. Drug-nutrient interactions. Am Family Phys 1991;44:1651-8.
      3. Chesney RW, Mazess RB, Hamstra AJ, et al. Reduction of serum-1,25-dihydroxyvitamin-D, in children receiving glucocorticoids. Lancet 1978;ii:1123-5.
      4. Nielsen HK, Eriksen EF, Storm T, Mosekilde K. The effects of short-term, high-dose prednisone on the nuclear uptake of 1,25-dihydroxyvitamin D3 in monocytes from normal human subjects. Metabolism 1988;37:109-14.
      5. Avioli LV. Serum 25-hydroxyvitamin D concentrations in patients receiving chronic corticosteroid therapy. J Lab Clin Med 1977;23:399-404.
      6. Buckley LM, Leib ES, Cartularo KS, et al. Calcium and vitamin D3 supplementation prevents bone loss in the spine secondary to low-dose corticosteroids in patients with rheumatoid arthritis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1996;125:961-8.
      7. Amin S, LaValley PM, Simms RW, Felson DT. The role of vitamin D in corticosteroid-induced osteoporosis. Arthritis Rheum 1999;42:1740-51.
    • Calcium and Vitamin D

      Hydrocortisone Sod Succinate

      Reduce Side Effects

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Oral corticosteroids reduce absorption of calcium and interfere with the activation and metabolism of the vitamin, increasing the risk of bone loss. Doctors can measure levels of activated vitamin D (called 1,25 dihydroxycholecalciferol) to determine whether a deficiency exists; if so, activated vitamin D is only available by prescription. A study of rheumatoid arthritis patients treated with low amounts of prednisone found that those who received 1,000 mg of calcium per day plus 500 IU of vitamin D per day for two years experienced no bone loss during that time period. An analysis of properly conducted trials concluded that supplementation with vitamin D and calcium was more effective than placebo or calcium alone in protecting against corticosteroid-induced osteoporosis. Most doctors recommend 1,000 mg of calcium and 400–800 IU vitamin D per day for the prevention of osteoporosis.

      Hydrocortisone Sod Succinate
      Calcium and Vitamin D
      ×
      1. Hahn TJ, Halstead LR, Baran DT. Effects off short term glucocorticoid administration on intestinal calcium absorption and circulating vitamin D metabolite concentrations in man. J Clin Endocrinol Metab 1981;52:111-5.
      2. Trovato A, Nuhlicek DN, Midtling JE. Drug-nutrient interactions. Am Family Phys 1991;44:1651-8.
      3. Chesney RW, Mazess RB, Hamstra AJ, et al. Reduction of serum-1,25-dihydroxyvitamin-D, in children receiving glucocorticoids. Lancet 1978;ii:1123-5.
      4. Nielsen HK, Eriksen EF, Storm T, Mosekilde K. The effects of short-term, high-dose prednisone on the nuclear uptake of 1,25-dihydroxyvitamin D3 in monocytes from normal human subjects. Metabolism 1988;37:109-14.
      5. Avioli LV. Serum 25-hydroxyvitamin D concentrations in patients receiving chronic corticosteroid therapy. J Lab Clin Med 1977;23:399-404.
      6. Buckley LM, Leib ES, Cartularo KS, et al. Calcium and vitamin D3 supplementation prevents bone loss in the spine secondary to low-dose corticosteroids in patients with rheumatoid arthritis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1996;125:961-8.
      7. Amin S, LaValley PM, Simms RW, Felson DT. The role of vitamin D in corticosteroid-induced osteoporosis. Arthritis Rheum 1999;42:1740-51.
    • Calcium and Vitamin D

      Hydromorphone

      Reduce Side Effects

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Oral corticosteroids reduce absorption of calcium and interfere with the activation and metabolism of the vitamin, increasing the risk of bone loss. Doctors can measure levels of activated vitamin D (called 1,25 dihydroxycholecalciferol) to determine whether a deficiency exists; if so, activated vitamin D is only available by prescription. A study of rheumatoid arthritis patients treated with low amounts of prednisone found that those who received 1,000 mg of calcium per day plus 500 IU of vitamin D per day for two years experienced no bone loss during that time period. An analysis of properly conducted trials concluded that supplementation with vitamin D and calcium was more effective than placebo or calcium alone in protecting against corticosteroid-induced osteoporosis. Most doctors recommend 1,000 mg of calcium and 400–800 IU vitamin D per day for the prevention of osteoporosis.

      Hydromorphone
      Calcium and Vitamin D
      ×
      1. Hahn TJ, Halstead LR, Baran DT. Effects off short term glucocorticoid administration on intestinal calcium absorption and circulating vitamin D metabolite concentrations in man. J Clin Endocrinol Metab 1981;52:111-5.
      2. Trovato A, Nuhlicek DN, Midtling JE. Drug-nutrient interactions. Am Family Phys 1991;44:1651-8.
      3. Chesney RW, Mazess RB, Hamstra AJ, et al. Reduction of serum-1,25-dihydroxyvitamin-D, in children receiving glucocorticoids. Lancet 1978;ii:1123-5.
      4. Nielsen HK, Eriksen EF, Storm T, Mosekilde K. The effects of short-term, high-dose prednisone on the nuclear uptake of 1,25-dihydroxyvitamin D3 in monocytes from normal human subjects. Metabolism 1988;37:109-14.
      5. Avioli LV. Serum 25-hydroxyvitamin D concentrations in patients receiving chronic corticosteroid therapy. J Lab Clin Med 1977;23:399-404.
      6. Buckley LM, Leib ES, Cartularo KS, et al. Calcium and vitamin D3 supplementation prevents bone loss in the spine secondary to low-dose corticosteroids in patients with rheumatoid arthritis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1996;125:961-8.
      7. Amin S, LaValley PM, Simms RW, Felson DT. The role of vitamin D in corticosteroid-induced osteoporosis. Arthritis Rheum 1999;42:1740-51.
    • Vitamin D

      Levetiracetam

      Reduce Side Effects

      Though research results vary, long-term use of anticonvulsant drugs appears to interfere with vitamin D activity, which might lead to softening of bones (osteomalacia). One study showed that blood levels of vitamin D in males taking anticonvulsants were lower than those found in men who were not taking seizure medication. In a controlled study, bone strength improved in children taking anticonvulsant drugs who were supplemented with the activated form of vitamin D and 500 mg per day of calcium for nine months. Some research suggests that differences in exposure to sunlight—which normally increases blood levels of vitamin D—might explain why some studies have failed to find a beneficial effect of vitamin D supplementation. In one controlled study, blood vitamin D levels in children taking anticonvulsants were dramatically lower in winter months than in summer months. Another study of 450 people in Florida taking anticonvulsants found that few had drug-induced bone disease. Consequently, people taking anticonvulsant drugs who do not receive adequate sunlight should supplement with 400 IU of vitamin D each day to help prevent osteomalacia.

