Drug–Vitamin D Interactions, A Systematic Review – Jan 2013

Nutr Clin Pract January 10, 2013 0884533612467824
Kim Robien, PhD, RD, CSO 1
Sarah J. Oppeneer, MS 2
Julia A. Kelly, MS, MLIS 3
Jill M. Hamilton-Reeves, PhD, RD 4
1 Department of Epidemiology and Biostatistics, George Washington University School of Public Health and Health Services, Washington, DC
2 Division of Epidemiology and Community Health, University of Minnesota, Minneapolis
3 University Libraries, University of Minnesota, Minneapolis
4 University of Kansas Medical Center, School of Health Professions, Department of Dietetics & Nutrition, Kansas City, Kansas
Kim Robien, PhD, RD, CSO, Associate Professor, Department of Epidemiology and Biostatistics, George Washington University School of Public Health and Health Services, 2100-W Pennsylvania Ave NW, 8th Floor, Washington, DC, 20037, USA. Email: krobien at gwu.edu.

Extensive media coverage of the potential health benefits of vitamin D supplementation has translated into substantial increases in supplement sales over recent years. Yet, the potential for drug–vitamin D interactions is rarely considered. This systematic review of the literature was conducted to evaluate the extent to which drugs affect vitamin D status or supplementation alters drug effectiveness or toxicity in humans. Electronic databases were used to identify eligible peer-reviewed studies published through September 1, 2010. Study characteristics and findings were abstracted, and quality was assessed for each study.
A total of 109 unique reports met the inclusion criteria.
The majority of eligible studies were classified as class

• C (nonrandomized trials, case-control studies, or time series) or
• D (cross-sectional, trend, case report/series, or before-and-after studies).
    Only 2 class C and 3 class D studies were of positive quality.

Insufficient evidence was available to determine whether

• lipase inhibitors,
• antimicrobial agents,
• antiepileptic drugs,
• highly active antiretroviral agents, or
• H2 receptor antagonists
    alter serum 25(OH)D concentrations.

{However,}

• Atorvastatin appears to increase 25(OH)D concentrations, whereas
• concurrent vitamin D supplementation decreases concentrations of atorvastatin.
• Use of thiazide diuretics in combination with calcium and vitamin D supplements
    may cause hypercalcemia in the elderly or those with compromised renal function or hyperparathyroidism.

Larger studies with stronger study designs are needed to clarify potential drug–vitamin D interactions,
especially for drugs metabolized by cytochrome P450 3A4 (CYP3A4).

Healthcare providers should be aware of the potential for drug–vitamin D interactions.

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See also Vitamin D Life

• Drug-induced bone loss: a major safety concern (Vitamin D can help) – Sept 2018
• All items in category Drug interactions with and Vitamin D 102 items
• The statin Crestor dramatically increases levels of vitamin D in the blood – Jan 2012
• Extensive review of influence of drugs on vitamin D and Calcium – April 2012
• Is more medication needed with high level of vitamin D – March 2012
• Vitamin D interactions with drugs – Oct 2011
• Oral contraceptives may reduce or increase vitamin D
• On-line survey of drug uses and side effects – including vitamin D
• Possible Vitamin D interactions and vicious circles
• Drugs which create a vitamin D deficiency
• Antiretroviral (TDF) is yet another drug which reduces vitamin D levels – Aug 2013
• Review of vitamin D interaction with drugs – Jan 2014
• Drugs that may harm bone (vitamin D needed) -April 2016