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Prescription Drug / Nutritional Supplement Interactions
by Natural Medicine Online

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Patients taking prescription drugs need to be nutrition-conscious

Prescription drugs often become a necessary component of patients' health. And that presents a new need -- the need for physicians and pharmacists to discuss the possible ramifications of taking a prescription, including nutrient depletion in the body.

Most people are well-versed in the importance of vitamins, minerals, and herbs to their health. Stress, environmental pollutants, and poor diet all contribute to the depletion of nutrient levels in the body.

Unfortunately, most people are not aware of how prescription drugs create drug-induced nutrient depletion. This is an important issue that becomes even more important when a patient must take a prescription for a chronic condition.

As America ages, it's inevitable that more of the population will need prescription drugs for chronic conditions. There's already an influx of prescriptions for Americans' high blood pressure, high cholesterol levels, heart disease, and other health concerns. This is a prime opportunity to educate your patients about the need for nutritional therapy as an adjunct to taking prescription medications. Not only does this benefit the patient, but also enables you to integrate natural medicines into your clinic or pharmacy.

Consider that anti-hypertensive medications for blood pressure, drugs that comprise the sixth largest dollar-volume category of prescription drugs in the U.S. in 1998, will deplete zinc in the body. This mineral is crucial to the immune system and its many functions including wound healing and infection fighting. A zinc deficiency can also cause insulin resistance and sexual dysfunction.

Cholesterol-lowering drugs such as Lipitor® and Zocor® comprise the third largest category of prescription drugs in the United States in 1998 and can easily deplete Coenzyme Q10 (CoQ10). On the flip side, magnesium may inhibit the absorption of these drugs. And even commonplace NSAIDs deplete nutrients like folic acid. And it's this deficiency that poses greater risk for women because of the link to cervical dysplasia and birth defects in their children. Other problems associated with a lack of adequate folic acid include anemia, depression, elevated homocysteine levels (and corresponding risk of cardiovascular disease), and increased risks for developing breast and colorectal cancers.

In response, Natural Medicine Online offers a chart of the 20 most commonly prescribed drugs and their corresponding effects on body nutrient levels. Please use this chart to educate your patients about the added importance of nutritional supplements and natural medicines when taking prescription medications.

Top 20 Drugs

Norvasc®, Procardia®, and Adalat®

Description: Types of anti-anginal drugs used for heart disease.
Depletion: Procardia and Adalat can cause potassium depletion (hypokalemia).
Interactions: Ingestion of grapefruit or grapefruit juice has been shown to increase the blood levels of these drugs and may increase side effects.
Nutritional Support: Krebs Magnesium- Potassium Chelates.


NSAIDS including Aleve®, aspirin, ibuprofen, Feldene®, Indocin®, Relafen®, Naprelan®, Naprosyn, etc.

Description: Types of anti-inflammatory drugs.
Depletion: Iron, folic acid, zinc, vitamin C, and possibly vitamin B12.
Interaction: High dosages of vitamin E (i.e.,>400 IU/day) can decrease platelet aggregation. This may result in additive blood thinning effects already present in NSAIDs.
Nutritional Support: Glucosamine sulfate, a high potency daily multiple vitamin for women or men, and MSM.


Premarin®, Prempro®, and other estrogen hormones

Description: Types of estrogen replacement (HRT) used for menopause.
Depletion: Vitamin B6, folic acid, niacin, and vitamin C.
Interaction: Red clover extracts and soy isoflavones may interfere with absorption. Vitamin D, calcium, zinc, magnesium, and ipriflavone may increase absorption.
Nutritional Support: A high potency daily multiple vitamin for women or women 45+ and standardized black cohosh. Standardized black cohosh is effective for relief of menopause symptoms.


Prilosec® and other proton pump inhibitors

Description: Types of ulcer/gastric reflux medications (GERD).
Depletion: Vitamin B12.
Interaction: May decrease the absorption of calcium, magnesium, and other minerals by blocking the release of stomach acid.
Nutritional Support: Vitamin B12 (Methylcobalamin) and a high potency daily multiple vitamin for women or men. Gastro-Relief™ helps relieve acid indigestion. (GHOE Note: NSP Equivalent: Gastro Health)


Prozac®, Zoloft®, and other SSRIs

Description: Types of anti-depressants.
Depletion: Melatonin.
Interaction: Low levels of B vitamins may reduce the effectiveness of these drugs.
Nutritional Support: St. John's wort extract and 5-HTP should not be taken with any SSRI unless under a physician's
supervision. Melatonin and a complete daily multiple vitamin for women or men.