      Levetiracetam
      Vitamin D
      ×
      1. Nettekoven S, Strohle A, Trunz B, et al. Effects of antiepileptic drug therapy on vitamin D status and biochemical markers of bone turnover in children with epilepsy.Eur J Pediatr 2008;167:1369-77.
      2. Telci A, Cakatay U, Kurt BB, et al. Changes in bone turnover and deoxypyridinoline levels in epileptic patients Clin Chem Lab Med 2000 38:47-50.
      3. Jekovec-Vrhovsek M, Kocijancic A, Prezelj J. Effect of vitamin D and calcium on bone mineral density in children with CP and epilepsy in full-time care. Dev Med Child Neurol 2000;42:403-5.
      4. Riancho JA, Del Arco C, Arteaga R, et al. Influence of solar irradiation on vitamin D levels in children on anticonvulsant drugs. Acta Neurol Scand 1989;79:296-9.
      5. Williams C, Netzloff M, Folkerts L, et al. Vitamin D metabolism and anticonvulsant therapy: effect of sunshine on incidence of osteomalacia. South Med J 1984;77:834.
    • Vitamin D

      Lovastatin

      Reduce Side Effects
      In a preliminary trial, supplementation with vitamin D appeared to prevent muscle-related side effects in patients taking statin drugs. The amount of vitamin D used in this study was very large (up to 50,000 IU twice a week) and potentially toxic. People taking statin drugs should consult with their doctor regarding how much vitamin D can be taken.
      Lovastatin
      Vitamin D
      ×
      1. Glueck CJ, Budhani SB, Masineni SS, et al. Vitamin D deficiency, myositis-myalgia, and reversible statin intolerance. Curr Med Res Opin 2011;27:1683-90.
    • Calcium and Vitamin D

      Methylprednisolone

      Reduce Side Effects

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Oral corticosteroids reduce absorption of calcium and interfere with the activation and metabolism of the vitamin, increasing the risk of bone loss. Doctors can measure levels of activated vitamin D (called 1,25 dihydroxycholecalciferol) to determine whether a deficiency exists; if so, activated vitamin D is only available by prescription. A study of rheumatoid arthritis patients treated with low amounts of prednisone found that those who received 1,000 mg of calcium per day plus 500 IU of vitamin D per day for two years experienced no bone loss during that time period. An analysis of properly conducted trials concluded that supplementation with vitamin D and calcium was more effective than placebo or calcium alone in protecting against corticosteroid-induced osteoporosis. Most doctors recommend 1,000 mg of calcium and 400–800 IU vitamin D per day for the prevention of osteoporosis.

      Methylprednisolone
      Calcium and Vitamin D
      ×
      1. Hahn TJ, Halstead LR, Baran DT. Effects off short term glucocorticoid administration on intestinal calcium absorption and circulating vitamin D metabolite concentrations in man. J Clin Endocrinol Metab 1981;52:111-5.
      2. Trovato A, Nuhlicek DN, Midtling JE. Drug-nutrient interactions. Am Family Phys 1991;44:1651-8.
      3. Chesney RW, Mazess RB, Hamstra AJ, et al. Reduction of serum-1,25-dihydroxyvitamin-D, in children receiving glucocorticoids. Lancet 1978;ii:1123-5.
      4. Nielsen HK, Eriksen EF, Storm T, Mosekilde K. The effects of short-term, high-dose prednisone on the nuclear uptake of 1,25-dihydroxyvitamin D3 in monocytes from normal human subjects. Metabolism 1988;37:109-14.
      5. Avioli LV. Serum 25-hydroxyvitamin D concentrations in patients receiving chronic corticosteroid therapy. J Lab Clin Med 1977;23:399-404.
      6. Buckley LM, Leib ES, Cartularo KS, et al. Calcium and vitamin D3 supplementation prevents bone loss in the spine secondary to low-dose corticosteroids in patients with rheumatoid arthritis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1996;125:961-8.
      7. Amin S, LaValley PM, Simms RW, Felson DT. The role of vitamin D in corticosteroid-induced osteoporosis. Arthritis Rheum 1999;42:1740-51.
    • Calcium and Vitamin D

      Methylprednisolone Acetate

      Reduce Side Effects

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Oral corticosteroids reduce absorption of calcium and interfere with the activation and metabolism of the vitamin, increasing the risk of bone loss. Doctors can measure levels of activated vitamin D (called 1,25 dihydroxycholecalciferol) to determine whether a deficiency exists; if so, activated vitamin D is only available by prescription. A study of rheumatoid arthritis patients treated with low amounts of prednisone found that those who received 1,000 mg of calcium per day plus 500 IU of vitamin D per day for two years experienced no bone loss during that time period. An analysis of properly conducted trials concluded that supplementation with vitamin D and calcium was more effective than placebo or calcium alone in protecting against corticosteroid-induced osteoporosis. Most doctors recommend 1,000 mg of calcium and 400–800 IU vitamin D per day for the prevention of osteoporosis.

      Methylprednisolone Acetate
      Calcium and Vitamin D
      ×
      1. Hahn TJ, Halstead LR, Baran DT. Effects off short term glucocorticoid administration on intestinal calcium absorption and circulating vitamin D metabolite concentrations in man. J Clin Endocrinol Metab 1981;52:111-5.
      2. Trovato A, Nuhlicek DN, Midtling JE. Drug-nutrient interactions. Am Family Phys 1991;44:1651-8.
      3. Chesney RW, Mazess RB, Hamstra AJ, et al. Reduction of serum-1,25-dihydroxyvitamin-D, in children receiving glucocorticoids. Lancet 1978;ii:1123-5.
      4. Nielsen HK, Eriksen EF, Storm T, Mosekilde K. The effects of short-term, high-dose prednisone on the nuclear uptake of 1,25-dihydroxyvitamin D3 in monocytes from normal human subjects. Metabolism 1988;37:109-14.
      5. Avioli LV. Serum 25-hydroxyvitamin D concentrations in patients receiving chronic corticosteroid therapy. J Lab Clin Med 1977;23:399-404.
      6. Buckley LM, Leib ES, Cartularo KS, et al. Calcium and vitamin D3 supplementation prevents bone loss in the spine secondary to low-dose corticosteroids in patients with rheumatoid arthritis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1996;125:961-8.
      7. Amin S, LaValley PM, Simms RW, Felson DT. The role of vitamin D in corticosteroid-induced osteoporosis. Arthritis Rheum 1999;42:1740-51.
    • Calcium and Vitamin D

      Methylprednisolone Sodium Succ

      Reduce Side Effects

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Oral corticosteroids reduce absorption of calcium and interfere with the activation and metabolism of the vitamin, increasing the risk of bone loss. Doctors can measure levels of activated vitamin D (called 1,25 dihydroxycholecalciferol) to determine whether a deficiency exists; if so, activated vitamin D is only available by prescription. A study of rheumatoid arthritis patients treated with low amounts of prednisone found that those who received 1,000 mg of calcium per day plus 500 IU of vitamin D per day for two years experienced no bone loss during that time period. An analysis of properly conducted trials concluded that supplementation with vitamin D and calcium was more effective than placebo or calcium alone in protecting against corticosteroid-induced osteoporosis. Most doctors recommend 1,000 mg of calcium and 400–800 IU vitamin D per day for the prevention of osteoporosis.

