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

MediScript Communications Inc.

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

© 20162007 Mediscript Communications Inc. ISBN # 978 1 896616 00 1

Printed in Canada 1 2 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

3 4 Table of Contents Diovan ...... 30 Introduction ...... 9 Ditropan ...... 30 How to use this book .....13 Duragesic ...... 31 Effexor XR ...... 31 SECTION 1 Evista ...... 32 Prescribed drugs Exelon ...... 32 Flomax ...... 33 Accupril ...... 15 Flonase / Flovent ...... 33 Aciphex ...... 16 Foltx ...... 34 Actonel ...... 16 Fosamax ...... 34 Actos ...... 17 Glucotrol ...... 35 Advair Diskus ...... 17 Glucovance ...... 36 Aggrenox ...... 18 Humalin N ...... 37 Allegra ...... 18 Hyzaar ...... 36 Alphagan P ...... 18 Lanoxin ...... 38 Altace ...... 19 Lescol ...... 40 Amaryl ...... 19 Levaquin ...... 41 Ambien ...... 19 Lexapro ...... 42 Aricept ...... 19 Lipitor ...... 42 Arimidex ...... 20 Lotensin ...... 43 Asacol ...... 21 Lumigan ...... 44 Atacand...... 21 Macrobid ...... 44 Atrovent ...... 22 Metformin ...... 45 Avandia ...... 22 Miacalcin ...... 46 Avapro ...... 23 Mobic ...... 46 Celaxa ...... 23 Monopril ...... 47 Cipro ...... 24 Nasonex ...... 47 Clarinex ...... 25 Neurontin ...... 48 Combivent ...... 25 Nexium ...... 50 Coreg ...... 26 Norvasc ...... 51 Cosopt ...... 26 Oxycontin ...... 51 Coumadin ...... 27 Paxil ...... 52 Cozaar ...... 29 Plavix ...... 52 Detrol ...... 29 Pletal ...... 53

5 Pravachol ...... 53 Chondroitin Sulfate ...... 76 Premarin ...... 55 Chromium ...... 76 Prevacid ...... 56 Coenzyme Q10 ...... 77 Prilosec ...... 56 Copper ...... 78 Proscar ...... 57 Dehydroepian-Drosterone Protonix ...... 57 (DHEA) ...... 79 Reminyl ...... 57 Digetsive Enzymes Risperdal ...... 58 Evening Primrose Oil .....79 Serevent ...... 58 Fibre ...... 80 Seroquel ...... 59 Fish oil & Cod Liver Oil Singulair ...... 59 (EPA & DHA) ...... 80 Synthroid ...... 60 Folic Acid Toprol XL ...... 61 Glucosamine ...... 83 Travatan ...... 61 Glutamine ...... 84 Tricor ...... 62 Glutathione ...... 84 Ultracet ...... 62 Glycine ...... 84 Viagra ...... 62 Inositol ...... 84 Welchol ...... 63 Ipriflavone ...... 85 Wellbutrin ...... 63 Iron ...... 86 Xalatan ...... 63 L - Carnitine ...... 88 Zetia ...... 64 L – Tyrosine ...... 89 Zocor ...... 64 Magnesium ...... 89 Manganese ...... 92 SECTION 2 Melatonin ...... 93 Vitamin / Supplements N – Acetyl Cysteine (NAC) ...... 94 5 – Hydroxytryptophan ..67 PABA ( Para Amino Beta – Carotene ...... 68 Benzoic Acid) ...... 95 Bioflavanoids ...... 69 Pantothenic Acid Biotin ...... 69 (Vitamin B5) ...... 95 Brewer’s Yeast ...... 70 Phosphorous ...... 96 Bromelain ...... 72 Potassium ...... 96 Calcium ...... 73 Probiotics ...... 100 Carotenoids ...... 76 Quercetin ...... 102

6 SAMe (S – Adenosyl Methionine) ...... 102 Selenium ...... 102 Soy ...... 102 Spleen Extracts ...... 103 Taurine ...... 103 Thymus Extracts ...... 104 Vinpocetine ...... 104 Vitamin A ...... 106 Vitamin B1 ...... 106 Vitamin B2...... 107 Vitamin B3 ...... 108 Vitamin B6 ...... 109 Vitamin B12 ...... 111 Vitamin C ...... 113 Vitamin 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

7 8 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,

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

DEPLETION The 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.

INTERACTIONS A 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.

10 • 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.

11 12 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 information The 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.

13 14 Drug Supplement Type of Interaction

ACCUPRIL Zinc Drug may cause zinc depletion. (ACCUPRO) People taking Accupril (quinapril) on a long-term basis Combination drug: should consider taking a zinc ACCURETIC supplement or a multimineral tablet containing zinc. Generic name: Quinapril HCL Iron Can reduce a cough side effect.

Type of drug: High potassium foods, Avoid: Increased blood ACE inhibitor potassium supplements, potassium levels is an salt substitutes uncommon but potentially Use: serious side effect of taking Lower high blood ACE inhibitors. Consult your pressure. health professionals before supplementing additional potassium and have your blood levels of potassium checked periodically.

15 Drug Supplement Type of Interaction

ACIPHEX Many Miscellaneous May affect absorption of Supplements supplements and other drugs Generic name: due to changes in stomach Rabeprazole acidity. sodium You should take supplements 2 hours after taking Aciphex. Type of drug: Proton pump inhibitor (antacid)

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

ACTONEL Calcium and vitamin D People with Paget’s disease should take supplemental Generic name: calcium and vitamin D 1 to 2 Risedronate hours before taking Actonel, if dietary intake is inadequate. Type of drug: Biphosphonates Antacids May reduce drug absorption. People taking Actonel should take calcium- or magnesium- Use: containing antacids an hour Treat osteoporosis before or two hours after the and paget’s drug. disease

16 Drug Supplement Type of Interaction

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

Type of drug: Thiazolidinediones

Use: Treating high blood sugar in diabetes.

ADVAIR DISKUS At the time of this writing, no evidence of nutrient interactions Generic name: involving this drug has been Salmeterol found in the medical literature. xinafoate/ fluticasone propionate (inhalation powder)

Type of drug: Beta-adrenergic bronchodilator

Use: For control of asthma and COPD.

17 Drug Supplement Type of Interaction

AGGRENOX Iron Some studies suggest taking too much iron can result in tissue Generic name: damage. Dipyridamole might Dipyridamole reduce the damage caused by this mineral. Use: To prevent blood clots and reduce the risk of stroke.

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

Type of drug: Antihistamine

Use: Allergy symptom relief. ALPHAGAN P At the time of this writing, no evidence of nutrient interactions Generic name: involving this drug has been Brimonidine found in the medical literature. tartrate

Use: Treat glaucoma.

18 Drug Supplement Type of Interaction

ALTACE Zinc Drug may cause zinc depletion. People taking ramipril on a Generic name: long-term basis should consider Ramipril taking a zinc supplement or a multimineral tablet containing Type of drug: zinc. Angiotensin- converting enzyme Iron Supplementing with iron may (ACE) inhibitor prevent a cough side effect.

Use: Potassium Avoid if you have advanced Lower high blood kidney disease. pressure.

AMARYL Magnesium May enhance the blood-sugar lowering effects of this drug. Generic name: Monitor your blood glucose Glimepiride levels while taking Amaryl together with magnesium. Type of drug: Sulfonylurea Vitamin B3 (Niacin) Vitamin B3 can raise blood sugar levels; using niacin along Use: with Amaryl may increase To treat type 2 requirements for the drug. diabetes.

19 Drug Supplement Type of Interaction

AMBIEN 5-Hydroxytryptophan (5- Avoid: 5-HTP and L-tryptophan HTP) and L-tryptophan are converted to serotonin in the Generic name: brain. Although no interactions zolpidem tartrate have so far been reported with Amaryl and 5-HTP or L- Type of drug: tryptophan, taking them together Hypnotic drug may increase zolpidem-induced hallucinations. Use: To treat insomnia. ARICEPT Huperzine-A Avoid: Further studies are needed to determine the long- Generic name: term safety of using huperzine-A Donepezil with Aricept.

Use: Treat memory loss associated with Alzheimer’s disease ARIMIDEX At the time of this writing, the medical literature shows no Generic name: evidence of nutrient interactions Anastrozole involving Arimidex.

Use: Treat advanced breast cancer.