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Synthroid® and other thyroid hormone medications (Eltroxin®, Levo-T®, Levothroid®, Levoxyl®, Euthroid®, Thyrolar®, etc.)

Description: Types of thyroid hormone replacement.
Depletion: Calcium.
Interaction: Iron supplements and soy products taken at the same time as Synthroid® may interfere with absorption.
Nutritional Support: Milk thistle extract standardized to contain 70% silymarin. Thyroid preparations are best taken on an empty stomach at the same time every day.


Vasotec®, Capoten®, (Captopril), Prinivil®, Zestril®

Description: Types of (anti-hypertensives) medications for blood pressure.
Depletion: Zinc.
Interaction: These drugs may increase blood levels of potassium above normal or reduce potassium excretion in urine.
Nutritional Support: A high potency daily multiple vitamin for women or men.


Albuterol (Proventil®, Ventolin®)

Description: Types of bronchodilator (asthma).
Depletion: Magnesium and calcium.
Nutritional Support: A high potency daily multiple vitamin for men or women and Krebs Magnesium-Potassium Chelates. Bronchoril™ can help keep airways free of mucus.


Amoxicillin preparations including Augmentin®, Amoxil®, Polymox®, Trimox®, and others

Description: Types of antibiotics.
Depletion: Biotin, vitamin K, and possibly other B vitamins.
Interaction: The enzyme bromelain increases the absorption of amoxicillin and other antibiotics.
Nutritional Support: Acidophilus and bromelain. Bifidophilus Lactobacillus preparations can be taken with antibiotics.


Claritin®, Claritin®-D

Description: Types of allergy medications.
Depletion: None known.
Interaction: None known.
Nutritional Support: A high potency daily multiple vitamin for women or men.


Coumadin® (warfarin)

Description: Types of anticoagulant therapy used for heart disease (blood thinner).
Depletion: None known.
Interaction: Vitamin K may decrease the effect of Coumadin®.
Nutritional Support: Ginkgo biloba extract, vitamin E, and aspirin may increase the effect of Coumadin. A high potency, standardized grape seed extract helps to maintain healthy blood vessels. Iron, magnesium, and zinc may bind with Coumadin® and decrease its absorption. Take any supplement containing these compounds at least two hours before or after taking Coumadin®.


Diuretics including Lasix®, Aldactone®, Esidrix®, Hydrodiuril®, Edecrin®

Description: Types of blood pressure medications also used for fluid retention.
Depletion: Potassium, magnesium, and B vitamins (especially
thiamin).
Interaction: Diuretics cause the body to excrete higher levels of potassium, magnesium, and B vitamins. However, calcium levels tend to be preserved.
Nutritional Support: A high potency daily multiple vitamin for women or men. Potassium supplementation is routinely provided by medical doctors when they prescribe diuretics.


Glucophage®, also DiaBeta®, Micronase®, Glucotrol®

Description: Types of oral anti-diabetic agents.
Depletion: Folic acid and vitamin B12 .
Interaction: These drugs should be taken on an empty stomach.
Nutritional Support: Magnesium, chromium, and a high potency daily multiple for diabetics. Diabetics have higher needs for virtually all nutrients, especially vitamins C, E, and B, magnesium, and chromium.


Lanoxin® (digoxin)

Description: Type of inotropic heart medication.
Depletion: Magnesium, potassium, and thiamine.
Interaction: Low levels of potassium increase the risk of digoxin toxicity. Siberian ginseng should not be used with Lanoxin.
Nutritional Support: Krebs Magnesium-Potassium Chelates, and high potency daily multiple vitamin for women or men. Avoid licorice extract unless it is deglycyrrhizinated.


Lipitor®, Mevacor®, Zocor®, Pravachol®, and other HMG CoA Reductase Inhibitors.

Description: Types of anti-cholesterol medications.
Depletion: Coenzyme Q10.
Interaction: Magnesium may inhibit the absorption of these drugs. High doses of niacin will increase risk for adverse liver effects and myopathies.
Nutritional Support: Coenzyme Q10 (softgel). Do not use concomitantly with red yeast rice products unless under the supervision of a physician.


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