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24 drugs that typically reduce Vitamin D levels – Review Aug 2021

A Literature Review of the Potential Impact of Medication on Vitamin D Status

Risk Manag Healthc Policy. 2021 Aug 14;14:3357-3381. doi: 10.2147/RMHP.S316897
Michael Wakeman 1

Table of Contents

interactions with Vitamin D category listing has 106 items along with related searches

Not mentioned in this study
Note: Drugs also decrease vitamin D cofactors - example: Drugs Deplete Magnesium
Note: Drugs also decrease genes needed to activate and utilize Vitamin D
Note: Chemicals also decrease Vitamin D and cofactors
Note: Some drugs change potency when Vitamin D is increased (increase in a hormone)
Note: Some food decrease Vitamin D levels: e.g. coffee, dried beans and peas

 Download the PDF from VitaminDWiki
Sample of Table in PDF

In recent years, there has been a significant increase in media coverage of the putative actions of vitamin D as well as the possible health benefits that supplementation might deliver. However, the potential effect that medications may have on the vitamin D status is rarely taken into consideration. This literature review was undertaken to assess the degree to which vitamin D status may be affected by medication. Electronic databases were searched to identify literature relating to this subject, and study characteristics and conclusions were scrutinized for evidence of potential associations.
The following groups of drugs were identified in one or more studies to affect vitamin D status in some way:

  1. anti-epileptics
  2. laxatives
  3. metformin
  4. loop diuretics
  5. angiotensin-converting enzyme inhibitors
  6. thiazide diuretics
  7. statins
  8. calcium channel blockers
  9. antagonists of vitamin K
  10. platelet aggregation inhibitors
  11. digoxin
  12. potassium-sparing diuretics
  13. benzodiazepines
  14. antidepressants
  15. proton pump inhibitors
  16. histamine H2-receptor antagonists
  17. bile acid sequestrants
  18. corticosteroids
  19. antimicrobials
  20. sulphonamides and urea derivatives
  21. lipase inhibitors
  22. hydroxychloroquine
  23. highly active antiretroviral agents
  24. certain chemotherapeutic agents.

Given that the quality of the data is heterogeneous, newer, more robustly designed studies are required to better define likely interactions between vitamin D and medications. This is especially so for cytochrome P450 3A4 enzyme (CYP3A4)-metabolized medications. Nevertheless, this review suggests that providers of health care ought to be alert to the potential of vitamin D depletions induced by medications, especially in elderly people exposed to multiple-drug therapy, and to provide supplementation if required.

Review of this study by Grassroots Health - Aug 2021

Text was extracted from GRH table so that it can be read in any of 100+ languages

MedicationTypeEffect on Vitamin D
MetforminAntidiabeticMay lower vitamin D levels, with other oral antidiabetic medications
Thiazolidinediones (TDZs)AntidiabeticIncreases risk of bone loss, especially in women
Thiazide DiureticsDiureticPotential increased risk of hypercalcemia
Loop DiureticsDiureticPotential increased risk of hyperparathyroidism and increased conversion of 25(OH)D to 1,25(OH)2D
Potassium-Sparing DiureticsDiureticMixed findings
Calcium Channel BlockersCardiovascularIncrease risk of vitamin D deficiency
Angiotensin-ConvertingEnzyme (ACE) InhibitorsCardiovascularMay lower vitamin D levels
StatinsCardiovascularMixed findings; some have shown increased vitamin D levels while others have found decreased levels with statin use
Bile Acid SequestrantsCardiovascularMay decrease vitamin D absorption, increase risk of osteomalacia at certain doses
Vitamin K AntagonistsCardiovascularMay lower vitamin D levels
Platelet Aggregation InhibitorsCardiovascularMixed findings
HeparinCardiovascularNegatively affects vitamin D metabolism, increases risk of osteoporotic fractures, especially seen with unfractionated heparin
DigoxinCardiovascularLinked to lower vitamin D
BenzodiazepinesCNSLinked to lower vitamin D
Antidepressants (SSRIs)CNSLinked to lower vitamin D
Enzyme-Inducing Antiepileptic Drugs (AEDs)CNSLinked to lower vitamin D and vitamin D deficiency
Newer Antiepileptic DrugsCNSMixed findings; may lower bone mineral density and increase risk of fracture
Proton Pump Inhibitors (PPIs)GastrointestinalMay increased risk of osteoporosis; vitamin D and calcium supplementation recommended
Histamine H2-Receptor AntagonistsGastrointestinalMay decrease vitamin D, mixed findings
Lipase InhibitorsGastrointestinalMay inhibit vitamin D uptake and absorption
LaxativesGastrointestinalReduce vitamin D absorption, may result in osteomalacia
CorticosteroidsAnti-InflammatoryMay reduce vitamin D levels, increase risk of osteoporosis
Inhaled Corticosteroids (ICS)Anti-InflammatoryMixed findings; long term use may negatively impact bone metabolism and bone mineral density, especially in those with COPD
HydroxychloroquineAnti-InflammatoryMay increase vitamin D levels
May decrease vitamin D; increased risk of osteomalacia with prolonged use
Sulphonamides and Urea DerivativesAnti-infectives/
Lower vitamin D levels
Highly Active Antiretroviral Therapy (HAART)Anti-infectives/
Mixed findings, may lower vitamin D
Chemotherapeutic AgentsCancerMay lower vitamin D levels; studies show vitamin D may enhance the effect of these therapies

CNS = Central Nervous System

Created by admin. Last Modification: Monday August 30, 2021 10:32:34 GMT-0000 by admin. (Version 11)

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