A Literature Review of the Potential Impact of Medication on Vitamin D Status
Risk Management and Healthcare Policy 2021:14 3357-338110.2147/RMHP.S316897
Michael Wakeman
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: anti-epileptics, laxatives, metformin, loop diuretics, angiotensin-converting enzyme inhibitors, thiazide diuretics, statins, calcium channel blockers, antagonists of vitamin K, platelet aggregation inhibitors, digoxin, potassium-sparing diuretics, benzodiazepines, antidepressants, proton pump inhibitors, histamine H2-receptor antagonists, bile acid sequestrants, corticosteroids, antimicrobials, sulphonamides and urea derivatives, lipase inhibitors, hydroxychloroquine, highly active antiretroviral agents, and 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.
Enzyme-Inducing Anti-Epileptic Drugs (EIAEDs)
Carbamazepine, phenobarbital, and phenytoin
Medication - VitaminDWiki summary of lots of detai in the PDF
Antidiabetic Medications
Metformin
Thiazolidinediones (TDZs)
Thiazide Diuretics – mixed research
Calcium Channel Blockers (cardio)
Angiotensin-Converting Enzyme (ACE) Inhibitors
Statins – mixed
Bile Acid Sequestrants
Vitamin K Antagonists
Heparin
Digoxin unsure
CNS Medications
Benzodiazepines unsure
Antidepressants
Enzyme-Inducing Antiepileptic Drugs (AEDs)
Newer Antiepileptic Drugs mixed
Gastrointestinal Medications
Proton Pump Inhibitors (PPIs) perhaps
Histamine H2-Receptor Antagonists (H2RAs)
Laxatives
Anti-Inflammatory Medications
Inhaled Corticosteroids (ICS) mixed
Hydroxychloroquine increased /Vitamin D
Anti-infectives/Antivirals
Antimicrobials mixed results
Sulphonamides and Urea Derivatives
Highly Active Antiretroviral Therapy (HAART)
Chemotherapeutic Agents - tamoxifen, docetaxel, paclitaxel, ifosfamide, etoposide, vinblastine, vincristine, cyclophosphamide, imatinib, and irinotecan.
Note:Some others aredangerously inhanced by Vitamin D
Digoxin perhaps
CNS Medications
Benzodiazepines
Whereas a lack of a significant effect of benzodiazepines on vitamin D status has been reported in three cross-sectional studies,76,80,142 Sohl et al, in a subsequent subgroup analysis of participants in their study, did observe a significant inverse association.76
Antidepressants
T
Proton Pump Inhibitors (PPIs)
Theoretically, the hypochlorhydria induced by this class of medication could result in malabsorption of calcium, with the suggestion that prolonged exposure to acid suppression may be a clinically relevant consequence contributing to increased osteoporosis risk.144,145 One review suggests that it may be advisable to consider supplementation with vitamin D and calcium for the elderly, where highdose PPI therapy, especially over a long-term period, is being employed.146
VitaminDwiki - Interactions with Vitamin D category contains
Interactions with Vitamin D hasVarious drugs decrease Vitamin D
Drug interactions with Vitamin D - many studies - Feb 2024
Antidepressants reduce cellular Vitamin D, increasing fractures, CVD, etc. - Oct 2022
Medications that appear to lower Vitamin D – Aug 2021
24 drugs that typically reduce Vitamin D levels – Review Aug 2021
Proton pump inhibitors decrease Vitamin D and Magnesium – Dec 2018
Statins and Vitamin D - many studies
Glyphosate decreases Vitamin D getting to cells in many ways
Antibiotics and Vitamin D are associated with many of the same diseases
More colas lower vitamin D by 3 ng– July 2014
A few Drugs increase Vitamin D
Contraceptives, Probiotics
Vitamin D can decrease/increase impact of drugs
be careful of Chemotheraphy and Vitamin D
Vitamin D generally improves the efficacy of drugs while reducing their adverse effects – Jan 2020
Some Drugs decrease Vitiamin D co-factors or limit vitamin D getting to cells
Drugs which create deficiencies in Vitamin D, Vitamin K, Magnesium, Zinc, Iron, etc. – Sept 2017
Drugs Deplete Magnesium
Interaction of drugs with Vitamin D cofactors
Non-drugs also decrease vitamin D levels in blood and cells
Plastics, BPA, PCB and Vitamin D deficiency
Air pollution, toxins, heavy metals and smoking each result in lower Vitamin D levels – Nov 2018
Air Pollution reduces Vitamin D
Pesticides increase risk of Cancers, Alz, ALS, Asthma, ADHD, etc. (all related to low vitamin D) – Oct 2016
Smoking Coffee
Cooked dried beans or peas
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