20 Drug Supplement Type of Interaction

ASACOL Psyllium May be beneficial: A study showed that taking 20 grams Generic name: of psyllium together with Mesalamine mesalamine helped to keep ulcerative colitis in remission. Use: To treat ulcerative colitis. ATACAND At the time of this writing, no evidence of nutrient interactions Generic name: involving candesartan was found Candesartan in the medical literature. cilexetil

Type of drug: Angiotensin II receptor antagonist

Use: To treat high blood pressure.

21 Drug Supplement Type of Interaction

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

Use: Symptomatic relief in COPD, bronchitis, asthma and emphysema. AVANDIA At the time of this writing, no evidence of nutrient interactions Generic name: involving this drug was found in Rosiglitazone the medical literature. maleate

Use: To treat type 2 diabetes.

22 Drug Supplement Type of Interaction

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

Generic name: Irbesartan

Type of drug: Angiotensin II receptor antagonist

Use: To treat high blood pressure. CELEXA Lithium Taking lithium at the same time as citalopram can either Generic name: increase the effectiveness of the Citalopram drug or increase your chances of developing side effects. Type of drug: Contact your doctor if you Selective experience nausea, dry mouth serotonin reuptake or sleep disturbances. inhibitor (SSRI) antidepressant.

Use: To treat depression.

23 Drug Supplement Type of Interaction

CIPRO Vitamin K Natural practitioners sometimes recommend vitamin K Generic name: supplements to people taking Ciprofloxacin antibiotics to help prevent antibiotic-induced bleeding. Type of drug: Fluoroquinolone Minerals: Aluminum, Minerals can bind to family of Calcium, Copper, Iron, ciprofloxacin, greatly reducing antibiotics Magnesium, Manganese, its absorption power. Take Cipro Zinc two hours after consuming dairy Use: products, antacids and mineral- Treat infections. containing supplements.

Probiotics: Taking probiotic microorganisms Bifidobacterium longum, has been shown to help prevent Lactobacillus acidophilus, antibiotic-induced diarrhea. Lactobacillus casei, Also, lactobacillus acidophilus Saccharomyces boulardii might prevent candida vaginitis (an overgrowth of yeast in the vagina.)

Dandelion (Taraxacum Avoid: the high mineral content officinale) of the dandelion herb can decrease absorption of the drug.

Fennel (Foeniculum Avoid: Fennel has been shown vulgare) to reduce drug absorption in animals.

24 Drug Supplement Type of Interaction

CLARINEX At the time of this writing, no evidence of nutrient interactions Generic name: involving this drug was found in Desloratadine the medical literature.

Type of drug: Antihistamine

Use: Relieve allergy symptoms. COMBIVENT Minerals: Calcium, This drug has been associated Magnesium, Phosphate, with decreased plasma levels of Generic name: Potassium certain minerals. Whether diet Albuterol/ or mineral supplements can Ipratropium prevent this is not known.

Type of drug: Soy It’s very rare, but people with Beta-adrenergic soy sensitivities have reacted to bronchodilator this drug.

Use: Symptomatic treatment of COPD, bronchitis and emphysema.

25 Drug Supplement Type of Interaction

COREG At the time of this writing, no evidence of nutrient interactions Generic name: involving carvedilol was found in Carvedilol the medical literature.

Type of drug: Beta blocker

Use: Treat heart problems.

COSOPT Potassium The drug may decrease the uptake of potassium from the Generic name: blood into the cells, leading to Dorzolamide/ excess potassium in the blood. Timolol maleate Avoid potassium supplements or eating large quantities of fruit Type of drug: unless directed by your doctor. Beta blocker Pleurisy root Avoid: contains cardiac Use: glycosides. Lower blood pressure and as Coenzyme 10Q Can help reduce cardiovascular eyedrops to treat side effects when taking Cosopt glaucoma. eyedrops for glaucoma.

26 Drug Supplement Type of Interaction

COUMADIN

Generic name: Coenzyme Q10 May affect blood coagulation. Warfarin sodium Take only with doctor’s guidance. Type of drug: Anticoagulant Cranberry, Dan Shen, A wide variety of herbs interact Devil’s claw, Dong quai, with warfarin. It is not within Use: Feverfew, Garlic, Ginger, the scope of this book to list Slows blood Ginkgo biloba, Ginseng, those interactions in detail. clotting. Green tea, Papain, Please check with a health care Quilinggao, Reishi professional. (ganoderma lucidum), St. John’s wort

Herbs containing Although there are no specific coumarin derivatives: studies showing these herbs Angelica root, Arnica interacting with anticoagulants, flower, Anise, Asafoetida, they may interact with warfarin Celery, Chamomile, Corn and cause bleeding. Consult silk, Fenugreek, Horse your doctor if you are taking chestnut, Licorice root, warfarin and wish to use one of Lovage root, Parsley, these herbs. Passion flower herb, Quassia, Red Clover, Rue, Sweet clover, Sweet Woodruff

27 Drug Supplement Type of Interaction

COUMADIN (cont.) Minerals: Iron, May bind with warfarin, Magnesium, Zinc potentially decreasing its absorption and activity. Take drug and minerals 2 hours apart.

Vitamin C May or may not interfere with the effect of anticoagulants.

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

Vitamin K 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.

28 Drug Supplement Type of Interaction

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

Combination drugs: Cozaar-Comp; Hyzaar

Type of drug: Angiotensin-II receptor blocker

Use: To treat high blood pressure. DETROL At the time of this writing, no evidence of nutrient interactions Generic name: involving tolterodine was found Tolterodine in the medical literature.

Type of drug: Competitive muscarinic receptor antagonist

Use: Treat overactive bladder.

29 Drug Supplement Type of Interaction

DIOVAN At the time of this writing, no evidence of nutrient or herb Generic name: interactions involving valsartan Valsartan was found in the medical literature. Type of drug: Angiotensin-II receptor blocker

Use: Treat high blood pressure. DITROPAN XL At the time of this writing, no evidence of nutrient interactions Generic name: involving oxybutynin was found Oxybutynin in the medical literature. chloride

Type of drug: Anticholinergic/ Antispasmodic

Use: Treat overactive bladder.

30 Drug Supplement Type of Interaction

DURAGESIC Magnesium A study showed that giving magnesium intravenously before Generic name: surgery dramatically reduced the Fentanyl amount of fentanyl needed to transdermal control pain.

Type of drug: Opioid analgesic

Use: Treat chronic pain. EFFEXOR XR 5-Hydroxytryptophan (5- Avoid: Venlafaxine is a potent HTP) and L-tryptophan serotonin reuptake inhibitor Generic name: and it has been associated Venlafaxine HCL with several cases of serotonin syndrome. 5-HTP and L- Use: tryptophan are converted to Treat depression. serotonin in the brain, and taking them with this drug may increase its side effects.

Sour date nut (ziziphus Avoid this Chinese herbal jujube) remedy when taking venlafaxine.

St. John’s wort 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.

31 Drug Supplement Type of Interaction

EVISTA Phytoestrogens e.g. This drug may block the benefits Formononetin of the supplement. Further Generic name: research is necessary. Raloxifene

Type of drug: Selective estrogen receptor modulator (SERM)

Use: To prevent osteoporosis in women after menopause. EXELON At the time of this writing, no evidence of nutrient interactions Generic name: involving this drug was found in Rivastigmine the medical literature. tartrate

Type of drug: Cholinesterase inhibitor

Use: Treat Alzheimer’s disease.

32 Drug Supplement Type of Interaction

FLOMAX At the time of this writing, no evidence of nutrient interactions Generic name: involving tamsulosin was found Tamsulosin HCL in the medical literature.

Type of drug: Alpha 1A- adrenoceptor antagonist

Use: Treat BPH (Benign Prostatic Hyperplasia)

FLONASE; Calcium Although Flonase has no FLOVENT documented interactions, a similar drug, beclomethasone, Generic name: may lead to reduced Fluticasone calcium absorption. Calcium propionate supplements may be recommended. Type of drug: Inhaled DHEA Again beclomethasone patients corticosteroid were found to have low levels of DHEA. Supplemental DHEA may Use: be beneficial. Treat asthma.

33 Drug Supplement Type of Interaction

FOLTX Zinc Zinc supplements are recommended when folic acid Generic name: intake is high; people taking Folic acid; Vitamin moderate amounts do not need B12; Vitamin B6 to supplement with zinc.

