mediscript.net · any other professionally trained persons who may provide medical treatment,...

Section 1 • + 80 top brand prescription drugs listed• Specific vitamin/supplement Interactions

explained

Section 2 • + 60 vitamins & supplements listed • Specific generic named drugs named which

interact and noted: a. may be beneficial b. should be avoided or c. more information needed

Web links for more information

“This reference guide is practical, comprehensive and easy to use not only for patients but also pharmacists in this fast changing new era of treatment complexity where adjustments have to be made to ensure treatment harmony” George Simpson, Pharmacist, Ohio

$9.95ISBN 978-1-896616-00-1

MediScriptCommunications Inc.

1

DRUG / VITAMIN SUPPLEMENT INTERACTIONS

A reference guide for consumers and health professionals

Contributors: Dr. James Sinclair and Audrey Wilson PhD

In consultation with the Institute of Medicine (IOM), Physicians Association for Patient Education (PAPE), Health Canada, Federal Drug Administration (FDA), the Natural Products Association (NPA), American Nutraceutical Association, American Pharmacists Association (APA), and the Association of Managed Care Pharmacists (AMCP).Cover design by: Seth Meierotto of BarkinSpider Studio.www.Barkerspider.com

Our thanks to the many pharmacists, naturopaths, physicians and other health care professionals that assisted, encouraged, edited and/or contributed to the development of this reference guide.

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form by any means electronic, mechanical, photocopying, recording, or otherwise, without prior permission of the publisher Mediscript Communications Inc.

The publisher acknowledges the financial support of the Government of Canada through the Book Publishing Industry Development Program (BPIDP) for our publishing activities.

© 2007 Mediscript Communications Inc. ISBN # 978 1 896616 00 1

Printed in Canada

t

2016

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General Notice and Disclaimer

This reference guide is for the use of patients, consumers, health care professionals or any other professionally trained persons who may provide medical treatment, services or advice to patients, clients or customers.

The information presented has been obtained from research of reference books, clinical and scientific published papers and other published works. The contributors and editors have made every possible attempt to verify the accuracy of the content of this book.

It should be noted by that there are constant changes in information resulting from ongoing research and clinical experience, differences in opinions among authorities, unique individual experiences, translation misunderstandings and the possibility of human error in compiling this reference guide requiring the reader to use judgment and further research from other resources and to seek professional advice when making decisions based on this material.

Many of the interactions denoted between a drug and a vitamin or supplement do not necessarily qualitatively or quantitatively describe the manner of the interaction. We advise a cautious approach and recommend further checking and seeking more detailed information.

This book refers only to the most widely used prescription drugs at the time of writing. There may be other medications not listed in this book that also have interactions with vitamins and supplements.

The publisher, author and contributors highly recommend that the reader should consider the succinct information provided as suggestive for further research and seek advice from a health professional, especially if medication or other changes are being considered.

The contributors, editors, authors, publishing company and distributors do not accept any responsibility for the accuracy of the information itself or the consequences from the use or misuse of the information from this book.

It must be emphasized that this book is not intended as a guide to self medication or self treatment by consumers or patients. The lay reader is advised to discuss the information contained here with a health care professional or authorized health care practitioner.

DS1002007

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Table of ContentsIntroduction ................... 9 How to use this book ..... 13

SECTION 1 Prescribed drugs

Accupril ......................... 15Aciphex ......................... 16Actonel ......................... 16Actos ........................... 17Advair Diskus ................. 17Aggrenox ....................... 18Allegra ......................... 18Alphagan P ................... 18Altace .......................... 19Amaryl ......................... 19 Ambien ........................ 19Aricept ......................... 19Arimidex ........................ 20Asacol ........................... 21Atacand......................... 21Atrovent ........................ 22Avandia ........................ 22Avapro ......................... 23Celaxa ........................... 23Cipro ............................ 24Clarinex ......................... 25Combivent .................... 25Coreg ............................ 26Cosopt ......................... 26Coumadin ..................... 27Cozaar ......................... 29Detrol ........................... 29

Diovan .......................... 30 Ditropan ........................ 30 Duragesic ...................... 31 Effexor XR ..................... 31 Evista ........................... 32Exelon .......................... 32 Flomax ......................... 33 Flonase / Flovent ........... 33 Foltx ............................. 34Fosamax ...................... 34Glucotrol ....................... 35Glucovance ................... 36Humalin N .................... 37Hyzaar .......................... 36Lanoxin ........................ 38Lescol ........................... 40Levaquin ...................... 41 Lexapro ........................ 42Lipitor .......................... 42 Lotensin ....................... 43Lumigan ....................... 44Macrobid ....................... 44Metformin .................... 45Miacalcin ...................... 46Mobic ........................... 46 Monopril ........................ 47Nasonex ....................... 47 Neurontin ...................... 48Nexium ......................... 50Norvasc ........................ 51 Oxycontin ..................... 51 Paxil ............................. 52Plavix ............................ 52 Pletal ........................... 53

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Pravachol ...................... 53Premarin ...................... 55 Prevacid ....................... 56Prilosec ........................ 56Proscar ........................ 57Protonix ......................... 57Reminyl ........................ 57 Risperdal ....................... 58 Serevent ....................... 58 Seroquel ........................ 59 Singulair ....................... 59 Synthroid ...................... 60 Toprol XL ...................... 61 Travatan ........................ 61 Tricor ........................... 62 Ultracet ......................... 62 Viagra .......................... 62 Welchol ........................ 63 Wellbutrin ..................... 63 Xalatan .......................... 63 Zetia ............................ 64Zocor ............................ 64

SECTION 2 Vitamin / Supplements

5 – Hydroxytryptophan .. 67Beta – Carotene ............. 68Bioflavanoids ................. 69Biotin ........................... 69 Brewer’s Yeast .............. 70Bromelain ..................... 72 Calcium ........................ 73Carotenoids ................... 76

Chondroitin Sulfate ........ 76Chromium .................... 76 Coenzyme Q10 ............. 77Copper ......................... 78 Dehydroepian-Drosterone (DHEA) .......................... 79Digetsive Enzymes Evening Primrose Oil ..... 79Fibre ............................ 80 Fish oil & Cod Liver Oil (EPA & DHA) .................. 80 Folic AcidGlucosamine ................. 83Glutamine ..................... 84Glutathione ................... 84 Glycine ......................... 84 Inositol .......................... 84 Ipriflavone ..................... 85Iron .............................. 86L - Carnitine ................. 88 L – Tyrosine .................. 89Magnesium .................. 89Manganese .................. 92Melatonin ...................... 93 N – Acetyl Cysteine (NAC) ........................... 94PABA ( Para Amino Benzoic Acid) ................. 95Pantothenic Acid (Vitamin B5) ................... 95Phosphorous ................ 96Potassium .................... 96Probiotics ..................... 100Quercetin ..................... 102

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SAMe (S – Adenosyl Methionine) .................. 102Selenium ...................... 102 Soy .............................. 102 Spleen Extracts .............. 103Taurine .......................... 103 Thymus Extracts ........... 104 Vinpocetine ................... 104 Vitamin A ...................... 106 Vitamin B1 .................... 106Vitamin B2..................... 107Vitamin B3 .................... 108 Vitamin B6 .................... 109 Vitamin B12 .................. 111Vitamin C ..................... 113Vitamin D ..................... 115 Vitamin E ...................... 117 Vitamin K ...................... 119 Zinc ............................. 122

Section 3

Vitamins & Supplements with no significant interactions ................... 125

Useful Web sites ........... 127

How to order this book .. 128

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INTRODUCTION There are a vast number of prescription drugs available today – too many to list in a pocket size reference guide like this. However, the most commonly prescribed drugs account for as much as approximately 80% of all prescriptions.

With this in mind, we have listed more than 80 top prescribed medications and concisely explained any interaction that may occur between the drug and a vitamin, mineral or other nutritional supplement.

We chose not to focus on herb supplements because the “sister” book to this publication, Herb Drug Interactions, covers the 100 most popular herbs and their interactions with generic drugs. Information on Herb Drug Interactions can be found at www.mediscript.net/hdsample.html. Where it was considered vital information, however, we have listed some herbs.

The information contained in this book can tell you the following:

How supplements help drugs work better

Which drugs deplete your body of important nutrients

Which drugs and supplements should never be taken together

Which drug side effects can be reduced by taking a particular supplement

Millions of biochemical reactions take place within your body all the time. What you eat, drink or in any way ingest can influence those biochemical reactions, and influence the effect of prescription drugs.

Drugs are used to help correct the body’s chemistry when problems arise caused by illness. The biochemical mechanism of action is varied and complex but in most cases there is usually enough research and clinical trials for your physician to have confidence in the benefits of the drug outweighing the risks,

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In the process of helping you, however, the drug may cause the following actions:

DEPLETIONThe drug may cause the body to lose important nutrients. For example, furosemide is a diuretic (removes water from the body). It also causes the body to lose potassium, causing side effects such as muscle cramping. Consequently, the patient may have to supplement with potassium. The top selling drug Lipitor can cause the loss of CoenzymeQ10 (a powerful antioxidant in all cells of the body) in such amounts that the patient may have to supplement with CoenzymeQ10.

Usually a person does not know that a drug is depleting nutrients until nutrient deficiency symptoms appear. Your health care provider may take a blood test, even before symptoms appear, to see if your nutrients are low.

INTERACTIONSA drug may interact positively or negatively with a supplement, meaning the interaction could be beneficial, like improving the effectiveness of the drug, or harmful, like reducing the drug’s effectiveness by reducing its ability to be absorbed by your body.

The psychotropic drug Prozac, for instance, can have greater effectiveness when taken with the supplement folic acid. Conversely, St John’s wort can make an oral contraceptive ineffective.

SIDE EFFECT CHANGES Drugs have the potential to create side effects. Some supplements when taken with the drug may make the side effect less severe or prevent it altogether. This book does not provide the following information:

• Side effects caused by the drug itself. These can be found on the drug package inserts or label.

• Interactions between actual drugs.

• Interactions between alcohol and specific nutrients or drugs.