      Methylprednisolone Sodium Succ
      Calcium and Vitamin D
      ×
      1. Hahn TJ, Halstead LR, Baran DT. Effects off short term glucocorticoid administration on intestinal calcium absorption and circulating vitamin D metabolite concentrations in man. J Clin Endocrinol Metab 1981;52:111-5.
      2. Trovato A, Nuhlicek DN, Midtling JE. Drug-nutrient interactions. Am Family Phys 1991;44:1651-8.
      3. Chesney RW, Mazess RB, Hamstra AJ, et al. Reduction of serum-1,25-dihydroxyvitamin-D, in children receiving glucocorticoids. Lancet 1978;ii:1123-5.
      4. Nielsen HK, Eriksen EF, Storm T, Mosekilde K. The effects of short-term, high-dose prednisone on the nuclear uptake of 1,25-dihydroxyvitamin D3 in monocytes from normal human subjects. Metabolism 1988;37:109-14.
      5. Avioli LV. Serum 25-hydroxyvitamin D concentrations in patients receiving chronic corticosteroid therapy. J Lab Clin Med 1977;23:399-404.
      6. Buckley LM, Leib ES, Cartularo KS, et al. Calcium and vitamin D3 supplementation prevents bone loss in the spine secondary to low-dose corticosteroids in patients with rheumatoid arthritis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1996;125:961-8.
      7. Amin S, LaValley PM, Simms RW, Felson DT. The role of vitamin D in corticosteroid-induced osteoporosis. Arthritis Rheum 1999;42:1740-51.
    • Vitamin D

      Oxcarbazepine

      Reduce Side Effects

      Though research results vary, long-term use of anticonvulsant drugs appears to interfere with vitamin D activity, which might lead to softening of bones (osteomalacia). One study showed that blood levels of vitamin D in males taking anticonvulsants were lower than those found in men who were not taking seizure medication. In a controlled study, bone strength improved in children taking anticonvulsant drugs who were supplemented with the activated form of vitamin D and 500 mg per day of calcium for nine months. Some research suggests that differences in exposure to sunlight—which normally increases blood levels of vitamin D—might explain why some studies have failed to find a beneficial effect of vitamin D supplementation. In one controlled study, blood vitamin D levels in children taking anticonvulsants were dramatically lower in winter months than in summer months. Another study of 450 people in Florida taking anticonvulsants found that few had drug-induced bone disease. Consequently, people taking anticonvulsant drugs who do not receive adequate sunlight should supplement with 400 IU of vitamin D each day to help prevent osteomalacia.

      Oxcarbazepine
      Vitamin D
      ×
      1. Nettekoven S, Strohle A, Trunz B, et al. Effects of antiepileptic drug therapy on vitamin D status and biochemical markers of bone turnover in children with epilepsy.Eur J Pediatr 2008;167:1369-77.
      2. Telci A, Cakatay U, Kurt BB, et al. Changes in bone turnover and deoxypyridinoline levels in epileptic patients Clin Chem Lab Med 2000 38:47-50.
      3. Jekovec-Vrhovsek M, Kocijancic A, Prezelj J. Effect of vitamin D and calcium on bone mineral density in children with CP and epilepsy in full-time care. Dev Med Child Neurol 2000;42:403-5.
      4. Riancho JA, Del Arco C, Arteaga R, et al. Influence of solar irradiation on vitamin D levels in children on anticonvulsant drugs. Acta Neurol Scand 1989;79:296-9.
      5. Williams C, Netzloff M, Folkerts L, et al. Vitamin D metabolism and anticonvulsant therapy: effect of sunshine on incidence of osteomalacia. South Med J 1984;77:834.
    • Vitamin D

      Pitavastatin

      Reduce Side Effects
      In a preliminary trial, supplementation with vitamin D appeared to prevent muscle-related side effects in patients taking statin drugs. The amount of vitamin D used in this study was very large (up to 50,000 IU twice a week) and potentially toxic. People taking statin drugs should consult with their doctor regarding how much vitamin D can be taken.
      Pitavastatin
      Vitamin D
      ×
      1. Glueck CJ, Budhani SB, Masineni SS, et al. Vitamin D deficiency, myositis-myalgia, and reversible statin intolerance. Curr Med Res Opin 2011;27:1683-90.
    • Vitamin D

      Pravastatin

      Reduce Side Effects
      In a preliminary trial, supplementation with vitamin D appeared to prevent muscle-related side effects in patients taking statin drugs. The amount of vitamin D used in this study was very large (up to 50,000 IU twice a week) and potentially toxic. People taking statin drugs should consult with their doctor regarding how much vitamin D can be taken.
      Pravastatin
      Vitamin D
      ×
      1. Glueck CJ, Budhani SB, Masineni SS, et al. Vitamin D deficiency, myositis-myalgia, and reversible statin intolerance. Curr Med Res Opin 2011;27:1683-90.
    • Calcium and Vitamin D

      Prednisolone

      Reduce Side Effects

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Oral corticosteroids reduce absorption of calcium and interfere with the activation and metabolism of the vitamin, increasing the risk of bone loss. Doctors can measure levels of activated vitamin D (called 1,25 dihydroxycholecalciferol) to determine whether a deficiency exists; if so, activated vitamin D is only available by prescription. A study of rheumatoid arthritis patients treated with low amounts of prednisone found that those who received 1,000 mg of calcium per day plus 500 IU of vitamin D per day for two years experienced no bone loss during that time period. An analysis of properly conducted trials concluded that supplementation with vitamin D and calcium was more effective than placebo or calcium alone in protecting against corticosteroid-induced osteoporosis. Most doctors recommend 1,000 mg of calcium and 400–800 IU vitamin D per day for the prevention of osteoporosis.

      Prednisolone
      Calcium and Vitamin D
      ×
      1. Hahn TJ, Halstead LR, Baran DT. Effects off short term glucocorticoid administration on intestinal calcium absorption and circulating vitamin D metabolite concentrations in man. J Clin Endocrinol Metab 1981;52:111-5.
      2. Trovato A, Nuhlicek DN, Midtling JE. Drug-nutrient interactions. Am Family Phys 1991;44:1651-8.
      3. Chesney RW, Mazess RB, Hamstra AJ, et al. Reduction of serum-1,25-dihydroxyvitamin-D, in children receiving glucocorticoids. Lancet 1978;ii:1123-5.
      4. Nielsen HK, Eriksen EF, Storm T, Mosekilde K. The effects of short-term, high-dose prednisone on the nuclear uptake of 1,25-dihydroxyvitamin D3 in monocytes from normal human subjects. Metabolism 1988;37:109-14.
      5. Avioli LV. Serum 25-hydroxyvitamin D concentrations in patients receiving chronic corticosteroid therapy. J Lab Clin Med 1977;23:399-404.
      6. Buckley LM, Leib ES, Cartularo KS, et al. Calcium and vitamin D3 supplementation prevents bone loss in the spine secondary to low-dose corticosteroids in patients with rheumatoid arthritis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1996;125:961-8.
      7. Amin S, LaValley PM, Simms RW, Felson DT. The role of vitamin D in corticosteroid-induced osteoporosis. Arthritis Rheum 1999;42:1740-51.
    • Calcium and Vitamin D