Type of drug: Vitamin B6 People with elevated blood Multi-vitamin levels of homocysteine, which has been associated Use: with atherosclerosis, should Treat heart and supplement with both folic acid blood circulation and vitamin B6. problems Antacids Folic acid should be taken 1 hour before or 2 hours after taking antacids containing aluminum and magnesium hydroxide. FOSAMAX Calcium Calcium supplements may interfere with alendronate Generic name: absorption. Take drug 2 Alendronate hours before or after calcium sodium supplements.

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

34 Drug Supplement Type of Interaction

GLUCOTROL Ginkgo biloba Avoid: In patients with type 2 diabetes who were taking oral Generic name: anti-diabetes medication, ginkgo Glipizide biloba extract resulted in a significant worsening of glucose Type of drug: tolerance. Sulfonylunea Gymnema sylvestre Herbs such as gymnema Use: sylvestre will often improve Lower blood sugar blood-sugar control in diabetics. in type 2 diabetes. In such cases, the amount of blood sugar-lowering drugs may need to be reduced in order to avoid a hypoglycemic reaction.

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

35 Drug Supplement Type of Interaction

GLUCOVANCE Aloe vera May be beneficial: One study reported that combining 15 ml Generic name: of aloe juice twice daily with Glyburide/ glyburide significantly improved Metformin HC1 blood sugar and lipid levels in people with diabetes. Type of drug: Sulfonylurea Chromium Avoid: May cause adverse reaction. Use: Lower blood sugar Ginkgo biloba Avoid: In patients with type 2 levels in type 2 diabetes who were taking oral diabetes. anti-diabetes medication, ginkgo biloba extract resulted in a significant worsening of glucose tolerance.

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

36 Drug Supplement Type of Interaction

HUMULIN N Dehydroepiandrosterone Insulin has been shown to (DHEA) decrease the levels of DHEA and Generic name: DHEA-sulfate in the blood. More Human insulin NPH research is needed to determine the significance of this finding. Type of drug: Synthetic injectable Biotin May naturally reduce blood insulin (Insulins Chromium sugar levels, therefore may have may be from Fenugreek to reduce amount of injected animal source or Gymnema sylvestre insulin. synthesized) Vitamin E

Use: To lower blood sugar in diabetes. HYZAAR Potassium Avoid: Losartan has caused significant increases in blood Generic name: potassium levels. See Cozaar. Losartan potassium and hydrochlorothiazide

Type of drug: Angiotensin-II receptor blocker

Use: To treat high blood pressure.

37 Drug Supplement Type of Interaction

LANOXIN Alder buckthorn Extended consecutive use may Buckthorn cause a loss of electrolytes, Generic name: especially potassium. Loss of Digoxin potassium may increase the toxicity of the medication with Type of drug: potentially fatal consequences. Derived from foxglove plant. Digitalis (Foxglove) Avoid: This group of plants contain chemicals with actions Use: and toxicities similar to digoxin. Helps in treatment Because of the added risk of of congestive heart toxicity, digitalis and digoxin failure. should never be used together.

Hawthorn 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

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

Pleurisy root Avoid: Contains cardiac glycosides.

38 Drug Supplement Type of Interaction

LANOXIN (cont.) Magnesium People needing digoxin may Potassium 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.

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

Senna (Cassia senna, Avoid: May deplete potassium Cassia angustifolia) levels and increase digoxin activity and risk of toxicity. It could also decrease the levels of the drug and therefore decrease digoxin activity.

St. John’s wort Avoid: May reduce blood levels of digoxin.

39 Drug Supplement Type of Interaction

LESCOL Coenzyme Q10 Drugs similar to Lescol have shown decreased Generic name: concentrations of Coenzyme Fluvastatin sodium Q10; may have to supplement with Coenzyme Q10 Type of drug: HMG-CoA Niacin Fluvastatin and niacin used reductase inhibitor together have been shown to be more effective than either Use: substance alone. Large amounts To treat high of niacin may cause rare muscle cholesterol. disorders.

Vitamin A Avoid: Fluvastatin therapy can increase levels of Vitamin A.

40 Drug Supplement Type of Interaction

LEVAQUIN Iron Avoid: Can reduce the absorption and effectiveness of Generic name: the drug. Levofloxacin Magnesium Taking magnesium supplements Type of drug: at the same time as Levaquin Antibiotic can reduce the absorption of the drug. Consequently, Use: supplements or antacids To treat bacterial containing magnesium should infections. be taken 2 hours before or after taking the drug.

Probiotics: Taking probiotic microorganisms Bifidobacterium longum, has been shown to help prevent Lactobacillus acidophilus, antibiotic-induced diarrhea. Lactobacillus casei, Also, lactobacillus acidophilus Saccharomyces boulardii might prevent candida vaginitis (an overgrowth of yeast in the vagina.)

Vitamin K 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.

41 Drug Supplement Type of Interaction

LEXAPRO At the time of this writing, no evidence of nutrient interactions Generic name: involving this drug was found in Escitalopram the medical literature. oxalate

Type of drug: Selective serotonin reuptake inhibitor (SSRI)

Use: Treat depression LIPITOR Antacids containing Can interfere with drug Magnesium/Aluminum absorption. Avoid this interaction Generic name: by taking atorvastatin 2 hours Atorvastatin before or after any magnesium- or aluminum-containing Type of drug: antacids. HMG-CoA reductase inhibitor Coenzyme Q10 Decreases concentration; may have to supplement with more Use: Coenzyme Q10 To lower high cholesterol. Grapefruit Inhibits the body’s ability to break down Lipitor and can increase toxicity of drug.

42 Drug Supplement Type of Interaction

LIPITOR (cont.) Vitamin A Lipitor can increase levels of vitamin A.

Niacin (Vitamin B3) 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 Zinc A study of people taking ACE inhibitors linked to benazepril Generic name: showed decreased zinc levels Benazepril in certain white blood cells. While zinc depletion hasn’t Combination drug: been reported with this drug, LOTREL people taking benazepril on a long-term basis should consider Type of drug: taking a zinc supplement or a Angiotensin- multimineral tablet containing Converting Enzyme zinc. (ACE) inhibitor Iron May reduce the severity of Use: cough side effect attributed to To treat high blood taking ACE inhibitors. pressure. High potassium foods Avoid: People with advanced Potassium supplements kidney disease may develop Potassium-containing increased blood potassium salt substitutes levels as a result of taking benazepril.

43 Drug Supplement Type of Interaction

LUMIGAN At the time of this writing, no evidence of nutrient interactions Generic name: involving this drug was found in Bimatoprost the medical literature.

Type of drug: Eye drops.

Use: Treat glaucoma. MACROBID Magnesium Avoid: May reduce drug absorption and/or bioavailability Generic name: Nitrofurantoin Probiotics: Taking probiotic microorganisms macro/ Bifidobacterium longum, has been shown to help prevent monohydrate Lactobacillus acidophilus, antibiotic-induced diarrhea. Lactobacillus casei, Also, lactobacillus acidophilus Type of drug: Saccharomyces boulardii might prevent candida vaginitis Antibiotic (an overgrowth of yeast in the vagina.) Use: Treat urinary tract Vitamin K May be beneficial: Some infections. 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.

44 Drug Supplement Type of Interaction

METFORMIN Dehydroepiandrosterone Metformin can increase blood (DHEA) levels of DHEA-sulfate. Generic name: Metformin HCL Folic acid; Vitamin B12 Metformin therapy can deplete Calcium vitamin B12 and sometimes folic Use: acid as well. In a clinical trial Treat Type 2 supplementation with calcium diabetes. reversed this effect. Supplement vitamin B12 and folic acid or ask your doctor to monitor folic acid and vitamin B12 levels.

Guar gum Avoid: May slow the rate of metformin absorption.

Ginkgo biloba 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.

45 Drug Supplement Type of Interaction

MIACALCIN Calcium Supplementation with 1500 mg a day of calcium enhances Generic name: the effects of calcitonin on Calcitonin salmon bone mass of the lumbar spine. Women who take a calcitonin Type of drug: product for osteoporosis should Natural hormone also take calcium.

Use: Treat osteoporosis and can provide symptomatic relief of acute pain due to fractures. MOBIC Lithium Avoid: Lithium is a mineral that may be present in some Generic name: supplements and is also used to Meloxicam treat mood disorders. Meloxicam may inhibit the excretion of Type of drug: lithium from the body, resulting NSAID (Non in higher levels of the mineral. steroidal anti- inflamatory) White willow bark (salix Avoid: White willow bark alba) contains salicin, related to Use: aspirin. It can produce anti- Arthritis and other inflammatory effects which may indications with lower blood levels of meloxicam. associated pain.