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• Interactions between drugs and water. In summary, this book is aimed at helping people who are taking supplements (mostly vitamins, minerals and nutrient supplements) or who wish to take them and want to know if there is any potential for an interaction or depletion with a particular prescribed drug. The information contained here can provide a “red flag” prompting you to find out more information and/or seek advice from a health care professional.

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HOW TO USE THIS BOOK Section 1 lists the most commonly prescribed drugs in alphabetical order. Together with each drug listed is the name or names of any possible supplements that might present an issue for your consideration or subsequent action. The name of the supplement is followed in the third column with succinct notes explaining the issue. Sometimes, as in the case of “oral contraceptives” or “antibiotics”, a group of drugs is listed because many of these drugs have similar interactions or depletions.

Section 2 is an attempt to depict most supplements (excluding herbs) and the generic drugs or group of drugs that have interactions or depletions. There is a brief description of the supplement and its uses. In the “Comments” column we indicate whether the supplement may be beneficial, whether you should seek more information, or whether it should be avoid altogether either because there is an undesirable interaction or it affects the drug’s bioavailability.

In section 2 just the generic names of drugs are listed to allow for more comprehensive coverage of drugs used. You can find your brand name of drug by looking on the drug bottle or the fact sheet received from your pharmacist, or you can Google or carry out further research to find out its name.

Section 3 lists the remaining vitamins and supplements, which at the time of writing this book, do not appear to have any interactions with prescribed drugs.

References / Further informationThe reference information has been taken mostly from human studies published in major medical or scientific journals. If you or your health care provider would like to read the original study on a particular brand of drug and specific interaction, then please go to www.mediscript.net and navigate to drug interactions.

Drug Supplement Type of Interaction

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ACCUPRIL (ACCUPRO)

Combination drug: ACCURETIC

Generic name: Quinapril HCL

Type of drug:ACE inhibitor

Use: Lower high blood pressure.

Zinc

Iron

High potassium foods, potassium supplements, salt substitutes

Drug may cause zinc depletion. People taking Accupril (quinapril) on a long-term basis should consider taking a zinc supplement or a multimineral tablet containing zinc.

Can reduce a cough side effect.

Avoid: Increased blood potassium levels is an uncommon but potentially serious side effect of taking ACE inhibitors. Consult your health professionals before supplementing additional potassium and have your blood levels of potassium checked periodically.


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ACIPHEX

Generic name: Rabeprazole sodium

Type of drug:Proton pump inhibitor (antacid)

Use:Treating stomach ulcers and gastro-esophageal reflux disease (GERD)

Many Miscellaneous Supplements

May affect absorption of supplements and other drugs due to changes in stomach acidity.You should take supplements 2 hours after taking Aciphex.

ACTONEL

Generic name: Risedronate

Type of drug:Biphosphonates

Use:Treat osteoporosis and paget’s disease

Calcium and vitamin D

Antacids

People with Paget’s disease should take supplemental calcium and vitamin D 1 to 2 hours before taking Actonel, if dietary intake is inadequate.

May reduce drug absorption. People taking Actonel should take calcium- or magnesium-containing antacids an hour before or two hours after the drug.


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ACTOS

Generic name: Pioglitazone

Type of drug:Thiazolidinediones

Use: Treating high blood sugar in diabetes.

At the time of this writing, no evidence of nutrient interactions involving this drug has been found in the medical literature.

ADVAIR DISKUS

Generic name: Salmeterol xinafoate/fluticasone propionate (inhalation powder)

Type of drug:Beta-adrenergic bronchodilator

Use:For control of asthma and COPD.



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AGGRENOX

Generic name: Dipyridamole

Use:To prevent blood clots and reduce the risk of stroke.

Iron Some studies suggest taking too much iron can result in tissue damage. Dipyridamole might reduce the damage caused by this mineral.

ALLEGRA

Generic name: Fexofenadine

Type of drug:Antihistamine

Use:Allergy symptom relief.

St. John’s wort Until more is known, St. John’s wort should not be combined with this drug, except under a doctor’s supervision.

ALPHAGAN P

Generic name: Brimonidine tartrate

Use:Treat glaucoma.



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ALTACE

Generic name: Ramipril

Type of drug:Angiotensin-converting enzyme (ACE) inhibitor

Use:Lower high blood pressure.

Zinc

Iron

Potassium

Drug may cause zinc depletion. People taking ramipril on a long-term basis should consider taking a zinc supplement or a multimineral tablet containing zinc.

Supplementing with iron may prevent a cough side effect.

Avoid if you have advanced kidney disease.

AMARYL

Generic name: Glimepiride

Type of drug:Sulfonylurea

Use:To treat type 2 diabetes.

Magnesium

Vitamin B3 (Niacin)

May enhance the blood-sugar lowering effects of this drug. Monitor your blood glucose levels while taking Amaryl together with magnesium.

Vitamin B3 can raise blood sugar levels; using niacin along with Amaryl may increase requirements for the drug.


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AMBIEN

Generic name: zolpidem tartrate

Type of drug:Hypnotic drug

Use:To treat insomnia.

5-Hydroxytryptophan (5-HTP) and L-tryptophan

Avoid: 5-HTP and L-tryptophan are converted to serotonin in the brain. Although no interactions have so far been reported with Amaryl and 5-HTP or L-tryptophan, taking them together may increase zolpidem-induced hallucinations.

ARICEPT

Generic name: Donepezil

Use:Treat memory loss associated with Alzheimer’s disease

Huperzine-A Avoid: Further studies are needed to determine the long-term safety of using huperzine-A with Aricept.

ARIMIDEX

Generic name: Anastrozole

Use:Treat advanced breast cancer.

At the time of this writing, the medical literature shows no evidence of nutrient interactions involving Arimidex.


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ASACOL

Generic name: Mesalamine

Use:To treat ulcerative colitis.

Psyllium May be beneficial: A study showed that taking 20 grams of psyllium together with mesalamine helped to keep ulcerative colitis in remission.

ATACAND

Generic name: Candesartan cilexetil

Type of drug:Angiotensin II receptor antagonist

Use:To treat high blood pressure.

At the time of this writing, no evidence of nutrient interactions involving candesartan was found in the medical literature.


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ATROVENT

Combination drug: Combivent

Generic name: Ipratropium bromide

Use:Symptomatic relief in COPD, bronchitis, asthma and emphysema.

Soy It’s very rare, but people with soy sensitivities have reacted to this drug because it contains soy lecithin. Ipratropium bromide nasal spray and solution for inhalation does not contain soy lecithin.

AVANDIA

Generic name: Rosiglitazone maleate

Use:To treat type 2 diabetes.

At the time of this writing, no evidence of nutrient interactions involving this drug was found in the medical literature.


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AVAPRO

Combination drug:CoAprovel

Generic name: Irbesartan

Type of drug:Angiotensin II receptor antagonist

Use: To treat high blood pressure.


CELEXA

Generic name: Citalopram

Type of drug:Selective serotonin reuptake inhibitor (SSRI) antidepressant.

Use:To treat depression.

Lithium Taking lithium at the same time as citalopram can either increase the effectiveness of the drug or increase your chances of developing side effects. Contact your doctor if you experience nausea, dry mouth or sleep disturbances.


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CIPRO

Generic name: Ciprofloxacin

Type of drug:Fluoroquinolone family of antibiotics

Use:Treat infections.

Vitamin K

Minerals: Aluminum, Calcium, Copper, Iron, Magnesium, Manganese, Zinc

Probiotics: Bifidobacterium longum, Lactobacillus acidophilus, Lactobacillus casei, Saccharomyces boulardii

Dandelion (Taraxacum officinale)

Fennel (Foeniculum vulgare)

Natural practitioners sometimes recommend vitamin K supplements to people taking antibiotics to help prevent antibiotic-induced bleeding.

Minerals can bind to ciprofloxacin, greatly reducing its absorption power. Take Cipro two hours after consuming dairy products, antacids and mineral-containing supplements.

Taking probiotic microorganisms has been shown to help prevent antibiotic-induced diarrhea.Also, lactobacillus acidophilus might prevent candida vaginitis (an overgrowth of yeast in the vagina.)

Avoid: the high mineral content of the dandelion herb can decrease absorption of the drug.

Avoid: Fennel has been shown to reduce drug absorption in animals.


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CLARINEX

Generic name: Desloratadine

Type of drug:Antihistamine

Use:Relieve allergy symptoms.


COMBIVENT

Generic name: Albuterol/Ipratropium

Type of drug:Beta-adrenergic bronchodilator

Use:Symptomatic treatment of COPD, bronchitis and emphysema.

Minerals: Calcium, Magnesium, Phosphate, Potassium

Soy

This drug has been associated with decreased plasma levels of certain minerals. Whether diet or mineral supplements can prevent this is not known.

It’s very rare, but people with soy sensitivities have reacted to this drug.


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COREG

Generic name: Carvedilol

Type of drug:Beta blocker

Use:Treat heart problems.

At the time of this writing, no evidence of nutrient interactions involving carvedilol was found in the medical literature.

COSOPT

Generic name: Dorzolamide/Timolol maleate


Use:Lower blood pressure and as eyedrops to treat glaucoma.

Potassium

Pleurisy root

Coenzyme 10Q

The drug may decrease the uptake of potassium from the blood into the cells, leading to excess potassium in the blood. Avoid potassium supplements or eating large quantities of fruit unless directed by your doctor.

Avoid: contains cardiac glycosides.

Can help reduce cardiovascular side effects when taking Cosopt eyedrops for glaucoma.


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COUMADIN

Generic name: Warfarin sodium

Type of drug:Anticoagulant

Use:Slows blood clotting.

Coenzyme Q10

Cranberry, Dan Shen, Devil’s claw, Dong quai, Feverfew, Garlic, Ginger, Ginkgo biloba, Ginseng, Green tea, Papain, Quilinggao, Reishi (ganoderma lucidum), St. John’s wort

Herbs containing coumarin derivatives: Angelica root, Arnica flower, Anise, Asafoetida, Celery, Chamomile, Corn silk, Fenugreek, Horse chestnut, Licorice root, Lovage root, Parsley, Passion flower herb, Quassia, Red Clover, Rue, Sweet clover, Sweet Woodruff

May affect blood coagulation. Take only with doctor’s guidance.