      Prednisolone Acetate

      Reduce Side Effects

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Oral corticosteroids reduce absorption of calcium and interfere with the activation and metabolism of the vitamin, increasing the risk of bone loss. Doctors can measure levels of activated vitamin D (called 1,25 dihydroxycholecalciferol) to determine whether a deficiency exists; if so, activated vitamin D is only available by prescription. A study of rheumatoid arthritis patients treated with low amounts of prednisone found that those who received 1,000 mg of calcium per day plus 500 IU of vitamin D per day for two years experienced no bone loss during that time period. An analysis of properly conducted trials concluded that supplementation with vitamin D and calcium was more effective than placebo or calcium alone in protecting against corticosteroid-induced osteoporosis. Most doctors recommend 1,000 mg of calcium and 400–800 IU vitamin D per day for the prevention of osteoporosis.

      Prednisolone Acetate
      Calcium and Vitamin D
      ×
      1. Hahn TJ, Halstead LR, Baran DT. Effects off short term glucocorticoid administration on intestinal calcium absorption and circulating vitamin D metabolite concentrations in man. J Clin Endocrinol Metab 1981;52:111-5.
      2. Trovato A, Nuhlicek DN, Midtling JE. Drug-nutrient interactions. Am Family Phys 1991;44:1651-8.
      3. Chesney RW, Mazess RB, Hamstra AJ, et al. Reduction of serum-1,25-dihydroxyvitamin-D, in children receiving glucocorticoids. Lancet 1978;ii:1123-5.
      4. Nielsen HK, Eriksen EF, Storm T, Mosekilde K. The effects of short-term, high-dose prednisone on the nuclear uptake of 1,25-dihydroxyvitamin D3 in monocytes from normal human subjects. Metabolism 1988;37:109-14.
      5. Avioli LV. Serum 25-hydroxyvitamin D concentrations in patients receiving chronic corticosteroid therapy. J Lab Clin Med 1977;23:399-404.
      6. Buckley LM, Leib ES, Cartularo KS, et al. Calcium and vitamin D3 supplementation prevents bone loss in the spine secondary to low-dose corticosteroids in patients with rheumatoid arthritis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1996;125:961-8.
      7. Amin S, LaValley PM, Simms RW, Felson DT. The role of vitamin D in corticosteroid-induced osteoporosis. Arthritis Rheum 1999;42:1740-51.
    • Calcium and Vitamin D

      Prednisolone Sodium Phosphate

      Reduce Side Effects

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Oral corticosteroids reduce absorption of calcium and interfere with the activation and metabolism of the vitamin, increasing the risk of bone loss. Doctors can measure levels of activated vitamin D (called 1,25 dihydroxycholecalciferol) to determine whether a deficiency exists; if so, activated vitamin D is only available by prescription. A study of rheumatoid arthritis patients treated with low amounts of prednisone found that those who received 1,000 mg of calcium per day plus 500 IU of vitamin D per day for two years experienced no bone loss during that time period. An analysis of properly conducted trials concluded that supplementation with vitamin D and calcium was more effective than placebo or calcium alone in protecting against corticosteroid-induced osteoporosis. Most doctors recommend 1,000 mg of calcium and 400–800 IU vitamin D per day for the prevention of osteoporosis.

      Prednisolone Sodium Phosphate
      Calcium and Vitamin D
      ×
      1. Hahn TJ, Halstead LR, Baran DT. Effects off short term glucocorticoid administration on intestinal calcium absorption and circulating vitamin D metabolite concentrations in man. J Clin Endocrinol Metab 1981;52:111-5.
      2. Trovato A, Nuhlicek DN, Midtling JE. Drug-nutrient interactions. Am Family Phys 1991;44:1651-8.
      3. Chesney RW, Mazess RB, Hamstra AJ, et al. Reduction of serum-1,25-dihydroxyvitamin-D, in children receiving glucocorticoids. Lancet 1978;ii:1123-5.
      4. Nielsen HK, Eriksen EF, Storm T, Mosekilde K. The effects of short-term, high-dose prednisone on the nuclear uptake of 1,25-dihydroxyvitamin D3 in monocytes from normal human subjects. Metabolism 1988;37:109-14.
      5. Avioli LV. Serum 25-hydroxyvitamin D concentrations in patients receiving chronic corticosteroid therapy. J Lab Clin Med 1977;23:399-404.
      6. Buckley LM, Leib ES, Cartularo KS, et al. Calcium and vitamin D3 supplementation prevents bone loss in the spine secondary to low-dose corticosteroids in patients with rheumatoid arthritis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1996;125:961-8.
      7. Amin S, LaValley PM, Simms RW, Felson DT. The role of vitamin D in corticosteroid-induced osteoporosis. Arthritis Rheum 1999;42:1740-51.
    • Calcium and Vitamin D

      Prednisone

      Reduce Side Effects

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Oral corticosteroids reduce absorption of calcium and interfere with the activation and metabolism of the vitamin, increasing the risk of bone loss. Doctors can measure levels of activated vitamin D (called 1,25 dihydroxycholecalciferol) to determine whether a deficiency exists; if so, activated vitamin D is only available by prescription. A study of rheumatoid arthritis patients treated with low amounts of prednisone found that those who received 1,000 mg of calcium per day plus 500 IU of vitamin D per day for two years experienced no bone loss during that time period. An analysis of properly conducted trials concluded that supplementation with vitamin D and calcium was more effective than placebo or calcium alone in protecting against corticosteroid-induced osteoporosis. Most doctors recommend 1,000 mg of calcium and 400–800 IU vitamin D per day for the prevention of osteoporosis.

      Prednisone
      Calcium and Vitamin D
      ×
      1. Hahn TJ, Halstead LR, Baran DT. Effects off short term glucocorticoid administration on intestinal calcium absorption and circulating vitamin D metabolite concentrations in man. J Clin Endocrinol Metab 1981;52:111-5.
      2. Trovato A, Nuhlicek DN, Midtling JE. Drug-nutrient interactions. Am Family Phys 1991;44:1651-8.
      3. Chesney RW, Mazess RB, Hamstra AJ, et al. Reduction of serum-1,25-dihydroxyvitamin-D, in children receiving glucocorticoids. Lancet 1978;ii:1123-5.
      4. Nielsen HK, Eriksen EF, Storm T, Mosekilde K. The effects of short-term, high-dose prednisone on the nuclear uptake of 1,25-dihydroxyvitamin D3 in monocytes from normal human subjects. Metabolism 1988;37:109-14.
      5. Avioli LV. Serum 25-hydroxyvitamin D concentrations in patients receiving chronic corticosteroid therapy. J Lab Clin Med 1977;23:399-404.
      6. Buckley LM, Leib ES, Cartularo KS, et al. Calcium and vitamin D3 supplementation prevents bone loss in the spine secondary to low-dose corticosteroids in patients with rheumatoid arthritis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1996;125:961-8.
      7. Amin S, LaValley PM, Simms RW, Felson DT. The role of vitamin D in corticosteroid-induced osteoporosis. Arthritis Rheum 1999;42:1740-51.
    • Vitamin D