46 Drug Supplement Type of Interaction

MONOPRIL Iron May reduce the severity of a cough side effect caused by Generic name: the drug. Fosinopril sodium High potassium foods, Avoid: Increased blood Type of drug: potassium supplements, potassium levels is an Angiotension- salt substitutes uncommon but potentially converting Enzyme serious side effect of taking (ACE) inhibitor ACE inhibitors. Consult your health professional before Use: supplementing additional To treat high blood potassium and have your blood pressure. levels of potassium checked periodically. NASONEX Calcium This drug may lead to reduced absorption of calcium so health Generic name: practitioners may recommend Mometasone calcium supplementation. furoate

Type of drug: Inhaled corticosteroid

Use: Treat asthma.

47 Drug Supplement Type of Interaction

NEURONTIN Biotin Long-term anticonvulsant treatment decreases levels of Generic name: biotin. Supplement with biotin Gabapentin either alone or as part of a multivitamin. Type of drug: Anticonvulsant Calcium Individuals on long-term multiple Vitamin D anticonvulsant therapy may develop below-normal blood Use: levels of calcium, which may be Treat seizure related to drug-induced vitamin disorders. D deficiency.

Folic acid 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.

L-carnitine Multiple anticonvulsant therapy can dramatically reduce blood carnitine levels.

Vitamin A 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.

48 Drug Supplement Type of Interaction

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

Vitamin B12 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.

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

Vitamin D 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.

49 Drug Supplement Type of Interaction

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 At the time of this writing, no evidence of nutrient interactions Generic name: involving this drug was found in Esomeprazole the medical literature. magnesium

Type of drug: Antacid (proton pump inhibitor)

Use: Treat stomach problems, e.g. GERD

50 Drug Supplement Type of Interaction

NORVASC Pleurisy root Avoid: Contains cardiac glycosides. Generic name: Amlodipine Grapefruit juice Avoid: Increases the absorption besylate of felodipine, a drug similar to amlodipine, and increases Type of drug: the adverse effects of the Calcium-channel medication in patients with blocker hypertension.

Use: Treat cardiac problems and high blood pressure.

OXYCONTIN At the time of this writing, no evidence of nutrient or herb Generic name: interactions involving this drug Oxycodone HCL has been found in the medical literature. Type of drug: Narcotic analgesic

Use: Pain relief

51 Drug Supplement Type of Interaction

PAXIL 5-Hydroxytryptophan (5- Avoid: 5-HTP and L-tryptophan HTP) and L-tryptophan are converted to serotonin in the Generic name: brain and taking either of these Paroxetine HCL compounds with paroxetine may increase side effects such as Type of drug: headache, sweating, dizziness, SSRI (Selective agitation, restlessness, nausea, serotonin reuptake vomiting and so on. inhibitor) Sodium May be beneficial: Paroxetine Use: can cause sodium depletion. Treat depression. Ginkgo biloba 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 At the time of this writing, no evidence of nutrient interactions Generic name: involving this drug has been Clopidogrel found in the medical literature. bisulfate

Type of drug: Antiplatelet

Use: To prevent second heart attack or stroke.

52 Drug Supplement Type of Interaction

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

Use: Treat intermittent claudication. PRAVACHOL Coenzyme Q10 Supplementation with 90-100 mg of Coenzyme Q10 per day Generic name: has been shown to prevent Pravastatin sodium reductions in blood levels due to simvastatin, another drug in the Type of drug: same category as pravastatin. HMG-CoA reductase inhibitor. Fish oil (EPA) The omega-3 fatty acid EPA in fish oil may improve the Use: cholesterol- and triglyceride- To lower lowering effect of pravastatin. cholesterol levels. Milk thistle (silybum Liver toxicity is a possible side marianum) effect of pravastatin. A milk thistle extract standardized to 70-80% silymarin may be beneficial.

53 Drug Supplement Type of Interaction

PRAVACHOL Red yeast rice Avoid: A supplement containing (cont.) 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.

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

54 Drug Supplement Type of Interaction

PREMARIN Calcium May be beneficial: Many doctors recommend 800-1200 mg Generic name: of supplemental calcium in Conjugated addition to the several hundred estrogens milligrams found in a typical daily diet. Type of drug: Estrogen Herbal sources of May interfere with or even isoflavone supplements have an additive effect with Use: (red clover, soy) conjugated estrogens. Consult To treat your health professional. menopausal symptoms. Ipriflavone A synthetic variation of isoflavones found in soy, it can preserve bone mass in postmenopausal women.

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

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

55 Drug Supplement Type of Interaction

PREVACID Beta-carotene This drug deletes beta-carotene. People taking these drugs may Generic name: want to have carotenoid blood Lansoprazole SR levels checked, eat plenty of fruits and vegetables and Type of drug: consider supplementing with Proton pump carotenoids. inhibitor Folic acid Antacids, including lansoprazole, Use: inhibit folic acid absorption, To treat stomach which is needed to utilize acid problems. vitamin B12. Therefore folic acid supplements are recommended.

Vitamin B12 Acid blocking drugs like lansoprazole may create a decrease in vitamin B12. PRILOSEC Folic acid See Prevacid (lansoprazole) Vitamin B12 above. Generic name: Cranberry Omeprazole SA St. John’s wort Avoid: Shown to interfere with Type of drug: the actions of omeprazole. Proton pump inhibitor

Use: To treat stomach acid problems.

56 Drug Supplement Type of Interaction

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

Use: To treat BPH (Benign Prostatic Hyperplasia) PROTONIX Beta-carotene See Prevacid (lansoprazole). Cranberry page 56 Generic name: Folic acid Pantoprazole Vitamin B12

Type of drug: Antacid (proton pump inhibitor)

Use: Treat stomach problems. REMINYL At the time of this writing, no evidence of nutrient interactions Generic name: involving this drug was found in Galantamine HBr the medical literature.

Type of drug: Cholinesterase inhibitor

Use: Treat Alzheimer’s disease.

57 Drug Supplement Type of Interaction

RISPERDAL Glycine People with schizophrenia being treated with risperidone Generic name: experienced an improvement in Risperidone their symptoms when glycine was added to their treatment Use: regime. Treat psychotic disorders. Vitamin B6 These vitamins together were Vitamin E used to treat a side effect of risperidone called neuroleptic malignant syndrome and the results were encouraging.

Lithium The combination of lithium and risperidone has produced some side effects such as delirium, confusion and fever. SEREVENT Coleus Adding forskolin, the active component of the herb coleus, Generic name: to beta-antagonist drugs like Salmeterol salmeterol might provide an xinofoate alternative to raising the doses (inhalation powder) of the drugs as they lose effectiveness. Coleus should not Type of drug: be combined with salmeterol Long acting without a doctor’s supervision. beta-adrenergic bronchodilator

Use: Treat asthma and prevent bronchospasm

58 Drug Supplement Type of Interaction

SEROQUEL At the time of this writing, no evidence of nutrient interactions Generic name: involving this drug has been Quetiapine found in the medical literature. fumarate

Type of drug: Class of antipsychotic drugs known as dibenzapines

Use: Treat psychiatric disorders. SINGULAIR At the time of this writing, no evidence of nutrient interactions Generic name: involving this drug has been Montelukast found in the medical literature. sodium

Type of drug: Leukotriene receptor antagonist

Use: To treat and prevent asthma.

59 Drug Supplement Type of Interaction

SYNTHROID Bugleweed Avoid: These herbs may interfere Lemon Balm with the action of thyroid Generic name: hormones and should not be Levothyroxine used during treatment. sodium Calcium There are reports of Type of drug: some calcium loss but Thyroid hormone supplementation for people taking long-term thyroid Use: medication has not yet been Treat proven helpful or necessary. hyperthyroidism Iron 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.

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

60 Drug Supplement Type of Interaction

TOPROL XL Pleurisy root Avoid: Pleurisy root and other plants in the Aesclepius genus Generic name: contain cardiac glycosides. Metoprolol succinate Potassium Avoid: Some “nonselective” beta blockers decrease the uptake Type of drug: of potassium from the blood Beta blocker into the cells, leading to excess potassium in the blood. People Use: taking metoprolol should avoid Reduce symptoms potassium supplements or of angina and eating large quantities of fruit lower blood unless directed by their doctors. pressure. TRAVATAN At the time of this writing, no evidence of nutrient interactions Generic name: involving this drug was found in Travoprost the medical literature.

Type of drug: Eye drops

Use: Treat high pressure in the eye.