A wide variety of herbs interact with warfarin. It is not within the scope of this book to list those interactions in detail. Please check with a health care professional.

Although there are no specific studies showing these herbs interacting with anticoagulants, they may interact with warfarin and cause bleeding. Consult your doctor if you are taking warfarin and wish to use one of these herbs.


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COUMADIN (cont.) Minerals: Iron, Magnesium, Zinc

Vitamin C

Vitamin E

Vitamin K

May bind with warfarin, potentially decreasing its absorption and activity. Take drug and minerals 2 hours apart.

May or may not interfere with the effect of anticoagulants.

Despite information to the contrary, it now appears safe for people taking warfarin to take vitamin E supplements.

Avoid: Vitamin K reverses the anticoagulant effects of warfarin. Foods high in vitamin K include broccoli, Brussels sprouts, kale, parsley, spinach, soybean oil, olive oil, cottonseed oil and canola oil.


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COZAAR

Generic name: Losartan potassium

Combination drugs:Cozaar-Comp; Hyzaar

Type of drug:Angiotensin-II receptor blocker


Potassium Avoid: Losartan has caused significant increases in blood potassium levels.

DETROL

Generic name: Tolterodine

Type of drug:Competitive muscarinic receptor antagonist

Use:Treat overactive bladder.

At the time of this writing, no evidence of nutrient interactions involving tolterodine was found in the medical literature.


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DIOVAN

Generic name: Valsartan


Use: Treat high blood pressure.

At the time of this writing, no evidence of nutrient or herb interactions involving valsartan was found in the medical literature.

DITROPAN XL

Generic name: Oxybutynin chloride

Type of drug:Anticholinergic/ Antispasmodic

Use:Treat overactive bladder.

At the time of this writing, no evidence of nutrient interactions involving oxybutynin was found in the medical literature.


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DURAGESIC

Generic name: Fentanyl transdermal

Type of drug:Opioid analgesic

Use:Treat chronic pain.

Magnesium A study showed that giving magnesium intravenously before surgery dramatically reduced the amount of fentanyl needed to control pain.

EFFEXOR XR

Generic name: Venlafaxine HCL

Use:Treat depression.


Sour date nut (ziziphus jujube)

St. John’s wort

Avoid: Venlafaxine is a potent serotonin reuptake inhibitor and it has been associated with several cases of serotonin syndrome. 5-HTP and L-tryptophan are converted to serotonin in the brain, and taking them with this drug may increase its side effects.

Avoid this Chinese herbal remedy when taking venlafaxine.

Avoid taking this when using venlafaxine unless you’re under the supervision of a qualified health care professional.

ELUTHERO This special type of ginsing herb can raise Digoxin blood levels. No toxicity has yet to be reported, so first check with your doctor.


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EVISTA

Generic name: Raloxifene

Type of drug:Selective estrogen receptor modulator (SERM)

Use: To prevent osteoporosis in women after menopause.

Phytoestrogens e.g. Formononetin

This drug may block the benefits of the supplement. Further research is necessary.

EXELON

Generic name: Rivastigmine tartrate

Type of drug:Cholinesterase inhibitor

Use:Treat Alzheimer’s disease.



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FLOMAX

Generic name: Tamsulosin HCL

Type of drug:Alpha 1A-adrenoceptor antagonist

Use:Treat BPH (Benign Prostatic Hyperplasia)

At the time of this writing, no evidence of nutrient interactions involving tamsulosin was found in the medical literature.

FLONASE; FLOVENT

Generic name: Fluticasone propionate

Type of drug:Inhaled corticosteroid

Use:Treat asthma.

Calcium

DHEA

Although Flonase has no documented interactions, a similar drug, beclomethasone, may lead to reduced calcium absorption. Calcium supplements may be recommended.

Again beclomethasone patients were found to have low levels of DHEA. Supplemental DHEA may be beneficial.


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FOLTX

Generic name: Folic acid; Vitamin B12; Vitamin B6

Type of drug:Multi-vitamin

Use:Treat heart and blood circulation problems

Zinc

Vitamin B6

Antacids

Zinc supplements are recommended when folic acid intake is high; people taking moderate amounts do not need to supplement with zinc.

People with elevated blood levels of homocysteine, which has been associated with atherosclerosis, should supplement with both folic acid and vitamin B6.

Folic acid should be taken 1 hour before or 2 hours after taking antacids containing aluminum and magnesium hydroxide.

FOSAMAX

Generic name: Alendronate sodium

Type of drug:Bisphosphonate

Use:Treat or prevent osteoporosis.

Calcium

Magnesium

Calcium supplements may interfere with alendronate absorption. Take drug 2 hours before or after calcium supplements.

Absorption of tiludronate, a drug related to alendronate, is reduced when taken with magnesium and/or aluminum-containing antacids. Until more is known, alendronate should be taken 2 hours before or after these antacids.


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GLUCOTROL

Generic name: Glipizide

Type of drug:Sulfonylunea

Use:Lower blood sugar in type 2 diabetes.

Ginkgo biloba

Gymnema sylvestre

Magnesium

Avoid: In patients with type 2 diabetes who were taking oral anti-diabetes medication, ginkgo biloba extract resulted in a significant worsening of glucose tolerance.

Herbs such as gymnema sylvestre will often improve blood-sugar control in diabetics. In such cases, the amount of blood sugar-lowering drugs may need to be reduced in order to avoid a hypoglycemic reaction.

Glipizide may increase magnesium levels significantly. This could be therapeutic or detrimental depending on the circumstance.


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GLUCOVANCE

Generic name: Glyburide/Metformin HC1

Type of drug:Sulfonylurea

Use:Lower blood sugar levels in type 2 diabetes.

Aloe vera

Chromium

Ginkgo biloba

Gymnema sylvestreBiotinVitamin E

May be beneficial: One study reported that combining 15 ml of aloe juice twice daily with glyburide significantly improved blood sugar and lipid levels in people with diabetes.

Avoid: May cause adverse reaction.


Will often improve blood-sugar control in diabetics. In such cases, the amount of blood sugar-lowering drugs may need to be reduced in order to avoid a hypoglycemic reaction.


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HUMULIN N

Generic name: Human insulin NPH

Type of drug:Synthetic injectable insulin (Insulins may be from animal source or synthesized)

Use:To lower blood sugar in diabetes.

Dehydroepiandrosterone (DHEA)

BiotinChromiumFenugreekGymnema sylvestreVitamin E

Insulin has been shown to decrease the levels of DHEA and DHEA-sulfate in the blood. More research is needed to determine the significance of this finding.

May naturally reduce blood sugar levels, therefore may have to reduce amount of injected insulin.

HYZAAR

Generic name: Losartan potassium and hydrochlorothiazide



Potassium Avoid: Losartan has caused significant increases in blood potassium levels. See Cozaar.


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LANOXIN

Generic name: Digoxin

Type of drug:Derived from foxglove plant.

Use:Helps in treatment of congestive heart failure.

Alder buckthornBuckthorn

Digitalis (Foxglove)

Hawthorn

Licorice (Glycyrrhiza glabra)

Pleurisy root

Extended consecutive use may cause a loss of electrolytes, especially potassium. Loss of potassium may increase the toxicity of the medication with potentially fatal consequences.

Avoid: This group of plants contain chemicals with actions and toxicities similar to digoxin. Because of the added risk of toxicity, digitalis and digoxin should never be used together.

In some countries hawthorn is approved to treat mild congestive heart failure. People taking digoxin for congestive heart failure should consult with their doctor before taking hawthorn-containing products

Avoid: Excessive use of licorice plant or licorice plant products may cause loss of potassium, increasing the risk of digoxin toxicity.

Avoid: Contains cardiac glycosides.


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LANOXIN (cont.) MagnesiumPotassium

Sarsaparilla

Senna (Cassia senna, Cassia angustifolia)

St. John’s wort

People needing digoxin may have low levels of potassium or magnesium. Digoxin therapy may increase the elimination of magnesium from the body, so people may benefit from taking magnesium supplements. Digoxin interferes with the ability of the blood to send potassium into cells, so potassium supplements should be avoided unless prescribed by your doctor.

Avoid: May increase the absorption of digitalis and bismuth, increasing the chance of toxicity.

Avoid: May deplete potassium levels and increase digoxin activity and risk of toxicity. It could also decrease the levels of the drug and therefore decrease digoxin activity.

Avoid: May reduce blood levels of digoxin.


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LESCOL

Generic name: Fluvastatin sodium

Type of drug:HMG-CoA reductase inhibitor

Use:To treat high cholesterol.

Coenzyme Q10

Niacin

Vitamin A

Drugs similar to Lescol have shown decreased concentrations of Coenzyme Q10; may have to supplement with Coenzyme Q10

Fluvastatin and niacin used together have been shown to be more effective than either substance alone. Large amounts of niacin may cause rare muscle disorders.

Avoid: Fluvastatin therapy can increase levels of Vitamin A.


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LEVAQUIN

Generic name: Levofloxacin

Type of drug:Antibiotic

Use:To treat bacterial infections.

Iron

Magnesium


Vitamin K

Avoid: Can reduce the absorption and effectiveness of the drug.

Taking magnesium supplements at the same time as Levaquin can reduce the absorption of the drug. Consequently, supplements or antacids containing magnesium should be taken 2 hours before or after taking the drug.


Some antibiotics reduce vitamin K activity and/or production and some do not. More research is needed to determine whether vitamin K supplements are needed to prevent antibiotic-induced bleeding.


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LEXAPRO

Generic name: Escitalopram oxalate

Type of drug:Selective serotonin reuptake inhibitor (SSRI)

Use:Treat depression


LIPITOR

Generic name: Atorvastatin

Type of drug:HMG-CoA reductase inhibitor

Use:To lower high cholesterol.

Antacids containing Magnesium/Aluminum

Coenzyme Q10

Grapefruit

Can interfere with drug absorption. Avoid this interaction by taking atorvastatin 2 hours before or after any magnesium- or aluminum-containing antacids.