      Primidone

      Reduce Side Effects

      Though research results vary, long-term use of anticonvulsant drugs appears to interfere with vitamin D activity, which might lead to softening of bones (osteomalacia). One study showed that blood levels of vitamin D in males taking anticonvulsants were lower than those found in men who were not taking seizure medication. In a controlled study, bone strength improved in children taking anticonvulsant drugs who were supplemented with the activated form of vitamin D and 500 mg per day of calcium for nine months. Some research suggests that differences in exposure to sunlight—which normally increases blood levels of vitamin D—might explain why some studies have failed to find a beneficial effect of vitamin D supplementation. In one controlled study, blood vitamin D levels in children taking anticonvulsants were dramatically lower in winter months than in summer months. Another study of 450 people in Florida taking anticonvulsants found that few had drug-induced bone disease. Consequently, people taking anticonvulsant drugs who do not receive adequate sunlight should supplement with 400 IU of vitamin D each day to help prevent osteomalacia.

      Primidone
      Vitamin D
      ×
      1. Nettekoven S, Strohle A, Trunz B, et al. Effects of antiepileptic drug therapy on vitamin D status and biochemical markers of bone turnover in children with epilepsy.Eur J Pediatr 2008;167:1369-77.
      2. Telci A, Cakatay U, Kurt BB, et al. Changes in bone turnover and deoxypyridinoline levels in epileptic patients Clin Chem Lab Med 2000 38:47-50.
      3. Jekovec-Vrhovsek M, Kocijancic A, Prezelj J. Effect of vitamin D and calcium on bone mineral density in children with CP and epilepsy in full-time care. Dev Med Child Neurol 2000;42:403-5.
      4. Riancho JA, Del Arco C, Arteaga R, et al. Influence of solar irradiation on vitamin D levels in children on anticonvulsant drugs. Acta Neurol Scand 1989;79:296-9.
      5. Williams C, Netzloff M, Folkerts L, et al. Vitamin D metabolism and anticonvulsant therapy: effect of sunshine on incidence of osteomalacia. South Med J 1984;77:834.
    • Vitamin D

      Rosuvastatin

      Reduce Side Effects
      In a preliminary trial, supplementation with vitamin D appeared to prevent muscle-related side effects in patients taking statin drugs. The amount of vitamin D used in this study was very large (up to 50,000 IU twice a week) and potentially toxic. People taking statin drugs should consult with their doctor regarding how much vitamin D can be taken.
      Rosuvastatin
      Vitamin D
      ×
      1. Glueck CJ, Budhani SB, Masineni SS, et al. Vitamin D deficiency, myositis-myalgia, and reversible statin intolerance. Curr Med Res Opin 2011;27:1683-90.
    • Vitamin D

      Simvastatin

      Reduce Side Effects
      In a preliminary trial, supplementation with vitamin D appeared to prevent muscle-related side effects in patients taking statin drugs. The amount of vitamin D used in this study was very large (up to 50,000 IU twice a week) and potentially toxic. People taking statin drugs should consult with their doctor regarding how much vitamin D can be taken.
      Simvastatin
      Vitamin D
      ×
      1. Glueck CJ, Budhani SB, Masineni SS, et al. Vitamin D deficiency, myositis-myalgia, and reversible statin intolerance. Curr Med Res Opin 2011;27:1683-90.
    • Vitamin D

      Topiramate

      Reduce Side Effects

      Though research results vary, long-term use of anticonvulsant drugs appears to interfere with vitamin D activity, which might lead to softening of bones (osteomalacia). One study showed that blood levels of vitamin D in males taking anticonvulsants were lower than those found in men who were not taking seizure medication. In a controlled study, bone strength improved in children taking anticonvulsant drugs who were supplemented with the activated form of vitamin D and 500 mg per day of calcium for nine months. Some research suggests that differences in exposure to sunlight—which normally increases blood levels of vitamin D—might explain why some studies have failed to find a beneficial effect of vitamin D supplementation. In one controlled study, blood vitamin D levels in children taking anticonvulsants were dramatically lower in winter months than in summer months. Another study of 450 people in Florida taking anticonvulsants found that few had drug-induced bone disease. Consequently, people taking anticonvulsant drugs who do not receive adequate sunlight should supplement with 400 IU of vitamin D each day to help prevent osteomalacia.

      Topiramate
      Vitamin D
      ×
      1. Nettekoven S, Strohle A, Trunz B, et al. Effects of antiepileptic drug therapy on vitamin D status and biochemical markers of bone turnover in children with epilepsy.Eur J Pediatr 2008;167:1369-77.
      2. Telci A, Cakatay U, Kurt BB, et al. Changes in bone turnover and deoxypyridinoline levels in epileptic patients Clin Chem Lab Med 2000 38:47-50.
      3. Jekovec-Vrhovsek M, Kocijancic A, Prezelj J. Effect of vitamin D and calcium on bone mineral density in children with CP and epilepsy in full-time care. Dev Med Child Neurol 2000;42:403-5.
      4. Riancho JA, Del Arco C, Arteaga R, et al. Influence of solar irradiation on vitamin D levels in children on anticonvulsant drugs. Acta Neurol Scand 1989;79:296-9.
      5. Williams C, Netzloff M, Folkerts L, et al. Vitamin D metabolism and anticonvulsant therapy: effect of sunshine on incidence of osteomalacia. South Med J 1984;77:834.
    • Calcium and Vitamin D

      Triamcinolone

      Reduce Side Effects

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Oral corticosteroids reduce absorption of calcium and interfere with the activation and metabolism of the vitamin, increasing the risk of bone loss. Doctors can measure levels of activated vitamin D (called 1,25 dihydroxycholecalciferol) to determine whether a deficiency exists; if so, activated vitamin D is only available by prescription. A study of rheumatoid arthritis patients treated with low amounts of prednisone found that those who received 1,000 mg of calcium per day plus 500 IU of vitamin D per day for two years experienced no bone loss during that time period. An analysis of properly conducted trials concluded that supplementation with vitamin D and calcium was more effective than placebo or calcium alone in protecting against corticosteroid-induced osteoporosis. Most doctors recommend 1,000 mg of calcium and 400–800 IU vitamin D per day for the prevention of osteoporosis.