61 Drug Supplement Type of Interaction

TRICOR Folic acid Fenofibrate has been shown Vitamin B6 to dramatically increase Generic name: Vitamin B12 blood homocysteine levels, Fenofibrate associated with increased risk of atherosclerosis and heart Type of drug: disease. Folic acid, vitamin B6 Cholesterol and vitamin B12 are all capable lowering drug. of lowering these homocysteine levels. Use: Lower elevated Vitamin C Taking vitamins C and E prior to cholesterol and Vitamin E ultraviolet exposure can block triglyceride levels. UV-fenofibrate damage to red blood cells. ULTRACET At the time of this writing, no evidence of nutrient interactions Generic name: involving this drug was found in Tramadol HC1/ the medical literature. Acetaminophen

Type of drug: Unique analgesic

Use: Treat acute pain. VIAGRA Grapefruit juice Avoid: May delay the absorption of the drug when taken together. Generic name: Sildenafil citrate

Use: Treat erectile dysfunction.

62 Drug Supplement Type of Interaction

WELCHOL Beta-carotene and other May be beneficial: Long-term carotenoids use of drug can significantly Generic name: lower blood levels of Colesevelam carotenoids.

Type of drug: Calcium This medication may prevent Non-systemic Folic acid absorption of folic acid and cholesterol Vitamin A the fat-soluble vitamins A, D, lowering drug. Vitamin D E and K. Vitamin supplements Vitamin E should be taken 1 hour before Use: Vitamin K to 6 hours after colesevelam for Treat high Zinc optimal absorption. Calcium and cholesterol levels. zinc may also be depleted. WELLBUTRIN Yohimbe May be beneficial: When added to bupropion therapy, may Generic name: improve mood. Bupropion HCL

Use: Treat depression and help in smoking cessation. XALATAN At the time of this writing, no evidence of nutrient interactions Generic name: involving this drug has been Latanoprost found in the medical literature.

Type of drug: Prostaglandin analog

Use: Treat glaucoma.

63 Drug Supplement Type of Interaction

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

Type of drug: Antihyperlipidemic

Use: Reduce cholesterol absorption.

ZOCOR Coenzyme Q10 Decreases concentration of supplement, may have Generic name: to supplement with more Simvastin Coenzyme Q10

Type of drug: Fish oil (EPA) Improves the cholesterol HMG-CoA lowering effect of Zocor and reductase inhibitor using this supplement with Zocor may be beneficial in Use: preventing heart attacks. To lower High Cholesterol Niacin (Vitamin B3) 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.

Grapefruit Avoid, this can result in increase toxicity of Zocor.

64 65 VITAMIN & SUPPLEMENT INDEX OF INTERACTIONS To 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.

66 Supplement Generic Drug Comments 5-HYDROXYTRYPTOPHAN Carbidopa Further information

A naturally occurring Fluvoxamine Avoid amino acid. Helps in brain function. Paroxetine Avoid

Fluoxetine Avoid

Selegiline May be beneficial

Setraline Avoid

Sibutramine Avoid

Sumatripan Avoid

Tramadol Avoid

Venlafaxine Avoid

Zolmitriptan Avoid

Zolpidem Avoid

67 Supplement Generic Drug Comments BETA-CAROTENE Bile acid sequestrants May be beneficial

A precursor for vitamin A. Chemotherapy May be beneficial Helps in night vision, bone development, Cisplatin May be beneficial the immune system and some menstrual Colchicine May be beneficial problems. Colestipol May be beneficial

Cyclosphosphamide May be beneficial

Docetaxel May be beneficial

Fluorouracil May be beneficial

Lansoprazile May be beneficial

Methotrexate May be beneficial

Methyltesterone May be beneficial

Mineral oil May be beneficial

Neomycin May be beneficial

Orlistat May be beneficial

Paclitaxtel May be beneficial

Quinidine May be beneficial

68 Supplement Generic Drug Comments BIOFLAVONOIDS Acyclovir oral May be beneficial

Water-soluble plant pigments which act as anti-inflammatory, antihistaminic and antiviral agents. BIOTIN (VITAMIN B7) Anticonvulsants May be beneficial

A protein needed in small Gabapentin May be beneficial amounts to act as an enzyme in biochemical Glyburide Further information processes. Help in energy Insulin May be beneficial production, fatty acid production and skin Phenobarbital May be beneficial health. Topical corticosteroids May be beneficial

Valproic acid May be beneficial

69 Supplement Generic Drug Comments BREWER’S YEAST Aminoglycoside May be beneficial antibiotics A rich source of the B- May be beneficial complex vitamins, protein Amoxicillin and minerals, particularly May be beneficial chromium. Ampicillin May be beneficial Antibiotics May be beneficial Azithromycin May be beneficial Cephalosporins May be beneficial Chlorhexidine May be beneficial Ciprogloxacin May be beneficial Clarithromycin May be beneficial Clindamycin oral May be beneficial Clindamycin topical May be beneficial Dicloxacillin May be beneficial Doxycycline May be beneficial Erythromycin May be beneficial Gnetamycin May be beneficial Levofloxacin

70 Supplement Generic Drug Comments BREWER’S YEAST (cont.) Loracarbef May be beneficial

Macrolides May be beneficial

Minocycline May be beneficial

Neomycin May be beneficial

Nitrofurantoin May be beneficial

Ofloxacin May be beneficial

Penicillin V May be beneficial

Penicillins May be beneficial

Quinolones May be beneficial

Sulfamethoxazole May be beneficial

Sulfasalazine May be beneficial

Sulfonamides May be beneficial

Tetracycline May be beneficial

Tetracyclines May be beneficial

Tobramycin May be beneficial

Trimethoprim May be beneficial

Trimethoprin/ May be beneficial Sulfamethoxazole

71 Supplement Generic Drug Comments BROMELAIN Amoxicillin May be beneficial

A proteolytic enzyme Erythromycin May be beneficial that helps digest dietary protein. Penicillamine May be beneficial Acts as a natural blood thinner because it Penicillin V May be beneficial prevents excessive blood platelet stickiness. Warfarin Further information

72 Supplement Generic Drug Comments CALCIUM Albuterol May be beneficial

Needed to form bones Alendronate Further information and teeth and is also required for blood Aluminum hydroxide May be beneficial clotting, transmission of signals in nerve cells and Anticonvulsants May be beneficial muscle contraction. Important for preventing Bile acid sequestrants May be beneficial osteoporosis. Caffeine May be beneficial

Calcitonin May be beneficial

Calcium acetate Avoid

Ciprofloxacin Avoid

Cisplatin May be beneficial

Colestipol May be beneficial

Cycloserine May be beneficial

Diclofenac May be beneficial

Doxycycline Avoid

Erythromycin Further information

Estrogens (combined) May be beneficial

Felodipine May be beneficial

73 Supplement Generic Drug Comments CALCIUM (cont.) Flurbiprofen May be beneficial

Gabapentin May be beneficial

Gemifloxacin Avoid

Gentamicin May be beneficial

Hydroxychloroquine May be beneficial

Indapamide May be beneficial

Indomethacin May be beneficial

Inhaled corticosteroids May be beneficial

Insoniazid May be beneficial

Lactase Further information

Metformin May be beneficial

Mineral oil May be beneficial

Minocycline Further information

Nadolol Avoid

Neomycin May be beneficial

Ofloxacin Avoid

Oral contraceptives Further information

74 Supplement Generic Drug Comments CALCIUM (cont.) Oral corticosteroids May be beneficial

Phenobarbital May be beneficial

Quinolones Avoid

Risedronate Further information

Sodium fluoride Further information

Sotalol Avoid

Sucralfate May be beneficial

Sulfamethoxazole May be beneficial

Tetracycline Avoid

Tetracyclines Avoid

Thiazide diuretics Further information

Thyroid hormones Further information

Tobramycin May be beneficial

Triamterene May be beneficial

Trimethoprim May be beneficial

Valproic acid May be beneficial

Verapamil Further information

75 Supplement Generic Drug Comments CAROTENOIDS Bile acid sequestrants May be beneficial

Naturally occurring fat- Colestipol May be beneficial soluble pigments found in plants. CHONDROITIN SULFATE At this time of writing, no evidence of drug One of the most common interactions with used supplements used chondroitin sulfate was usually in conjunction found in the medical with glucosamine literature. for helping improve symptoms and arresting the degenerative process of osteoarthritis. It is an amino sugar derived from shark beef cartilage or bovine trachea. CHROMIUM Glyburide Avoid

An essential trace Insulin Further information mineral that helps the body maintain normal Oral corticosteroids May be beneficial blood sugar levels. It may also play a role Sertraline May be beneficial in maintaining healthy levels of HDL – the “good” cholesterol.