Decreases concentration; may have to supplement with more Coenzyme Q10

Inhibits the body’s ability to break down Lipitor and can increase toxicity of drug.


43

LIPITOR (cont.) Vitamin A

Niacin (Vitamin B3)

Lipitor can increase levels of vitamin A.

Niacin also lowers cholesterol and may interact with Lipitor and similar drugs. Sometimes, in rare cases, it may cause a muscle disorder. Check with your doctor on this.

LOTENSIN

Generic name: Benazepril

Combination drug: LOTREL

Type of drug:Angiotensin-Converting Enzyme (ACE) inhibitor


Zinc

Iron

High potassium foodsPotassium supplementsPotassium-containing salt substitutes

A study of people taking ACE inhibitors linked to benazepril showed decreased zinc levels in certain white blood cells. While zinc depletion hasn’t been reported with this drug, people taking benazepril on a long-term basis should consider taking a zinc supplement or a multimineral tablet containing zinc.

May reduce the severity of cough side effect attributed to taking ACE inhibitors.

Avoid: People with advanced kidney disease may develop increased blood potassium levels as a result of taking benazepril.


44

LUMIGAN

Generic name: Bimatoprost

Type of drug:Eye drops.

Use:Treat glaucoma.


MACROBID

Generic name: Nitrofurantoin macro/monohydrate

Type of drug:Antibiotic

Use:Treat urinary tract infections.

Magnesium


Vitamin K

Avoid: May reduce drug absorption and/or bioavailability


May be beneficial: Some antibiotics reduce vitamin K activity and/or production and some do not. More research is needed to determine whether vitamin K supplements are sufficient to prevent antibiotic-induced bleeding.


45

METFORMIN

Generic name: Metformin HCL

Use:Treat Type 2 diabetes.

Dehydroepiandrosterone (DHEA)

Folic acid; Vitamin B12Calcium

Guar gum

Ginkgo biloba

Metformin can increase blood levels of DHEA-sulfate.

Metformin therapy can deplete vitamin B12 and sometimes folic acid as well. In a clinical trial supplementation with calcium reversed this effect. Supplement vitamin B12 and folic acid or ask your doctor to monitor folic acid and vitamin B12 levels.

Avoid: May slow the rate of metformin absorption.



46

MIACALCIN

Generic name: Calcitonin salmon

Type of drug:Natural hormone

Use:Treat osteoporosis and can provide symptomatic relief of acute pain due to fractures.

Calcium Supplementation with 1500 mg a day of calcium enhances the effects of calcitonin on bone mass of the lumbar spine. Women who take a calcitonin product for osteoporosis should also take calcium.

MOBIC

Generic name: Meloxicam

Type of drug:NSAID (Non steroidal anti-inflamatory)

Use:Arthritis and other indications with associated pain.

Lithium

White willow bark (salix alba)

Avoid: Lithium is a mineral that may be present in some supplements and is also used to treat mood disorders. Meloxicam may inhibit the excretion of lithium from the body, resulting in higher levels of the mineral.

Avoid: White willow bark contains salicin, related to aspirin. It can produce anti-inflammatory effects which may lower blood levels of meloxicam.


47

MONOPRIL

Generic name: Fosinopril sodium

Type of drug:Angiotension-converting Enzyme (ACE) inhibitor


Iron

High potassium foods, potassium supplements, salt substitutes

May reduce the severity of a cough side effect caused by the drug.

Avoid: Increased blood potassium levels is an uncommon but potentially serious side effect of taking ACE inhibitors. Consult your health professional before supplementing additional potassium and have your blood levels of potassium checked periodically.

NASONEX

Generic name: Mometasone furoate

Type of drug:Inhaled corticosteroid

Use:Treat asthma.

Calcium This drug may lead to reduced absorption of calcium so health practitioners may recommend calcium supplementation.


48

NEURONTIN

Generic name: Gabapentin

Type of drug:Anticonvulsant

Use:Treat seizure disorders.

Biotin

CalciumVitamin D

Folic acid

L-carnitine

Vitamin A

Long-term anticonvulsant treatment decreases levels of biotin. Supplement with biotin either alone or as part of a multivitamin.

Individuals on long-term multiple anticonvulsant therapy may develop below-normal blood levels of calcium, which may be related to drug-induced vitamin D deficiency.

Studies have shown multiple anticonvulsant therapy reduced blood levels of folic acid. However, individuals should consult with their health care practitioners before supplementing with folic acid.

Multiple anticonvulsant therapy can dramatically reduce blood carnitine levels.

Anticonvulsant drugs can occasionally cause birth defects which may be related to low levels of vitamin A. More research is needed to determine if vitamin A supplements can help.


49

NEURONTIN (cont.) Vitamin A

Vitamin B6

Vitamin B12

Vitamin E

Vitamin D

Anticonvulsant drugs can occasionally cause birth defects which may be related to low levels of vitamin A. More research is needed to determine if vitamin A supplements can help.

Vitamin B6 deficiency is associated with dizziness, fatigue, mental depression and seizures. Discuss with your professional whether B6 supplement is advisable.

Individuals taking anticonvulsant drugs for several months or years might develop low levels of vitamin B12 which can lead to and mental problems. Discuss with your health professional about supplementing with vitamin B12.

People taking multiple anticonvulsant drugs should probably supplement with 100 to 200 IU of vitamin E daily.

Drug may interfere with vitamin D activity which may lead to bone softening (osteomalacia). People taking anticonvulsants who do not receive adequate sunlight should supplement with 400 IV of vitamin D each day.


50

NEURONTIN (cont.) Vitamin K Some studies have shown that babies born to women taking anticonvulsant drugs have low blood levels of vitamin K, which might cause bleeding in the infant. Pregnant women or women who might become pregnant while taking these drugs should discuss vitamin K therapy with their doctor

NEXIUM

Generic name: Esomeprazole magnesium

Type of drug:Antacid (proton pump inhibitor)

Use:Treat stomach problems, e.g. GERD



51

NORVASC

Generic name: Amlodipine besylate

Type of drug:Calcium-channel blocker

Use:Treat cardiac problems and high blood pressure.

Pleurisy root

Grapefruit juice

Avoid: Contains cardiac glycosides.

Avoid: Increases the absorption of felodipine, a drug similar to amlodipine, and increases the adverse effects of the medication in patients with hypertension.

OXYCONTIN

Generic name: Oxycodone HCL

Type of drug:Narcotic analgesic

Use:Pain relief

At the time of this writing, no evidence of nutrient or herb interactions involving this drug has been found in the medical literature.


52

PAXIL

Generic name: Paroxetine HCL

Type of drug:SSRI (Selective serotonin reuptake inhibitor)

Use:Treat depression.


Sodium

Ginkgo biloba

Avoid: 5-HTP and L-tryptophan are converted to serotonin in the brain and taking either of these compounds with paroxetine may increase side effects such as headache, sweating, dizziness, agitation, restlessness, nausea, vomiting and so on.

May be beneficial: Paroxetine can cause sodium depletion.

Sexual dysfunction experienced by patients being treated with fluoxetine or sertraline (drugs closely related to paroxetine) was effectively reversed with 240 mg per day of ginkgo biloba extract.

PLAVIX

Generic name: Clopidogrel bisulfate

Type of drug:Antiplatelet

Use:To prevent second heart attack or stroke.



53

PLETAL

Generic name: Cilostazol

Use:Treat intermittent claudication.


PRAVACHOL

Generic name: Pravastatin sodium

Type of drug:HMG-CoA reductase inhibitor.

Use:To lower cholesterol levels.

Coenzyme Q10

Fish oil (EPA)

Milk thistle (silybum marianum)

Supplementation with 90-100 mg of Coenzyme Q10 per day has been shown to prevent reductions in blood levels due to simvastatin, another drug in the same category as pravastatin.

The omega-3 fatty acid EPA in fish oil may improve the cholesterol- and triglyceride-lowering effect of pravastatin.

Liver toxicity is a possible side effect of pravastatin. A milk thistle extract standardized to 70-80% silymarin may be beneficial.


54

PRAVACHOL (cont.)

Red yeast rice

Vitamin A

Avoid: A supplement containing red yeast rice has been shown to effectively lower cholesterol and triglycerides in people with moderately elevated levels of these blood lipids. This extract contains small amounts of HMG-CoA reductase inhibitors and should not be used by people currently taking lovastatin or pravastatin.

A study showed a rise in vitamin A levels when using this drug.


55

PREMARIN

Generic name: Conjugated estrogens

Type of drug:Estrogen

Use:To treat menopausal symptoms.

Calcium

Herbal sources of isoflavone supplements (red clover, soy)

Ipriflavone

Vitamin B6

Vitamin D

May be beneficial: Many doctors recommend 800-1200 mg of supplemental calcium in addition to the several hundred milligrams found in a typical daily diet.

May interfere with or even have an additive effect with conjugated estrogens. Consult your health professional.

A synthetic variation of isoflavones found in soy, it can preserve bone mass in postmenopausal women.

Some studies have shown that women taking conjugated estrogens without a progestin have lower levels of vitamin B6.

May increase bone density. Talk with a physician before combining vitamin D with conjugated estrogens.


56

PREVACID

Generic name: Lansoprazole SR

Type of drug:Proton pump inhibitor

Use:To treat stomach acid problems.

Beta-carotene

Folic acid

Vitamin B12

This drug deletes beta-carotene. People taking these drugs may want to have carotenoid blood levels checked, eat plenty of fruits and vegetables and consider supplementing with carotenoids.

Antacids, including lansoprazole, inhibit folic acid absorption, which is needed to utilize vitamin B12. Therefore folic acid supplements are recommended.

Acid blocking drugs like lansoprazole may create a decrease in vitamin B12.

PRILOSEC

Generic name: Omeprazole SA

Type of drug:Proton pump inhibitor

Use:To treat stomach acid problems.

Folic acidVitamin B12Cranberry

St. John’s wort

See Prevacid (lansoprazole) above.

Avoid: Shown to interfere with the actions of omeprazole.