      Triamcinolone
      Calcium and Vitamin D
      ×
      1. Hahn TJ, Halstead LR, Baran DT. Effects off short term glucocorticoid administration on intestinal calcium absorption and circulating vitamin D metabolite concentrations in man. J Clin Endocrinol Metab 1981;52:111-5.
      2. Trovato A, Nuhlicek DN, Midtling JE. Drug-nutrient interactions. Am Family Phys 1991;44:1651-8.
      3. Chesney RW, Mazess RB, Hamstra AJ, et al. Reduction of serum-1,25-dihydroxyvitamin-D, in children receiving glucocorticoids. Lancet 1978;ii:1123-5.
      4. Nielsen HK, Eriksen EF, Storm T, Mosekilde K. The effects of short-term, high-dose prednisone on the nuclear uptake of 1,25-dihydroxyvitamin D3 in monocytes from normal human subjects. Metabolism 1988;37:109-14.
      5. Avioli LV. Serum 25-hydroxyvitamin D concentrations in patients receiving chronic corticosteroid therapy. J Lab Clin Med 1977;23:399-404.
      6. Buckley LM, Leib ES, Cartularo KS, et al. Calcium and vitamin D3 supplementation prevents bone loss in the spine secondary to low-dose corticosteroids in patients with rheumatoid arthritis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1996;125:961-8.
      7. Amin S, LaValley PM, Simms RW, Felson DT. The role of vitamin D in corticosteroid-induced osteoporosis. Arthritis Rheum 1999;42:1740-51.
    • Vitamin D

      Zoledronic Acid

      Reduce Side Effects
      Musculoskeletal pain is one of the side effects of zoledronic acid. In a double-blind trial, supplementation with a single dose of vitamin D (300,000 IU) significantly decreased the severity of musculoskeletal pain in women being treated with zoledronic acid. The large amount of vitamin D used in this study has the potential to cause adverse effects, and therefore should be taken only under medical supervision.
      Zoledronic Acid
      Vitamin D
      ×
      1. Catalano A, Morabito N, Atteritano M, et al. Vitamin D reduces musculoskeletal pain after infusion of zoledronic acid for postmenopausal osteoporosis. Calcif Tissue Int 2012;90:279-85.
    • Vitamin D

      Zonisamide

      Reduce Side Effects

      Though research results vary, long-term use of anticonvulsant drugs appears to interfere with vitamin D activity, which might lead to softening of bones (osteomalacia). One study showed that blood levels of vitamin D in males taking anticonvulsants were lower than those found in men who were not taking seizure medication. In a controlled study, bone strength improved in children taking anticonvulsant drugs who were supplemented with the activated form of vitamin D and 500 mg per day of calcium for nine months. Some research suggests that differences in exposure to sunlight—which normally increases blood levels of vitamin D—might explain why some studies have failed to find a beneficial effect of vitamin D supplementation. In one controlled study, blood vitamin D levels in children taking anticonvulsants were dramatically lower in winter months than in summer months. Another study of 450 people in Florida taking anticonvulsants found that few had drug-induced bone disease. Consequently, people taking anticonvulsant drugs who do not receive adequate sunlight should supplement with 400 IU of vitamin D each day to help prevent osteomalacia.

      Zonisamide
      Vitamin D
      ×
      1. Nettekoven S, Strohle A, Trunz B, et al. Effects of antiepileptic drug therapy on vitamin D status and biochemical markers of bone turnover in children with epilepsy.Eur J Pediatr 2008;167:1369-77.
      2. Telci A, Cakatay U, Kurt BB, et al. Changes in bone turnover and deoxypyridinoline levels in epileptic patients Clin Chem Lab Med 2000 38:47-50.
      3. Jekovec-Vrhovsek M, Kocijancic A, Prezelj J. Effect of vitamin D and calcium on bone mineral density in children with CP and epilepsy in full-time care. Dev Med Child Neurol 2000;42:403-5.
      4. Riancho JA, Del Arco C, Arteaga R, et al. Influence of solar irradiation on vitamin D levels in children on anticonvulsant drugs. Acta Neurol Scand 1989;79:296-9.
      5. Williams C, Netzloff M, Folkerts L, et al. Vitamin D metabolism and anticonvulsant therapy: effect of sunshine on incidence of osteomalacia. South Med J 1984;77:834.
  • Explanation Required

    14
    • Vitamin D

      Allopurinol

      Needs Explanation

      Individuals with gout have low blood concentration of the active form of vitamin D (1,25 dihydroxycholecalciferol), and allopurinol corrects this problem.

      Allopurinol
      Vitamin D
      ×
      1. Takahashi S, Yamamoto T, Moriwaki Y, et al. Decreased serum concentrations of 1, 25 (OH)2-vitamin D3 in patients with gout. Metabolism 1998;47:336-8.
    • Vitamin D

      Bendroflumethiazide

      Needs Explanation

      The reduction in urinary calcium loss resulting from treatment with thiazide diuretics is due primarily to changes in kidney function and may also be due, in part, to changes in vitamin D metabolism. However, there is no evidence to suggest that people taking diuretics have different requirements for vitamin D.

      Bendroflumethiazide
      Vitamin D
      ×
      1. Riis B, Christiansen C. Actions of thiazide on vitamin D metabolism: A controlled therapeutic trial in normal women early in the postmenopause. Metabolism 1985;34:421-4.
    • Vitamin D

      Chlorothiazide

      Needs Explanation

      The reduction in urinary calcium loss resulting from treatment with thiazide diuretics is due primarily to changes in kidney function and may also be due, in part, to changes in vitamin D metabolism. However, there is no evidence to suggest that people taking diuretics have different requirements for vitamin D.

      Chlorothiazide
      Vitamin D
      ×
      1. Riis B, Christiansen C. Actions of thiazide on vitamin D metabolism: A controlled therapeutic trial in normal women early in the postmenopause. Metabolism 1985;34:421-4.
    • Vitamin D

      Chlorthalidone

      Needs Explanation

      The reduction in urinary calcium loss resulting from treatment with thiazide diuretics is due primarily to changes in kidney function and may also be due, in part, to changes in vitamin D metabolism. However, there is no evidence to suggest that people taking diuretics have different requirements for vitamin D.

      Chlorthalidone
      Vitamin D
      ×
      1. Riis B, Christiansen C. Actions of thiazide on vitamin D metabolism: A controlled therapeutic trial in normal women early in the postmenopause. Metabolism 1985;34:421-4.
    • Vitamin D

      Gabapentin

      Needs Explanation

      Though research results vary, long-term use of anticonvulsant drugs appears to interfere with vitamin D activity, which might lead to softening of bones (osteomalacia). One study showed that blood levels of vitamin D in males taking anticonvulsants were lower than those found in men who were not taking seizure medication. In a controlled study, bone strength improved in children taking anticonvulsant drugs who were supplemented with the activated form of vitamin D and 500 mg per day of calcium for nine months. Some research suggests that differences in exposure to sunlight—which normally increases blood levels of vitamin D—might explain why some studies have failed to find a beneficial effect of vitamin D supplementation. In one controlled study, blood vitamin D levels in children taking anticonvulsants were dramatically lower in winter months than in summer months. Another study of 450 people in Florida taking anticonvulsants found that few had drug-induced bone disease. Consequently, people taking anticonvulsant drugs who do not receive adequate sunlight should supplement with 400 IU of vitamin D each day to help prevent osteomalacia.