76 Supplement Generic Drug Comments COENZYME Q10 Atorvastatin May be beneficial

A powerful antioxidant Doxoorubicin May be beneficial that protects the body from free radicals. Fluvastatin May be beneficial Helps with metabolic reactions, such as the Gemfibrozil May be beneficial process of transforming food into ATP, the energy Lovastatin May be beneficial the body runs on. Perphenazine May be beneficial

Pravastatin May be beneficial

Propranolol May be beneficial

Simvastatin May be beneficial

Thioridazine May be beneficial

Timolol May be beneficial

Tricyclic antidepressants May be beneficial

Warfarin Avoid

77 Supplement Generic Drug Comments COPPER AZT May be beneficial

Needed to absorb and Ciprofloxacin Avoid use iron. Part of the antioxidant Etodolac May be beneficial enzyme superoxide dismutase (SOD). Famotidine Further information Needed to make ATP, the energy the body runs on. Ibuprofen May be beneficial

Nabumetone May be beneficial

Naproxen/Naproxen May be beneficial sodium

Nizatidine Further information

Oral contraceptives Further information

Oxaprozin May be beneficial

Penicillamine Further information

Valproic acid May be beneficial

78 Supplement Generic Drug Comments DEHYDROEPIAN- Amlodipine Further information DROSTERONE (DHEA) Clonidine May be beneficial A hormone produced by the adrenal glands. Diltiazem Avoid Circulates in the bloodstream as DHEA- Fluoxetine May be beneficial sulfate and is converted as needed into other Inhaled corticosteroids May be beneficial hormones. Insulin May be beneficial

Metformin Further information

Methyltestosterone Further information DIGESTIVE ENZYMES Warfarin Avoid

Help digest dietary protein. EVENING PRIMROSE OIL Tomoxifen May be beneficial

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.

79 Supplement Generic Drug Comments FIBER Lovastatin Avoid

Water-soluble fiber helps Propoxyphene Further information control blood sugar levels and cholesterol. Verapamil May be beneficial Insoluble fiber softens stool and helps it move through the body in less time.

FISH OIL AND COD LIVER Cyclosporine May be beneficial OIL (EPA AND DHA) Pravastatin May be beneficial Contains the omega-3 oils EPA and DHA which Simvastatin May be beneficial keep blood triglycerides in check and also keep blood from clotting too quickly.

80 Supplement Generic Drug Comments FOLIC ACID Aluminum hydroxide May be beneficial

Needed for DNA Anticonvulsants Further information synthesis. DNA allows cells to Aspirin May be beneficial replicate normally. Adequate intake of folic Azathioprine May be beneficial acid early in pregnancy is important for preventing Bile acid sequestrants May be beneficial most neural tube birth defects as well as some Chemotherapy Avoid birth defects of the arms, legs and heart. Colestipol May be beneficial

Cycloserine May be beneficial

Diuretics May be beneficial

Erythromycin Further information

Famotidine Further information

Fenofibrate May be beneficial

Fluoxetine May be beneficial

Gabapentin Further information

Indomethacin May be beneficial

Isoniazid May be beneficial

Lansoprazole May be beneficial

Lithium May be beneficial

81 Supplement Generic Drug Comments FOLIC ACID (cont.) Loop diuretics May be beneficial

Magnesium hydroxide May be beneficial

Medroxyprogesterone Further information

Metformin May be beneficial

Methotrexate Further information

Neomycin May be beneficial

Nitrous oxide May be beneficial

Nizatidine Further information

Omeprazole May be beneficial

Oral contraceptives May be beneficial

Phenobarbital Further information

Prioxicam Further information

Ranitidine May be beneficial

Salsalate May be beneficial

Sodium bicarbonate May be beneficial

Sulfamethoxazole May be beneficial

82 Supplement Generic Drug Comments FOLIC ACID (cont.) Sulfasalazine May be beneficial

Sulindac Further information

Tetracycline May be beneficial

Thiazide diuretics May be beneficial

Triamterene May be beneficial

Trimethoprim May be beneficial

Timethoprim/ May be beneficial Sulfamethoxazole

Valproic acid Further information

GLUCOSAMINE At this time of writing, no evidence of drug An amino sugar extracted interactions with from shelfish sources glucasmine was found in and is the number one the medical literature. 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.

83 Supplement Generic Drug Comments GLUTAMINE Chemotherapy May be beneficial

An amino acid (protein Cisplatin May be beneficial building block.) Serves as a source of Cyclophosphamide May be beneficial fuel for cells lining the intestines. Docetaxel May be beneficial Also used by white blood cells and is important for Fluorouracil May be beneficial immune function. Methotrexate May be beneficial

Paclitaxel May be beneficial GLUTATHIONE Cisplatin Further information

An antioxidant, it protects Cyclophosphamide May be beneficial cells from toxins such as free radicals. GLYCINE Clozapine Avoid

An amino acid commonly Haloperidol May be beneficial found in protein. Olanzapine May be beneficial

Risperidone May be beneficial INOSITOL Lithium May be beneficial

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

84 Supplement Generic Drug Comments IPRIFLAVONE Estrogens (combined) May be beneficial

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.

85 Supplement Generic Drug Comments IRON Angiotensin-converting May be beneficial enzyme (ACE) inhibitors Part of hemoglobin, the oxygen-carrying Aspirin May be beneficial component of the blood. Also part of myoglobin, Benazepril May be beneficial which helps muscle cells store oxygen. Captopril May be beneficial

Carbidopa Avoid

Carbidopa/Levodopa Avoid

Chlorhexidine Avoid

Cimetidine May be beneficial

Ciprofloxacin Avoid

Deferoxamine Avoid

Dipyridamole May be beneficial

Doxycycline Avoid

Enalapril May be beneficial

Etodolac May be beneficial

Famotidine May be beneficial

86 Supplement Generic Drug Comments IRON (cont.) Gemifloxacin Avoid

Haloperidol May be beneficial

Hyoscyamine May be beneficial

Ibuprofen May be beneficial

Indomethacin Further information

Levofloxacin Avoid

Magnesium hydroxide May be beneficial

Methyldopa Avoid

Minocycline Further information

Moexipril May be beneficial

Nabumetone May be beneficial

Naproxen/Naproxen May be beneficial sodium

Neomycin May be beneficial

Nizatidine May be beneficial

Ofloxacin Avoid

Oral contraceptives Further information

Oxaprozin May be beneficial

Penicillamine Avoid

87 Supplement Generic Drug Comments IRON (cont.) Quinapril May be beneficial

Ramipril May be beneficial

Ranitidine May be beneficial

Risedronate Avoid

Sodium bicarbonate May be beneficial

Stanozolol May be beneficial

Sulfasalazine Avoid

Tetracycline Avoid

Tetracyclines Avoid

Thyroid hormones Further information

Warfarin Avoid L-CARNITINE Allopurinol Further information

Made in the body from Anticonvulsants May be beneficial the amino acids lysine and methionine. AZT May be beneficial Needed to release energy from fat. Chemotherapy May be beneficial

Doxorubicin May be beneficial

Gabapentin May be beneficial

Phenobarbital May be beneficial

Valproic acid May be beneficial

88 Supplement Generic Drug Comments L-TYROSINE Mixed amphetamines May be beneficial An 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.