57

PROSCAR

Generic name: Finasteride

Use:To treat BPH (Benign Prostatic Hyperplasia)


PROTONIX

Generic name: Pantoprazole

Type of drug:Antacid (proton pump inhibitor)

Use:Treat stomach problems.

Beta-caroteneCranberryFolic acidVitamin B12

See Prevacid (lansoprazole).page 56

REMINYL

Generic name: Galantamine HBr

Type of drug:Cholinesterase inhibitor

Use:Treat Alzheimer’s disease.



58

RISPERDAL

Generic name: Risperidone

Use:Treat psychotic disorders.

Glycine

Vitamin B6Vitamin E

Lithium

People with schizophrenia being treated with risperidone experienced an improvement in their symptoms when glycine was added to their treatment regime.

These vitamins together were used to treat a side effect of risperidone called neuroleptic malignant syndrome and the results were encouraging.

The combination of lithium and risperidone has produced some side effects such as delirium, confusion and fever.

SEREVENT

Generic name: Salmeterol xinofoate (inhalation powder)

Type of drug:Long acting beta-adrenergic bronchodilator

Use:Treat asthma and prevent bronchospasm

Coleus Adding forskolin, the active component of the herb coleus, to beta-antagonist drugs like salmeterol might provide an alternative to raising the doses of the drugs as they lose effectiveness. Coleus should not be combined with salmeterol without a doctor’s supervision.


59

SEROQUEL

Generic name: Quetiapine fumarate

Type of drug:Class of antipsychotic drugs known as dibenzapines

Use:Treat psychiatric disorders.


SINGULAIR

Generic name: Montelukast sodium

Type of drug:Leukotriene receptor antagonist

Use:To treat and prevent asthma.



60

SYNTHROID

Generic name: Levothyroxine sodium

Type of drug:Thyroid hormone

Use:Treat hyperthyroidism

BugleweedLemon Balm

Calcium

Iron

Soy

Avoid: These herbs may interfere with the action of thyroid hormones and should not be used during treatment.

There are reports of some calcium loss but supplementation for people taking long-term thyroid medication has not yet been proven helpful or necessary.

Iron deficiency can impair the body’s ability to make its own thyroid hormones. However, iron supplements may decrease absorption of thyroid hormone medications. Talk with your doctor before taking iron-containing products.

Avoid: Soy appears to reduce the absorption of the hormones when taken simultaneously with thryroid hormones.


61

TOPROL XL

Generic name: Metoprolol succinate


Use:Reduce symptoms of angina and lower blood pressure.

Pleurisy root

Potassium

Avoid: Pleurisy root and other plants in the Aesclepius genus contain cardiac glycosides.

Avoid: Some “nonselective” beta blockers decrease the uptake of potassium from the blood into the cells, leading to excess potassium in the blood. People taking metoprolol should avoid potassium supplements or eating large quantities of fruit unless directed by their doctors.

TRAVATAN

Generic name: Travoprost

Type of drug:Eye drops

Use:Treat high pressure in the eye.



62

TRICOR

Generic name: Fenofibrate

Type of drug:Cholesterol lowering drug.

Use:Lower elevated cholesterol and triglyceride levels.

Folic acidVitamin B6Vitamin B12

Vitamin CVitamin E

Fenofibrate has been shown to dramatically increase blood homocysteine levels, associated with increased risk of atherosclerosis and heart disease. Folic acid, vitamin B6 and vitamin B12 are all capable of lowering these homocysteine levels.

Taking vitamins C and E prior to ultraviolet exposure can block UV-fenofibrate damage to red blood cells.

ULTRACET

Generic name: Tramadol HC1/Acetaminophen

Type of drug:Unique analgesic

Use:Treat acute pain.


VIAGRA

Generic name: Sildenafil citrate

Use:Treat erectile dysfunction.

Grapefruit juice Avoid: May delay the absorption of the drug when taken together.


63

WELCHOL

Generic name: Colesevelam

Type of drug:Non-systemic cholesterol lowering drug.

Use:Treat high cholesterol levels.

Beta-carotene and other carotenoids

CalciumFolic acidVitamin AVitamin DVitamin EVitamin KZinc

May be beneficial: Long-term use of drug can significantly lower blood levels of carotenoids.

This medication may prevent absorption of folic acid and the fat-soluble vitamins A, D, E and K. Vitamin supplements should be taken 1 hour before to 6 hours after colesevelam for optimal absorption. Calcium and zinc may also be depleted.

WELLBUTRIN

Generic name: Bupropion HCL

Use:Treat depression and help in smoking cessation.

Yohimbe May be beneficial: When added to bupropion therapy, may improve mood.

XALATAN

Generic name: Latanoprost

Type of drug:Prostaglandin analog

Use:Treat glaucoma.



64

ZETIA

Generic name: Ezetimibe

Type of drug:Antihyperlipidemic

Use:Reduce cholesterol absorption.


ZOCOR

Generic name:Simvastin

Type of drug: HMG-CoA reductase inhibitor

Use:To lower High Cholesterol

Coenzyme Q10

Fish oil (EPA)

Niacin (Vitamin B3)

Grapefruit

Decreases concentration of supplement, may have to supplement with more Coenzyme Q10

Improves the cholesterol lowering effect of Zocor and using this supplement with Zocor may be beneficial in preventing heart attacks.

Concurrent use of niacin with Zocor can be beneficial by further lowering cholesterol levels. In rare cases large doses of niacin may cause muscle disorders.

Avoid, this can result in increase toxicity of Zocor.

66

VITAMIN & SUPPLEMENT INDEX OF INTERACTIONSTo be more comprehensive we have listed most of the common vitamins and supplements and the generic names of medications that interact with them. In this way we have provided a practical and immediate aid to discovering any interactions.

For the patient/consumer this will be useful because you can further research by looking at the generic name on you prescription bottle, Google the brand names from the generic name or review other reference guides for further information.

For the health care professional in such a new area of developing information you can simply further research the interaction.

There will be 3 categories of information associated with each generic drug as follows:

1. Avoid until you obtain professional advice. This is either because there may be an adverse interaction or the nutrient decreases the absorption and/or the activity of the drug.

2. Further information required. In this case it is advisable to read the full information about the interaction.

3. May be beneficial. Taking the supplement may be necessary because: a)the drug causes a depletion of the nutrient, b)the supplement may reduce side effects or c)the supplement may help the drug work better.

Supplement Generic Drug Comments

67

5-HYDROXYTRYPTOPHAN

A naturally occurring amino acid. Helps in brain function.

Carbidopa

Fluvoxamine Paroxetine Fluoxetine

Selegiline Setraline

Sibutramine Sumatripan Tramadol Venlafaxine Zolmitriptan

Zolpidem

Further information

Avoid

Avoid

Avoid

May be beneficial

Avoid

Avoid

Avoid

Avoid

Avoid

Avoid

Avoid


68

BETA-CAROTENE

A precursor for vitamin A. Helps in night vision, bone development, the immune system and some menstrual problems.

Bile acid sequestrants

Chemotherapy

Cisplatin

Colchicine

Colestipol

Cyclosphosphamide

Docetaxel

Fluorouracil

Lansoprazile

Methotrexate

Methyltesterone

Mineral oil

Neomycin

Orlistat

Paclitaxtel

Quinidine

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial


69

BIOFLAVONOIDS

Water-soluble plant pigments which act as anti-inflammatory, antihistaminic and antiviral agents.

Acyclovir oral May be beneficial

BIOTIN (VITAMIN B7)

A protein needed in small amounts to act as an enzyme in biochemical processes. Help in energy production, fatty acid production and skin health.

Anticonvulsants

Gabapentin

Glyburide

Insulin

Phenobarbital

Topical corticosteroids

Valproic acid

May be beneficial

May be beneficial

Further information

May be beneficial

May be beneficial

May be beneficial

May be beneficial


70

BREWER’S YEAST

A rich source of the B-complex vitamins, protein and minerals, particularly chromium.

Aminoglycoside antibiotics

Amoxicillin

Ampicillin

Antibiotics

Azithromycin

Cephalosporins

Chlorhexidine

Ciprogloxacin

Clarithromycin

Clindamycin oral

Clindamycin topical

Dicloxacillin

Doxycycline

Erythromycin

Gnetamycin

Levofloxacin

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial


71

BREWER’S YEAST (cont.) Loracarbef

Macrolides

Minocycline

Neomycin

Nitrofurantoin

Ofloxacin

Penicillin V

Penicillins

Quinolones

Sulfamethoxazole

Sulfasalazine

Sulfonamides

Tetracycline

Tetracyclines

Tobramycin

Trimethoprim

Trimethoprin/Sulfamethoxazole

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial


72

BROMELAIN

A proteolytic enzyme that helps digest dietary protein.Acts as a natural blood thinner because it prevents excessive blood platelet stickiness.

Amoxicillin

Erythromycin

Penicillamine

Penicillin V

Warfarin

May be beneficial

May be beneficial

May be beneficial

May be beneficial

Further information


73

CALCIUM

Needed to form bones and teeth and is also required for blood clotting, transmission of signals in nerve cells and muscle contraction.Important for preventing osteoporosis.

Albuterol

Alendronate

Aluminum hydroxide

Anticonvulsants


Caffeine

Calcitonin

Calcium acetate

Ciprofloxacin

Cisplatin

Colestipol

Cycloserine

Diclofenac

Doxycycline

Erythromycin

Estrogens (combined)

Felodipine

May be beneficial

Further information

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

Avoid

Avoid

May be beneficial

May be beneficial

May be beneficial

May be beneficial

Avoid

Further information

May be beneficial

May be beneficial


74

CALCIUM (cont.) Flurbiprofen

Gabapentin

Gemifloxacin

Gentamicin

Hydroxychloroquine

Indapamide

Indomethacin

Inhaled corticosteroids

Insoniazid

Lactase

Metformin

Mineral oil

Minocycline

Nadolol

Neomycin

Ofloxacin

Oral contraceptives

May be beneficial

May be beneficial

Avoid

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

Further information

May be beneficial

May be beneficial

Further information

Avoid

May be beneficial

Avoid

Further information


75

CALCIUM (cont.) Oral corticosteroids

Phenobarbital

Quinolones

Risedronate

Sodium fluoride

Sotalol

Sucralfate

Sulfamethoxazole

Tetracycline

Tetracyclines

Thiazide diuretics

Thyroid hormones

Tobramycin

Triamterene

Trimethoprim

Valproic acid

Verapamil

May be beneficial

May be beneficial

Avoid

Further information

Further information

Avoid

May be beneficial

May be beneficial

Avoid

Avoid

Further information

Further information

May be beneficial

May be beneficial

May be beneficial

May be beneficial

Further information


76

CAROTENOIDS

Naturally occurring fat-soluble pigments found in plants.