      Gabapentin
      Vitamin D
      ×
      1. Telci A, Cakatay U, Kurt BB, et al. Changes in bone turnover and deoxypyridinoline levels in epileptic patients Clin Chem Lab Med 2000 38:47-50.
      2. Jekovec-Vrhovsek M, Kocijancic A, Prezelj J. Effect of vitamin D and calcium on bone mineral density in children with CP and epilepsy in full-time care. Dev Med Child Neurol 2000;42:403-5.
      3. Riancho JA, Del Arco C, Arteaga R, et al. Influence of solar irradiation on vitamin D levels in children on anticonvulsant drugs. Acta Neurol Scand 1989;79:296-9.
      4. Williams C, Netzloff M, Folkerts L, et al. Vitamin D metabolism and anticonvulsant therapy: effect of sunshine on incidence of osteomalacia. South Med J 1984;77:834.
    • Vitamin D

      Hydrochlorothiazide

      Needs Explanation

      The reduction in urinary calcium loss resulting from treatment with thiazide diuretics is due primarily to changes in kidney function and may also be due, in part, to changes in vitamin D metabolism. However, there is no evidence to suggest that people taking diuretics have different requirements for vitamin D.

      Hydrochlorothiazide
      Vitamin D
      ×
      1. Riis B, Christiansen C. Actions of thiazide on vitamin D metabolism: A controlled therapeutic trial in normal women early in the postmenopause. Metabolism 1985;34:421-4.
    • Vitamin D

      Hydroflumethiazide

      Needs Explanation

      The reduction in urinary calcium loss resulting from treatment with thiazide diuretics is due primarily to changes in kidney function and may also be due, in part, to changes in vitamin D metabolism. However, there is no evidence to suggest that people taking diuretics have different requirements for vitamin D.

      Hydroflumethiazide
      Vitamin D
      ×
      1. Riis B, Christiansen C. Actions of thiazide on vitamin D metabolism: A controlled therapeutic trial in normal women early in the postmenopause. Metabolism 1985;34:421-4.
    • Vitamin D

      Medroxyprogesterone

      Needs Explanation

      In a study of postmenopausal women, treatment with estrogen alone increased vitamin D blood levels, whereas estrogen plus medroxyprogesterone lowered vitamin D back to the level seen without estrogen use. This outcome might suggest that medroxyprogesterone interferes with beneficial effects estrogen may have on vitamin D metabolism and vitamin D supplementation would be called for. However, some research has not found the addition of vitamin D to estrogen/progestin combinations to be helpful. Therefore, while many doctors recommend 400 IU vitamin D to women taking estrogen/progestin combination hormone products, the efficacy of such supplementation has not been proven.

      Medroxyprogesterone
      Vitamin D
      ×
      1. Bikle DD, Halloran BP, Harris ST, Portale AA. Progestin antagonism of estrogen stimulated 1,25-dihydroxyvitamin D levels. J Clin Endocrinol Metab 1992;75:519-23.
      2. Komulainen M, Tuppurainen MT, Kroger H, et al. Vitamin D and HRT: no benefit additional to that of HRT alone in prevention of bone loss in early postmenopausal women. A 2.5-year randomized placebo-controlled study. Osteoporosis Int 1997;7:126-32.
    • Vitamin D

      Methyclothiazide

      Needs Explanation

      The reduction in urinary calcium loss resulting from treatment with thiazide diuretics is due primarily to changes in kidney function and may also be due, in part, to changes in vitamin D metabolism. However, there is no evidence to suggest that people taking diuretics have different requirements for vitamin D.

      Methyclothiazide
      Vitamin D
      ×
      1. Riis B, Christiansen C. Actions of thiazide on vitamin D metabolism: A controlled therapeutic trial in normal women early in the postmenopause. Metabolism 1985;34:421-4.
    • Vitamin D

      Metolazone

      Needs Explanation

      The reduction in urinary calcium loss resulting from treatment with thiazide diuretics is due primarily to changes in kidney function and may also be due, in part, to changes in vitamin D metabolism.10 However, there is no evidence to suggest that people taking diuretics have different requirements for vitamin D.

    • Vitamin D

      Polythiazide

      Needs Explanation

      The reduction in urinary calcium loss resulting from treatment with thiazide diuretics is due primarily to changes in kidney function and may also be due, in part, to changes in vitamin D metabolism. However, there is no evidence to suggest that people taking diuretics have different requirements for vitamin D.

      Polythiazide
      Vitamin D
      ×
      1. Riis B, Christiansen C. Actions of thiazide on vitamin D metabolism: A controlled therapeutic trial in normal women early in the postmenopause. Metabolism 1985;34:421-4.
    • Vitamin D

      Risedronate

      Needs Explanation

      Short-term treatment with risedronate in people with hyperparathydoidism—a disorder characterized by high blood levels of calcium—resulted in lower calcium blood levels. Additional research is needed to determine whether people taking risedronate for Paget’s disease might develop low blood calcium levels. As a precaution, people with Paget’s disease should take supplemental calcium and vitamin D if dietary intake is inadequate. However, taking risedronate at the same time as calcium supplements reduces absorption of the drug. Therefore, people taking risedronate for Paget’s disease should take calcium supplements an hour before or two hours after taking the drug.

      Risedronate
      Vitamin D
      ×
      1. Reasner CA, Stone MD, Hosking DJ, et al. Acute changes in calcium homeostasis during treatment of primary hyperparathyroidism with risedronate. J Clin Endocrinol Metab 1993;77:1067-71.
      2. Sifton DW, ed. Physicians' Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 2504-6.
    • Vitamin D

      Trichlormethiazide

      Needs Explanation

      The reduction in urinary calcium loss resulting from treatment with thiazide diuretics is due primarily to changes in kidney function and may also be due, in part, to changes in vitamin D metabolism. However, there is no evidence to suggest that people taking diuretics have different requirements for vitamin D.

      Trichlormethiazide
      Vitamin D
      ×
      1. Riis B, Christiansen C. Actions of thiazide on vitamin D metabolism: A controlled therapeutic trial in normal women early in the postmenopause. Metabolism 1985;34:421-4.
    • Vitamin D

      Valproate

      Needs Explanation

      Though research results vary, long-term use of anticonvulsant drugs appears to interfere with vitamin D activity, which might lead to softening of bones (osteomalacia). One study showed that blood levels of vitamin D in males taking anticonvulsants were lower than those found in men who were not taking seizure medication. In a controlled study, bone strength improved in children taking anticonvulsant drugs who were supplemented with the activated form of vitamin D and 500 mg per day of calcium for nine months. Some research suggests that differences in exposure to sunlight—which normally increases blood levels of vitamin D—might explain why some studies have failed to find a beneficial effect of vitamin D supplementation. In one controlled study, blood vitamin D levels in children taking anticonvulsants were dramatically lower in winter months than in summer months. Another study of 450 people in Florida taking anticonvulsants found that few had drug-induced bone disease. Consequently, people taking anticonvulsant drugs who do not receive adequate sunlight should supplement with 400 IU of vitamin D each day to help prevent osteomalacia.