MAGNESIUM Albuterol May be beneficial

Needed for bone, protein Alendronate Further information and fatty acid formation, making new cells, Amiloride Avoid activating B vitamins, relaxing muscles, clotting Amphotericin B May be beneficial blood and forming ATP, the energy the body Azithromycin Further information runs on. Insulin secretion and Cimetidine Avoid function also require magnesium. Ciprofloxacin Avoid

Cisplatin May be beneficial

Cycloserine May be beneficial

Cyclosporine May be beneficial

Digoxin May be beneficial

Docusate May be beneficial

Doxycycline Avoid

89 Supplement Generic Drug Comments MAGNESIUM (cont.) Epinephrine Further information

Erythromycin May be beneficial

Estrogens (combined) Further information

Famotidine Further information

Felodipine May be beneficial

Fentanyl May be beneficial

Gemifloxacin Avoid

Gentamicin May be beneficial

Glimepiride May be beneficial

Glipizide Further information

Hydroxychloroquine Avoid

Isoniazid May be beneficial

Levofloxacin Avoid

Loop diuretics May be beneficial

Medroxyprogesterone Further information

Metformin Further information

Minocycline Further information

Misoprostol Avoid

90 Supplement Generic Drug Comments MAGNESIUM (cont.) Mixed amphetamines Further information

Neomycin May be beneficial

Nitrofurantoin Avoid

Nizatidine Further information

Ofloxacin Avoid

Oral contraceptives May be beneficial

Oral corticosteroids Further information

Quinidine May be beneficial

Quinolones Avoid

Risedronate Avoid

Sotalol May be beneficial

Sprionolactone Avoid

Sulfamethoxazole May be beneficial

Tetracycline Avoid

Tetracyclines Avoid

Theophylline/ May be beneficial Aminophylline

Thiazide diuretics May be beneficial

91 Supplement Generic Drug Comments MAGNESIUM (cont.) Tobramydin May be beneficial

Triamterene Avoid

Trimethoprim May be beneficial

Warfarin Avoid

MANGANESE Ciprofloxacin Avoid

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

92 Supplement Generic Drug Comments MELATONIN Chemotherapy May be beneficial

A natural hormone that Cisplatin May be beneficial regulates the human biological clock. Cyclophosphamide May be beneficial Helpful in relieving sleep disorders and symptoms Docetaxel May be beneficial of jet lag. Doxorubicin May be beneficial

Fluorouracil May be beneficial

Fluoxetine Further information

Fluvoxamine Further information

Methotrexate May be beneficial

Mirtazapine Further information

Oral corticosteroids May be beneficial

Paclitaxel May be beneficial

Tamoxifen May be beneficial

Triazolam May be beneficial

93 Supplement Generic Drug Comments N-ACETYL CYSTEINE Acetaminophen May be beneficial (NAC) AZT Further information An altered form of the amino acid cysteine, Chemotherapy May be beneficial commonly found in food and synthesized by the Cisplatin May be beneficial body. Helps break down Clozapin May be beneficial mucus. Helps the body Cyclophosphamide May be beneficial synthesize glutathione, an important antioxidant. Docetaxel May be beneficial Also protects the body from acetaminophen Doxorubicin Further information toxicity and is used at very high doses Flurouracil May be beneficial in hospitals for that purpose. Flurbiprofen May be beneficial

Gentamicin May be beneficial

Interferon May be beneficial

Isosorbide dinitrate May be beneficial

Isosorbide mononitrate May be beneficial

Metoclopramide Avoid

Nitroglycerin Further information

Oral corticosteroids May be beneficial

Paclitaxel May be beneficial

94 Supplement Generic Drug Comments PABA Dapsone May be beneficial (PARAAMINOBENZOIC ACID) Methotrexate Avoid

Generally considered Sulfamethoxazole Avoid to be a member of the Vitamin B-complex. Sulfasalazine Avoid Appears to enhance the effects of cortisone, Trimethoprim/ Avoid estrogen, and possibly Sulfamethoxazole other hormones by delaying their breakdown in the liver. Also prevents or even reverses the accumulation of abnormal fibrous tissue. PANTOTHENIC ACID Tricyclic antidepressants May be beneficial (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.

95 Supplement Generic Drug Comments PHOSPHORUS Albuterol May be beneficial

A component of DNA and Aluminum hydroxide May be beneficial RNA and an essential element for all living Cisplatin May be beneficial cells. Mineral oil May be beneficial

Sucralfate May be beneficial

POTASSIUM Acebutolol Avoid

Needed to regulate water Albuterol May be beneficial balance, levels of acidity, blood pressure and Amiloride Avoid neuromuscular function. Also required for Angiotensin-converting Avoid carbohydrate and protein enzyme (ACE) inhibitors metabolism. Atenolol Avoid

Benazepril Avoid

Beta-adrenergic blockers Avoid

Betaxolol Avoid

Bisacodyl May be beneficial

Bisoprolol Avoid

Captopril Avoid

Celecoxib May be beneficial

Cisplatin May be beneficial

96 Supplement Generic Drug Comments POTASSIUM (cont.) Colchicine May be beneficial

Digoxin Further information

Docusate May be beneficial

Enalapril Avoid

Epinephrine Further information

Etodolac Further information

Felodipine May be beneficial

Gentamicin May be beneficial

Haloperidol Further information

Heparin Further information

Ibuprofen Further information

Indapamide May be beneficial

Indomethacin Avoid

Ipecac May be beneficial

Ketorolac Avoid

Labetalol Avoid

Lisinopril Avoid

Loop diuretics May be beneficial

97 Supplement Generic Drug Comments POTASSIUM (cont.) Losartan Further information

Magnesium hydroxide Further information

Metoprolol Further information

Mineral oil May be beneficial

Moexipril Further information

Nabumetone Further information

Nadolol Avoid

Naproxen/Naproxen Further information sodium

Neomycin May be beneficial

Oral corticosteroids May be beneficial

Oxaprozin Further information

Piroxicam Avoid

Propranolol Avoid

Quinapril Avoid

Quinidine May be beneficial

Ramipril Avoid

Salsalate May be beneficial

Senna Further information

98 Supplement Generic Drug Comments POTASSIUM (cont.) Sotalol Avoid

Spironolactone Avoid

Sulfamethoxazole Avoid

Sulindac May be beneficial

Tetracycline May be beneficial

Theophylline/ May be beneficial Aminophylline

Thiazide diuretics May be beneficial

Thioridazine May be beneficial

Tobramycin May be beneficial

Triamterene Avoid

Trimethoprim Avoid

Trimethoprim/ Avoid Sulfamethoxazole

99 Supplement Generic Drug Comments PROBIOTICS Aminoglycoside May be beneficial antibiotics Beneficial bacteria, May be beneficial such as lactobacillus Amoxicillin acidophilus and May be beneficial bifidobacterium bifidum, Ampicillin are called probiotics. May be beneficial Favourably alter the Antibiotics balance of intestinal May be beneficial microflora, inhibit the Azithromycin growth of harmful May be beneficial bacteria, promote good Cephalosporins digestion, boost immune May be beneficial function, and increase Chlorhexidine resistance to infection. May be beneficial Ciprofloxacin May be beneficial Clarithromycin May be beneficial Clindamycin oral May be beneficial Clindamycin topical May be beneficial Dapsone May be beneficial Dicloxacillin May be beneficial Coxycycline May be beneficial Erythromycin May be beneficial Gentamicin May be beneficial Levofloxacin

100 Supplement Generic Drug Comments PROBIOTICS (cont.) Loracarbef May be beneficial

Macrolides May be beneficial

Metronidazole May be beneficial

Minocycline May be beneficial

Neomycin May be beneficial

Nitrofurantoin May be beneficial

Ofloxacin May be beneficial

Penicillin V May be beneficial

Penicillins May be beneficial

Quinolones May be beneficial

Sulfamethoxazole May be beneficial

Sulfasalazine May be beneficial

Sulfonamides May be beneficial

Tetracycline May be beneficial

Tetracyclines May be beneficial

Tobramycin May be beneficial

Trimethoprim May be beneficial

Trimethoprim/ May be beneficial Sulfamethoxazole

101 Supplement Generic Drug Comments QUERCETIN Cyclosporine Avoid

Belongs to a class of Estradiol Avoid water-soluble plant pigments called Felodipine Avoid bioflavonoids. Acts as an antihistamine, anti-inflammatory and antioxidant. SAMe (S-ADENOSYL Tricyclic antidepressants May be beneficial METHIONINE)

Naturally-ocurring mood- affecting substance. SELENIUM Cisplatin May be beneficial

Activates an antioxidant Clozapine May be beneficial enzyme called glutathione peroxidase Oral corticosteroids May be beneficial which may protect the body from cancer. Valproic acid Further information SOY Estrogens (combined) Avoid

Contains protein, Ipratropium bromide Further information isoflavones, saponins and phytosterols. Thyroid hormones Avoid Soy protein provides most of the essential Warfarin Further information amino acids and can be used as well as animal protein by adults.