Colestipol

May be beneficial

May be beneficial

CHONDROITIN SULFATE

One of the most common used supplements used usually in conjunction with glucosamine for helping improve symptoms and arresting the degenerative process of osteoarthritis. It is an amino sugar derived from shark beef cartilage or bovine trachea.

At this time of writing, no evidence of drug interactions with chondroitin sulfate was found in the medical literature.

CHROMIUM

An essential trace mineral that helps the body maintain normal blood sugar levels.It may also play a role in maintaining healthy levels of HDL – the “good” cholesterol.

Glyburide

Insulin

Oral corticosteroids

Sertraline

Avoid

Further information

May be beneficial

May be beneficial


77

COENZYME Q10

A powerful antioxidant that protects the body from free radicals.Helps with metabolic reactions, such as the process of transforming food into ATP, the energy the body runs on.

Atorvastatin

Doxoorubicin

Fluvastatin

Gemfibrozil

Lovastatin

Perphenazine

Pravastatin

Propranolol

Simvastatin

Thioridazine

Timolol

Tricyclic antidepressants

Warfarin

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

Avoid


78

COPPER

Needed to absorb and use iron.Part of the antioxidant enzyme superoxide dismutase (SOD).Needed to make ATP, the energy the body runs on.

AZT

Ciprofloxacin

Etodolac

Famotidine

Ibuprofen

Nabumetone

Naproxen/Naproxen sodium

Nizatidine

Oral contraceptives

Oxaprozin

Penicillamine

Valproic acid

May be beneficial

Avoid

May be beneficial

Further information

May be beneficial

May be beneficial

May be beneficial

Further information

Further information

May be beneficial

Further information

May be beneficial


79

DEHYDROEPIAN-DROSTERONE (DHEA)

A hormone produced by the adrenal glands.Circulates in the bloodstream as DHEA-sulfate and is converted as needed into other hormones.

Amlodipine

Clonidine

Diltiazem

Fluoxetine

Inhaled corticosteroids

Insulin

Metformin

Methyltestosterone

Further information

May be beneficial

Avoid

May be beneficial

May be beneficial

May be beneficial

Further information

Further information

DIGESTIVE ENZYMES

Help digest dietary protein.

Warfarin Avoid

EVENING PRIMROSE OIL

Contains gamma linolenic acid (GLA), a fatty acid that the body converts to a hormone-like substance called prostaglandin E1 (PGE1). PGE1 has anti-inflammatory properties and may also act as a blood thinner and blood vessel dilator.

Tomoxifen May be beneficial


80

FIBER

Water-soluble fiber helps control blood sugar levels and cholesterol.Insoluble fiber softens stool and helps it move through the body in less time.

Lovastatin

Propoxyphene

Verapamil

Avoid

Further information

May be beneficial

FISH OIL AND COD LIVER OIL (EPA AND DHA)

Contains the omega-3 oils EPA and DHA which keep blood triglycerides in check and also keep blood from clotting too quickly.

Cyclosporine

Pravastatin

Simvastatin

May be beneficial

May be beneficial

May be beneficial


81

FOLIC ACID

Needed for DNA synthesis.DNA allows cells to replicate normally.Adequate intake of folic acid early in pregnancy is important for preventing most neural tube birth defects as well as some birth defects of the arms, legs and heart.

Aluminum hydroxide

Anticonvulsants

Aspirin

Azathioprine


Chemotherapy

Colestipol

Cycloserine

Diuretics

Erythromycin

Famotidine

Fenofibrate

Fluoxetine

Gabapentin

Indomethacin

Isoniazid

Lansoprazole

Lithium

May be beneficial

Further information

May be beneficial

May be beneficial

May be beneficial

Avoid

May be beneficial

May be beneficial

May be beneficial

Further information

Further information

May be beneficial

May be beneficial

Further information

May be beneficial

May be beneficial

May be beneficial

May be beneficial


82

FOLIC ACID (cont.) Loop diuretics

Magnesium hydroxide

Medroxyprogesterone

Metformin

Methotrexate

Neomycin

Nitrous oxide

Nizatidine

Omeprazole

Oral contraceptives

Phenobarbital

Prioxicam

Ranitidine

Salsalate

Sodium bicarbonate

Sulfamethoxazole

May be beneficial

May be beneficial

Further information

May be beneficial

Further information

May be beneficial

May be beneficial

Further information

May be beneficial

May be beneficial

Further information

Further information

May be beneficial

May be beneficial

May be beneficial

May be beneficial


83

FOLIC ACID (cont.) Sulfasalazine

Sulindac

Tetracycline

Thiazide diuretics

Triamterene

Trimethoprim

Timethoprim/Sulfamethoxazole

Valproic acid

May be beneficial

Further information

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

Further information

GLUCOSAMINE

An amino sugar extracted from shelfish sources and is the number one supplement used mostly to create cushioning fluids and tissues around joints. It can repair damaged arthritic joints, reduce pain and can help build synovial fluid. It is easily absorbed into the bloodstream and as well as helping in osteoarthritis it helps in skin, eyes, bones, tendons, nails and ligament health as well as parts of the heart.

At this time of writing, no evidence of drug interactions with glucasmine was found in the medical literature.


84

GLUTAMINE

An amino acid (protein building block.)Serves as a source of fuel for cells lining the intestines.Also used by white blood cells and is important for immune function.

Chemotherapy

Cisplatin

Cyclophosphamide

Docetaxel

Fluorouracil

Methotrexate

Paclitaxel

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

GLUTATHIONE

An antioxidant, it protects cells from toxins such as free radicals.

Cisplatin

Cyclophosphamide

Further information

May be beneficial

GLYCINE

An amino acid commonly found in protein.

Clozapine

Haloperidol

Olanzapine

Risperidone

Avoid

May be beneficial

May be beneficial

May be beneficial

INOSITOL

Required for proper formation of cell membranes.Affects nerve transmission and helps transport fats within the body.

Lithium May be beneficial


85

IPRIFLAVONE

A synthetic product based on a substance that occurs naturally in some plants.Slows down the work of the bone-eroding cells, allowing the bone-building cells to work more effectively.

Estrogens (combined) May be beneficial


86

IRON

Part of hemoglobin, the oxygen-carrying component of the blood.Also part of myoglobin, which helps muscle cells store oxygen.

Angiotensin-converting enzyme (ACE) inhibitors

Aspirin

Benazepril

Captopril

Carbidopa

Carbidopa/Levodopa

Chlorhexidine

Cimetidine

Ciprofloxacin

Deferoxamine

Dipyridamole

Doxycycline

Enalapril

Etodolac

Famotidine

May be beneficial

May be beneficial

May be beneficial

May be beneficial

Avoid

Avoid

Avoid

May be beneficial

Avoid

Avoid

May be beneficial

Avoid

May be beneficial

May be beneficial

May be beneficial


87

IRON (cont.) Gemifloxacin

Haloperidol

Hyoscyamine

Ibuprofen

Indomethacin

Levofloxacin

Magnesium hydroxide

Methyldopa

Minocycline

Moexipril

Nabumetone


Neomycin

Nizatidine

Ofloxacin

Oral contraceptives

Oxaprozin

Penicillamine

Avoid

May be beneficial

May be beneficial

May be beneficial

Further information

Avoid

May be beneficial

Avoid

Further information

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

Avoid

Further information

May be beneficial

Avoid


88

IRON (cont.) Quinapril

Ramipril

Ranitidine

Risedronate

Sodium bicarbonate

Stanozolol

Sulfasalazine

Tetracycline

Tetracyclines

Thyroid hormones

Warfarin

May be beneficial

May be beneficial

May be beneficial

Avoid

May be beneficial

May be beneficial

Avoid

Avoid

Avoid

Further information

Avoid

L-CARNITINE

Made in the body from the amino acids lysine and methionine.Needed to release energy from fat.

Allopurinol

Anticonvulsants

AZT

Chemotherapy

Doxorubicin

Gabapentin

Phenobarbital

Valproic acid

Further information

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial


89

L-TYROSINEAn amino acid, one of the building blocks of protein. It plays an important role in the production of neurotransmitters that regulate emotions. The body makes l-tyrosine from another amino acid, known as phenylalanine.

Mixed amphetamines May be beneficial

MAGNESIUM

Needed for bone, protein and fatty acid formation, making new cells, activating B vitamins, relaxing muscles, clotting blood and forming ATP, the energy the body runs on.Insulin secretion and function also require magnesium.

Albuterol

Alendronate

Amiloride

Amphotericin B

Azithromycin

Cimetidine

Ciprofloxacin

Cisplatin

Cycloserine

Cyclosporine

Digoxin

Docusate

Doxycycline

May be beneficial

Further information

Avoid

May be beneficial

Further information

Avoid

Avoid

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

Avoid


90

MAGNESIUM (cont.) Epinephrine

Erythromycin


Famotidine

Felodipine

Fentanyl

Gemifloxacin

Gentamicin

Glimepiride

Glipizide

Hydroxychloroquine

Isoniazid

Levofloxacin

Loop diuretics

Medroxyprogesterone

Metformin

Minocycline

Misoprostol

Further information

May be beneficial

Further information

Further information

May be beneficial

May be beneficial

Avoid

May be beneficial

May be beneficial

Further information

Avoid

May be beneficial

Avoid

May be beneficial

Further information

Further information

Further information

Avoid


91

MAGNESIUM (cont.) Mixed amphetamines

Neomycin

Nitrofurantoin

Nizatidine

Ofloxacin

Oral contraceptives


Quinidine

Quinolones

Risedronate

Sotalol

Sprionolactone

Sulfamethoxazole

Tetracycline

Tetracyclines

Theophylline/Aminophylline

Thiazide diuretics

Further information

May be beneficial

Avoid

Further information

Avoid

May be beneficial

Further information

May be beneficial

Avoid

Avoid

May be beneficial

Avoid

May be beneficial

Avoid

Avoid

May be beneficial

May be beneficial


92

MAGNESIUM (cont.) Tobramydin

Triamterene

Trimethoprim

Warfarin

May be beneficial

Avoid

May be beneficial

Avoid

MANGANESE

Needed for healthy skin, bone and cartilage formation as well as glucose tolerance.Helps activate superoxide dismutase (SOD), an important antioxidant enzyme.

