Drug–Vitamin D Interactions, A Systematic Review

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@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.

Partial PDF Table of Contents

📄 Download the PDF from VitaminDWiki

---

VitaminDWiki - Interactions with Vitamin D contains

{include}