      Valproate
      Vitamin D
      ×
      1. Telci A, Cakatay U, Kurt BB, et al. Changes in bone turnover and deoxypyridinoline levels in epileptic patients Clin Chem Lab Med 2000 38:47-50.
      2. Jekovec-Vrhovsek M, Kocijancic A, Prezelj J. Effect of vitamin D and calcium on bone mineral density in children with CP and epilepsy in full-time care. Dev Med Child Neurol 2000;42:403-5.
      3. Riancho JA, Del Arco C, Arteaga R, et al. Influence of solar irradiation on vitamin D levels in children on anticonvulsant drugs. Acta Neurol Scand 1989;79:296-9.
      4. Williams C, Netzloff M, Folkerts L, et al. Vitamin D metabolism and anticonvulsant therapy: effect of sunshine on incidence of osteomalacia. South Med J 1984;77:834.

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2. Lotfi A, Abdel-Nasser AM, Hamdy A, et al. Hypovitaminosis D in female patients with chronic low back pain. Clin Rheumatol 2007;26:1895-901.

3. De Torrente de la Jara G, Pecoud A, Favrat B. Musculoskeletal pain in female asylum seekers and hypovitaminosis D3. BMJ 2004;329:156-7.

4. Prakash S, Shah ND. Chronic tension-type headache with vitamin D deficiency: casual or causal association? Headache 2009;49:1214-22.

5. Wepner F, Scheuer R, Schuetz-Wieser B, et al. Effects of vitamin D on patients with fibromyalgia syndrome: A randomized placebo-controlled trial. Pain 2014;155:261–8.

6. Klein GL, Chen TC, Holick MF, et al. Synthesis of vitamin D in skin after burns. Lancet 2004;363:291-2.

7. Garrel D. Burn scars: a new cause of vitamin D deficiency? Lancet 2004;363:259-60.

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9. Thys-Jacobs S. Alleviation of migraines with therapeutic vitamin D and calcium. Headache 1994;34:590-2.

10. Brot C, Jorgensen N, Madsen OR, et al. Relationships between bone mineral density, serum vitamin D metabolites and calcium: phosphorus intake in healthy perimenopausal women. J Intern Med 1999;245:509-16.

11. Sahota O. Osteoporosis and the role of vitamin D and calcium-vitamin D deficiency, vitamin D insufficiency and vitamin D sufficiency. Age Ageing 2000;29:301-4.

12. Dawson-Hughes B, Dallal GE, Krall EA, et al. Effect of vitamin D supplementation on wintertime and overall bone loss in healthy postmenopausal women. Ann Intern Med 1991;115:505-12.

13. Adams JS, Kantorovich V, Wu C, et al. Resolution of vitamin D insufficiency in osteopenic patients results in rapid recovery of bone mineral density. J Clin Endocrinol Metab 1999;84:2729-30.

14. Macdonald HM, Wood AD, Aucott LS, et al. Hip bone loss is attenuated with 1000 IU but not 400 IU daily vitamin D3: a 1-year double-blind RCT in postmenopausal women. J Bone Miner Res 2013;28:2202–13.

15. Nordin BE, Baker MR, Horsman A, Peacock M. A prospective trial of the effect of vitamin D supplementation on metacarpal bone loss in elderly women. Am J Clin Nutr 1985;42(3):470-4.

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17. Komulainen M, Tuppurainen MT, Kroger H, et al. Vitamin D and HRT: no benefit additional to that of HRT alone in prevention of bone loss in early postmenopausal women. A 2.5-year randomized placebo-controlled study. Osteoporosis Int 1997;7:126-32.

18. Droisy R, Collette J, Chevallier T, et al. Effects of two 1-year calcium and vitamin D3 treatments on bone remodeling markers and femoral bone density in elderly women. Curr Ther Res 1998;59:850-62.

19. Chapuy MC, Arlot ME, Duboeuf F, et al. Vitamin D3 and calcium to prevent hip fractures in the elderly women. N Engl J Med 1992;327:1637-42.

20. Maki BE, Holliday PJ, Topper AK. A prospective study of postural balance and risk of falling in an ambulatory and independent elderly population. J Gerontol 1994;49:M72-84.

21. Leboff MS, Hawkes WG, Glowacki J, et al. Vitamin D-deficiency and post-fracture changes in lower extremity function and falls in women with hip fractures. Osteoporos Int 2008;19:1283-90.

22. Pfeifer M, Begerow B, Minne HW, et al. Effects of a short-term vitamin D and calcium supplementation on body sway and secondary hyperparathyroidism in elderly women. J Bone Miner Res 2000;15:1113-8.

23. Broe KE, Chen TC, Weinberg J, et al. A higher dose of vitamin D reduces the risk of falls in nursing home residents: a randomized, multiple-dose study. J Am Geriatr Soc 2007;55:234-9.

24. Abraham GE, Grewal H. A total dietary program emphasizing magnesium instead of calcium. J Reprod Med 1990;35:503-7.

25. Hyppönen E, Boucher BJ. Adiposity, vitamin D requirements, and clinical implications for obesity-related metabolic abnormalities. Nutr Rev 2018 09;76(9):678–692.

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27. Lotfi-Dizaji L, Mahboob S, Aliashrafi S, et al. Effect of vitamin D supplementation along with weight loss diet on meta-inflammation and fat mass in obese subjects with vitamin D deficiency: A double-blind placebo-controlled randomized clinical trial. Clin Endocrinol (Oxf) 2019 01;90(1):94–101.

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33. Cadario F, Savastio S, Ricotti R, et al. Administration of vitamin D and high dose of omega 3 to sustain remission of type 1 diabetes. Eur Rev Med Pharmacol Sci 2018;22:512–5.

34. Cadario F, Savastio S, Rizzo A, et al. Can Type 1 diabetes progression be halted? Possible role of high dose vitamin D and omega 3 fatty acids. Eur Rev Med Pharmacol Sci 2017;21:1604–9.

35. Gregoriou E, Mamais I, Tzanetakou I, et al. The Effects of Vitamin D Supplementation in Newly Diagnosed Type 1 Diabetes Patients: Systematic Review of Randomized Controlled Trials. Rev Diabet Stud 2017;14:260–8.

36. Felicio K, de Souza A, Neto J, et al. Glycemic Variability and Insulin Needs in Patients with Type 1 Diabetes Mellitus Supplemented with Vitamin D: A Pilot Study Using Continuous Glucose Monitoring System. Curr Diabetes Rev 2018;14:395–403.

37. Bogdanou D, Penna-Martinez M, Filmann N, et al. T-lymphocyte and glycemic status after vitamin D treatment in type 1 diabetes: A randomized controlled trial with sequential crossover. Diabetes Metab Res Rev 2017;33.

38. Wierzbicka E, Szalecki M, Pludowski P, et al. Vitamin D status, body composition and glycemic control in Polish adolescents with type 1 diabetes. Minerva Endocrinol 2016;41:445–55.

39. Savastio S, Cadario F, Genoni G, et al. Vitamin D Deficiency and Glycemic Status in Children and Adolescents with Type 1 Diabetes Mellitus. PLoS One 2016;11:e0162554.

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