Ciprofloxacin

Oral contraceptives

Avoid

Further information


93

MELATONIN

A natural hormone that regulates the human biological clock.Helpful in relieving sleep disorders and symptoms of jet lag.

Chemotherapy

Cisplatin

Cyclophosphamide

Docetaxel

Doxorubicin

Fluorouracil

Fluoxetine

Fluvoxamine

Methotrexate

Mirtazapine


Paclitaxel

Tamoxifen

Triazolam

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

Further information

Further information

May be beneficial

Further information

May be beneficial

May be beneficial

May be beneficial

May be beneficial


94

N-ACETYL CYSTEINE (NAC)

An altered form of the amino acid cysteine, commonly found in food and synthesized by the body.Helps break down mucus.Helps the body synthesize glutathione, an important antioxidant.Also protects the body from acetaminophen toxicity and is used at very high doses in hospitals for that purpose.

Acetaminophen

AZT

Chemotherapy

Cisplatin

Clozapin

Cyclophosphamide

Docetaxel

Doxorubicin

Flurouracil

Flurbiprofen

Gentamicin

Interferon

Isosorbide dinitrate

Isosorbide mononitrate

Metoclopramide

Nitroglycerin


Paclitaxel

May be beneficial

Further information

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

Further information

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

Avoid

Further information

May be beneficial

May be beneficial


95

PABA (PARAAMINOBENZOIC ACID)

Generally considered to be a member of the Vitamin B-complex.Appears to enhance the effects of cortisone, estrogen, and possibly other hormones by delaying their breakdown in the liver.Also prevents or even reverses the accumulation of abnormal fibrous tissue.

Dapsone

Methotrexate

Sulfamethoxazole

Sulfasalazine

Trimethoprim/Sulfamethoxazole

May be beneficial

Avoid

Avoid

Avoid

Avoid

PANTOTHENIC ACID (VITAMIN B5)

Needed to make the neurotransmitter acetylcholine.Essential in producing, transporting and releasing the energy from fats and to synthesize cholesterol.Also activates the adrenal glands.

Tricyclic antidepressants May be beneficial


96

PHOSPHORUS

A component of DNA and RNA and an essential element for all living cells.

Albuterol

Aluminum hydroxide

Cisplatin

Mineral oil

Sucralfate

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

POTASSIUM

Needed to regulate water balance, levels of acidity, blood pressure and neuromuscular function.Also required for carbohydrate and protein metabolism.

Acebutolol

Albuterol

Amiloride

Angiotensin-converting enzyme (ACE) inhibitors

Atenolol

Benazepril

Beta-adrenergic blockers

Betaxolol

Bisacodyl

Bisoprolol

Captopril

Celecoxib

Cisplatin

Avoid

May be beneficial

Avoid

Avoid

Avoid

Avoid

Avoid

Avoid

May be beneficial

Avoid

Avoid

May be beneficial

May be beneficial


97

POTASSIUM (cont.) Colchicine

Digoxin

Docusate

Enalapril

Epinephrine

Etodolac

Felodipine

Gentamicin

Haloperidol

Heparin

Ibuprofen

Indapamide

Indomethacin

Ipecac

Ketorolac

Labetalol

Lisinopril

Loop diuretics

May be beneficial

Further information

May be beneficial

Avoid

Further information

Further information

May be beneficial

May be beneficial

Further information

Further information

Further information

May be beneficial

Avoid

May be beneficial

Avoid

Avoid

Avoid

May be beneficial


98

POTASSIUM (cont.) Losartan

Magnesium hydroxide

Metoprolol

Mineral oil

Moexipril

Nabumetone

Nadolol


Neomycin


Oxaprozin

Piroxicam

Propranolol

Quinapril

Quinidine

Ramipril

Salsalate

Senna

Further information

Further information

Further information

May be beneficial

Further information

Further information

Avoid

Further information

May be beneficial

May be beneficial

Further information

Avoid

Avoid

Avoid

May be beneficial

Avoid

May be beneficial

Further information


99

POTASSIUM (cont.) Sotalol

Spironolactone

Sulfamethoxazole

Sulindac

Tetracycline


Thiazide diuretics

Thioridazine

Tobramycin

Triamterene

Trimethoprim


Avoid

Avoid

Avoid

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

Avoid

Avoid

Avoid


100

PROBIOTICS

Beneficial bacteria, such as lactobacillus acidophilus and bifidobacterium bifidum, are called probiotics.Favourably alter the balance of intestinal microflora, inhibit the growth of harmful bacteria, promote good digestion, boost immune function, and increase resistance to infection.


Amoxicillin

Ampicillin

Antibiotics

Azithromycin

Cephalosporins

Chlorhexidine

Ciprofloxacin

Clarithromycin

Clindamycin oral

Clindamycin topical

Dapsone

Dicloxacillin

Coxycycline

Erythromycin

Gentamicin

Levofloxacin

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial


101

PROBIOTICS (cont.) Loracarbef

Macrolides

Metronidazole

Minocycline

Neomycin

Nitrofurantoin

Ofloxacin

Penicillin V

Penicillins

Quinolones

Sulfamethoxazole

Sulfasalazine

Sulfonamides

Tetracycline

Tetracyclines

Tobramycin

Trimethoprim


May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial


102

QUERCETIN

Belongs to a class of water-soluble plant pigments called bioflavonoids.Acts as an antihistamine, anti-inflammatory and antioxidant.

Cyclosporine

Estradiol

Felodipine

Avoid

Avoid

Avoid

SAMe (S-ADENOSYL METHIONINE)

Naturally-ocurring mood-affecting substance.

Tricyclic antidepressants May be beneficial

SELENIUM

Activates an antioxidant enzyme called glutathione peroxidase which may protect the body from cancer.

Cisplatin

Clozapine


Valproic acid

May be beneficial

May be beneficial

May be beneficial

Further information

SOY

Contains protein, isoflavones, saponins and phytosterols.Soy protein provides most of the essential amino acids and can be used as well as animal protein by adults.


Ipratropium bromide

Thyroid hormones

Warfarin

Avoid

Further information

Avoid

Further information


103

SPLEEN EXTRACTS

Derived from the spleen of beef (bovine) sources.

Chemotherapy

Cisplatin

Cyclophosphamide

Docetaxel

Fluorouracil

Methotrexate

Paclitaxel

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

TAURINE

An amino acid (protein-building block) as well as a component of bile acids, which are used to absorb fats and fat-soluble vitamins.Also regulates heartbeat, maintains cell membrane stability, and helps prevent brain cell overactivity.

Chemotherapy

Cisplatin

Fluorouracil

Paclitaxel

May be beneficial

May be beneficial

May be beneficial

May be beneficial


104

THYMUS EXTRACTS

Usually derived from the thymus glands of young calves.

Chemotherapy

Cisplatin

Cyclophosphamide

Docetaxel

Flurouracil

Interferon

Paclitaxel

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

Further information

May be beneficial

VINPOCETINE

A semisynthetic derivative of vincamine, which is derived from the periwinkle plant.It increases cerebral blood flow and is said to improve memory.

Benzodiazepines May be beneficial


105

VITAMIN A

Helps cells reproduce normally.Also stimulates immunity and is needed for forming bone, protein and growth hormones.(See BETA-CAROTENE.)

Anticonvulsants

Atorvastatin


Chemotherapy

Cisplatin

Colestipol

Cyclophosphamide

Docetaxel

Fluorouracil

Fluvastatin

Gabapentin

Isotretinoin

Lovastatin

Medroxyprogesterone

Methotrexate

Methyltestosterone

Mineral oil

Minocycline

May be beneficial

Avoid

May be beneficial

Further information

Further information

May be beneficial

May be beneficial

Further information

Further information

Avoid

May be beneficial

Avoid

Further information

Further information

Further information

May be beneficial

May be beneficial

Avoid


106

VITAMIN A (cont.) Neomycin

Oral contraceptives


Orlistat

Paclitaxel

Phenobarbital

Pravastatin

Simvastatin

Thioridazine

Tretinoin

Valproic acid

May be beneficial

Further information

Further information

May be beneficial

Further information

May be beneficial

Further information

Avoid

May be beneficial

Avoid

May be beneficial

VITAMIN B1 (THIAMIN)

Needed to process carbohydrates, fat and protein.Every cell of the body requires Vitamin B1 to form ATP, the fuel the body runs on.Nerve cells require Vitamin B1 in order to function normally.

Loop diuretics

Oral contraceptives

Stavudine


May be beneficial

May be beneficial

May be beneficial

May be beneficial


107

VITAMIN B2 (RIBOFLAVIN)

Needed to process amino acids and fats, activate Vitamin B6 and folic acid, and help convert carbohydrates into ATP, the fuel the body runs on.Under some circumstances, Vitamin B2 acts as an antioxidant.

AZT

Didanosine

Doxorubicin

Oral contraceptives

Tetracyclin


May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial


108

VITAMIN B3 (NIACIN, NIACINIMIDE)

Aids in the process of releasing energy from carbohydrates. Needed to form fat from carbohydrates and to process alcohol.The niacin form of Vitamin B3 also regulates cholesterol.

Atorvastatin

Benztropine

Carbidopa

Carbidopa/Levodopa

Cerivastatin

Fluvastatin

Gemfibrozil

Glimepiride

Isoniazid

Lovastatin

Minocycline

Oral contraceptives

Pravastatin

Repaglinide

Rosuvastatin

Simvastatin

Tetracycline

Thioridazine


Further information

May be beneficial

May be beneficial

May be beneficial

Further information

Further information

May be beneficial

Avoid

May be beneficial

Further information

May be beneficial

May be beneficial

Further information

Further information

Further information

Further information

May be beneficial

May be beneficial

May be beneficial


109

VITAMIN B6 (PYRIDOXINE)

Essential for processing amino acids.Also needed to make serotonin, melatonin and dopamine.

Anticonvulsants

Carbidopa

Carbidopa/Levodopa

Cycloserine

Docetaxel

Erythromycin


Fenofibrate

Fluorouracil

Folic acid

Gabapentin

Gentamicin

Hydralazine

Hydroxychloroquine

Isoniazid

Levodopa

Mixed amphetamines

Neomycin

May be beneficial

Further information

Further information

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

Further information

May be beneficial

Further information

May be beneficial

May be beneficial

Further information

May be beneficial

May be beneficial

May be beneficial


110

VITAMIN B6 (PYRIDOXINE)

Oral contraceptives


Penicillamine

Phenelzine

Phenobarbital

Risperidone

Sulfamethoxazole

Tetracycline



Trimethoprim

Valproic acid

May be beneficial

May be beneficial

May be beneficial

May be beneficial

Further information

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial


111

VITAMIN B12 (COBALAMIN)

Needed for normal nerve cell activity, DNA reproduction, and production of the mood-affecting substance called S-adenosyl methionine (see SAMe).Works with folic acid to control homocysteine levels.

Anticonvulsants

Aspirin

AZT

Cimetidine

Clofibrate

Colchicine

Cycloserine

Erythromycin

Famotidine

Fenofibrate

Gabapentin

Gentamicin

Isoniazid

Lansoprazole

Metformin

Methyldopa

Neomycin

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial


112

VITAMIN B12 (COBALAMIN)

Nitrous oxide

Nizatidine

Omeprazole

Oral contraceptives

Phenobarbital

Ranitidine

Sulfamethoxazole

Tetracycline


Trimethorpim

Valproic acid

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial


113

VITAMIN C (ASCORBIC ACID)

A water-soluble vitamin that functionsas a powerful antioxidant.Needed to make collagen.Helps in wound healing and is anatural antihistamine.Aids in the formation of liver bile andhelps to fight viruses.Helps detoxify alcohol and other substances.

Acetaminophen

Ampicillin

Aspirin

Carbidopa

Carbidopa/Levodopa

Cardec DM

Chemotherapy

Cisplatin

Clozapine

Cyclophosphamide

Dapsone

Docetaxel

Doxorubicon

Ephedrine and Pseudoephedrine

Epinephrine

Fenofibrate

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

Further information

Further information

Further information

May be beneficial

Further information

May be beneficial

Further information

May be beneficial

Further information

Further information

May be beneficial


114

VITAMIN C (ASCORBIC ACID) (cont.)

Fluorouracil

Indomethacin

Isosorbide mononitrate

Methodtrexate

Minocycline

Mixed amphetamines

Nitroglycerine

Oral contraceptives


Paclitaxel

Perphenazine

Salsalate

Tacrine

Tetracycline

Thioridazine

Warfarin

Further information

May be beneficial

Further information

Further information

May be beneficial

Avoid

May be beneficial

May be beneficial

Further information

Further information

Further information

May be beneficial

May be beneficial

May be beneficial

Further information

Further information


115

VITAMIN D (CHOLECALCIFEROL)

Maintains blood levels of calcium by increasing absorption of calcium from food and reducing urinary calcium loss.Some Vitamin D is necessary for healthy bones and teeth.

Allopurinol

Anticonvulsants

Bile acid sequestrants Cimetidine

Colestipol

Estradiol


Flurbiprofen

Gabapentin

Heparin

Hydroxychloroquine

Indapamide

Isoniazid

Medroxyprogesterone

Mineral oil

Neomycin

Further information

May be beneficial

May be beneficial

May be beneficial

May be beneficial

Further information

Further information

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

Further information

May be beneficial

May be beneficial


116

VITAMIN D (CHOLECALCIFEROL) (cont.)


Orlistat

Phenobarbital

Sodium fluoride

Thiazide diuretics

Valproic acid

Verapamil

Warfarin

May be beneficial

May be beneficial

May be beneficial

May be beneficial

Further information

May be beneficial

Avoid

Avoid


117

VITAMIN E (TOCOPHEROL)

This is a powerful antioxidant that protects cell membranes and other fat-soluble parts of the body.

Amiodarone

Anthralin

Aspirin

AZT

Benzamycin


Chemotherapy

Cisplatin

Colestipol

Cyclosphosphamide

Cyclosporine

Dapsone

Docetaxel

Doxorubicin

Fenofibrate

Flourouracil

Gemfibrozil

May be beneficial

May be beneficial

Avoid

Further information

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial


118

VITAMIN E (TOCOPHEROL) (cont.)

Glyburide

Griseofulvin

Haloperidol

Insulin

Isoniazid

Isotretinoin

Lindane

Lovastatin

Mineral oil

Orlistat

Paclitaxel

Pentoxifylline

Risperidone

Simvastatin

Sodium fluoride

Valproic acid

Warfarin

Further information

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

Further information

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

Further information

May be beneficial

Further information

Further information


119

VITAMIN K (PHYLLOQUINONE)

Needed for proper bone formation and blood clotting, in both cases by helping the body transport calcium.


Amoxicillin

Ampicillin

Antibiotics

Anticonvulsants

Azithromycin


Cephalosporins

Chlorhexidine

Ciprofloxacin

Clarithromycin

Clindamycin oral

Colestipol

Cycloserine

Dapsone

Dicloxacillin

Doxycycline

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial


120

VITAMIN K (PHYLLOQUINONE)(cont.)

Erythromycin

Gabapentin

Gentamicin

Isoniazid

Levofloxacin

Loracarbef

Macrolides

Mineral oil

Minocycline

Neomycin

Nitrofurantoin

Ofloxacin


Penicillin V

Penicillins

Phenobarbital

Quinolones

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

Further information

May be beneficial

May be beneficial

May be beneficial

May be beneficial


121

VITAMIN K (PHYLLOQUINONE)(cont.)

Sulfamethoxazole

Sulfasalazine

Sulfonamides

Tetracycline

Tetracyclines

Tobramycin

Trimethoprim

Trimethrprim/Sulfamethoxazole

Valproic acid

Warfarin

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

Avoid


122

ZINC

A component of more than 300 enzymes that are needed to repair wounds, maintain fertility, synthesize protein, help cells reproduce, preserve vision, boost immunity and protect against free radicals, among other functions.

Aspirin

AZT

Benazepril

Benzamycin


Calcium acetate

Captopril

Chemotherapy

Chlorhexidine

Ciprofloxacin

Cisplatin

Clindamycin topical

Colestipol

Cyclophosphamide

Docetaxel

Doxycycline

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

Further information

Avoid

May be beneficial

May be beneficial

May be beneficial

May be beneficial

May be beneficial

Avoid


123

ZINC (cont.) Estrogens (combined)

Folic acid

Lisinopril

Medroxyprogesterone

Methodtrexate

Methyltestosterone

Metronidazole (vaginal)

Minocycline

Ofloxacin

Oral contraceptives


Penicillamine

Quinapril

Ramipril

Risedronate

Sodium fluoride

Tetracycline

Further information

May be beneficial

May be beneficial

Further information

May be beneficial

Avoid

May be beneficial

Further information

Avoid

May be beneficial

Further information

Avoid

May be beneficial

May be beneficial

Avoid

May be beneficial

Avoid


124

ZINC (cont.) Tetracyclines

Thiazide diuretics

Topical corticosteroids

Valproic acid

Warfarin

Avoid

May be beneficial

May be beneficial

Further information

Avoid

125

7 – KetoAcetyl – L – CarnitineAdrenal ExtractAlaninaAlpha Lipoic Acid Amylase Inhibitors ArginineBeta – GlucanBeta – SitosterolBetaine (Trimethylglycine)Blue – Green AlgaeBorage Oil Boric AcidBoron Bovine Colostrum Branched – Chain Amino AcidsCalcium D – GlucarateCarnosine Cartilage and CollagenCetyl MyristoleateChitosanChlorophyllChondroitin SulfateCoconut OilColloidal Silver Creatine MonohydrateCysteineD – Mannose

VITAMIN & SUPPLEMENTSWHICH HAVE NO SIGNIFICANTINTERACTIONS

WITH DRUGS (At the time of writing this guide)

DMAEDMSO Docosahexaenoic AcidFlaxseed and Flaxseed OilFluoride Fumaric AcidsGABA Gamma OryzanolGlucomannan GlucosamineGlutamic AcidGrapefruit Seed Extract Green – Lipped MusselHMBHydrooycitric Acid Indole – 3 – CarbinolInosineIodineIP – 6 Kelp LactaseLecithin / Phosphatidyl CholineLipaseLiver Extracts LuteinLycopeneLysine Malic Acid

126

MethionineMethoxyisoflavoneMethylsulfonylmethaneMolybdenumN – Acetyl – GlucosamineNADH OctacosanolOligosaccharidesOrnithinePhenylalaninePolicosanol PollenPregnenoloneProanthocyanidins

ProgesteronePropolisPyruvate ResveratrolRiboseRoyal JellySilica HydrideStrontiumSulforaphane Sulfur Thyroid ExtractsVanadiumWhey Protein Xylitol

127

USEFUL WEB SITESFOR HEALTH CARE PROFESSIONALS

Alternative Medicine Foundationwww.herbmed.org

American Pharmacist Associationwww.aphanet.org

American Nutraceutical Associationwww.americanutra.com

Association of Natural Medicine Pharmacistswww.anmp.org

Canadian Health Food Associationwww.chfa.ca

Canadian Health Networkwww.canadian-health-network.ca

Prescription Drug Informationwww.drugs.com

National Center forComplementary & Alternative Medicinewww.nccam.nih.gov

Natural Products Associationwww.naturalproductsassoc.org

128

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