102 Supplement Generic Drug Comments SPLEEN EXTRACTS Chemotherapy May be beneficial

Derived from the spleen Cisplatin May be beneficial of beef (bovine) sources. Cyclophosphamide May be beneficial

Docetaxel May be beneficial

Fluorouracil May be beneficial

Methotrexate May be beneficial

Paclitaxel May be beneficial TAURINE Chemotherapy May be beneficial

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

103 Supplement Generic Drug Comments THYMUS EXTRACTS Chemotherapy May be beneficial

Usually derived from the Cisplatin May be beneficial thymus glands of young calves. Cyclophosphamide May be beneficial

Docetaxel May be beneficial

Flurouracil May be beneficial

Interferon Further information

Paclitaxel May be beneficial VINPOCETINE Benzodiazepines May be beneficial

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

104 Supplement Generic Drug Comments VITAMIN A Anticonvulsants May be beneficial

Helps cells reproduce Atorvastatin Avoid normally. Also stimulates immunity Bile acid sequestrants May be beneficial and is needed for forming bone, protein and growth Chemotherapy Further information hormones. (See BETA-CAROTENE.) Cisplatin Further information

Colestipol May be beneficial

Cyclophosphamide May be beneficial

Docetaxel Further information

Fluorouracil Further information

Fluvastatin Avoid

Gabapentin May be beneficial

Isotretinoin Avoid

Lovastatin Further information

Medroxyprogesterone Further information

Methotrexate Further information

Methyltestosterone May be beneficial

Mineral oil May be beneficial

Minocycline Avoid

105 Supplement Generic Drug Comments VITAMIN A (cont.) Neomycin May be beneficial

Oral contraceptives Further information

Oral corticosteroids Further information

Orlistat May be beneficial

Paclitaxel Further information

Phenobarbital May be beneficial

Pravastatin Further information

Simvastatin Avoid

Thioridazine May be beneficial

Tretinoin Avoid

Valproic acid May be beneficial VITAMIN B1 (THIAMIN) Loop diuretics May be beneficial

Needed to process Oral contraceptives May be beneficial carbohydrates, fat and protein. Stavudine May be beneficial Every cell of the body requires Vitamin B1 to Tricyclic antidepressants May be beneficial form ATP, the fuel the body runs on. Nerve cells require Vitamin B1 in order to function normally.

106 Supplement Generic Drug Comments VITAMIN B2 (RIBOFLAVIN) AZT May be beneficial

Needed to process amino Didanosine May be beneficial acids and fats, activate Vitamin B6 and folic Doxorubicin May be beneficial acid, and help convert carbohydrates into ATP, Oral contraceptives May be beneficial the fuel the body runs on. Under some Tetracyclin May be beneficial circumstances, Vitamin B2 acts as an antioxidant. Tricyclic antidepressants May be beneficial

107 Supplement Generic Drug Comments VITAMIN B3 (NIACIN, Atorvastatin Further information NIACINIMIDE) Benztropine May be beneficial Aids in the process of releasing energy from Carbidopa May be beneficial carbohydrates. Needed to form fat from Carbidopa/Levodopa May be beneficial carbohydrates and to process alcohol. Cerivastatin Further information The niacin form of Fluvastatin Further information Vitamin B3 also regulates cholesterol. Gemfibrozil May be beneficial Glimepiride Avoid Isoniazid May be beneficial Lovastatin Further information Minocycline May be beneficial Oral contraceptives May be beneficial Pravastatin Further information Repaglinide Further information

Rosuvastatin Further information Simvastatin Further information Tetracycline May be beneficial Thioridazine May be beneficial Tricyclic antidepressants May be beneficial

108 Supplement Generic Drug Comments VITAMIN B6 Anticonvulsants May be beneficial (PYRIDOXINE) Carbidopa Further information Essential for processing amino acids. Carbidopa/Levodopa Further information Also needed to make serotonin, melatonin and Cycloserine May be beneficial dopamine. Docetaxel May be beneficial

Erythromycin May be beneficial

Estrogens (combined) May be beneficial

Fenofibrate May be beneficial

Fluorouracil May be beneficial

Folic acid Further information

Gabapentin May be beneficial

Gentamicin Further information

Hydralazine May be beneficial

Hydroxychloroquine May be beneficial

Isoniazid Further information

Levodopa May be beneficial

Mixed amphetamines May be beneficial

Neomycin May be beneficial

109 Supplement Generic Drug Comments VITAMIN B6 Oral contraceptives May be beneficial (PYRIDOXINE) Oral corticosteroids May be beneficial

Penicillamine May be beneficial

Phenelzine May be beneficial

Phenobarbital Further information

Risperidone May be beneficial

Sulfamethoxazole May be beneficial

Tetracycline May be beneficial

Theophylline/ May be beneficial Aminophylline

Tricyclic antidepressants May be beneficial

Trimethoprim May be beneficial

Valproic acid May be beneficial

110 Supplement Generic Drug Comments VITAMIN B12 Anticonvulsants May be beneficial (COBALAMIN) Aspirin May be beneficial Needed for normal nerve cell activity, AZT May be beneficial DNA reproduction, and production of the mood- Cimetidine May be beneficial affecting substance called S-adenosyl Clofibrate May be beneficial methionine (see SAMe). Works with folic acid to Colchicine May be beneficial control homocysteine levels. Cycloserine May be beneficial

Erythromycin May be beneficial

Famotidine May be beneficial

Fenofibrate May be beneficial

Gabapentin May be beneficial

Gentamicin May be beneficial

Isoniazid May be beneficial

Lansoprazole May be beneficial

Metformin May be beneficial

Methyldopa May be beneficial

Neomycin May be beneficial

111 Supplement Generic Drug Comments VITAMIN B12 Nitrous oxide May be beneficial (COBALAMIN) Nizatidine May be beneficial

Omeprazole May be beneficial

Oral contraceptives May be beneficial

Phenobarbital May be beneficial

Ranitidine May be beneficial

Sulfamethoxazole May be beneficial

Tetracycline May be beneficial

Tricyclic antidepressants May be beneficial

Trimethorpim May be beneficial

Valproic acid May be beneficial

112 Supplement Generic Drug Comments VITAMIN C (ASCORBIC Acetaminophen May be beneficial ACID) Ampicillin May be beneficial A water-soluble vitamin that functions Aspirin May be beneficial as a powerful antioxidant. Needed to make Carbidopa May be beneficial collagen. Helps in wound healing Carbidopa/Levodopa May be beneficial and is a natural antihistamine. Cardec DM Further information Aids in the formation of liver bile and Chemotherapy Further information helps to fight viruses. Helps detoxify alcohol Cisplatin Further information and other substances. Clozapine May be beneficial

Cyclophosphamide Further information

Dapsone May be beneficial

Docetaxel Further information

Doxorubicon May be beneficial

Ephedrine and Further information Pseudoephedrine

Epinephrine Further information

Fenofibrate May be beneficial

113 Supplement Generic Drug Comments VITAMIN C (ASCORBIC Fluorouracil Further information ACID) (cont.) Indomethacin May be beneficial

Isosorbide mononitrate Further information

Methodtrexate Further information

Minocycline May be beneficial

Mixed amphetamines Avoid

Nitroglycerine May be beneficial

Oral contraceptives May be beneficial

Oral corticosteroids Further information

Paclitaxel Further information

Perphenazine Further information

Salsalate May be beneficial

Tacrine May be beneficial

Tetracycline May be beneficial

Thioridazine Further information

Warfarin Further information

114 Supplement Generic Drug Comments VITAMIN D Allopurinol Further information (CHOLECALCIFEROL) Anticonvulsants May be beneficial Maintains blood levels of calcium by increasing Bile acid sequestrants May be beneficial absorption of calcium from food and reducing Cimetidine May be beneficial urinary calcium loss. Some Vitamin D is Colestipol May be beneficial necessary for healthy bones and teeth. Estradiol Further information

Estrogens (combined) Further information

Flurbiprofen May be beneficial

Gabapentin May be beneficial

Heparin May be beneficial

Hydroxychloroquine May be beneficial

Indapamide May be beneficial

Isoniazid May be beneficial

Medroxyprogesterone Further information

Mineral oil May be beneficial

Neomycin May be beneficial

115 Supplement Generic Drug Comments VITAMIN D Oral corticosteroids May be beneficial (CHOLECALCIFEROL) (cont.) Orlistat May be beneficial

Phenobarbital May be beneficial

Sodium fluoride May be beneficial

Thiazide diuretics Further information

Valproic acid May be beneficial

Verapamil Avoid

Warfarin Avoid

116 Supplement Generic Drug Comments VITAMIN E Amiodarone May be beneficial (TOCOPHEROL) Anthralin May be beneficial This is a powerful antioxidant that protects Aspirin Avoid cell membranes and other fat-soluble parts of AZT Further information the body. Benzamycin May be beneficial

Bile acid sequestrants May be beneficial

Chemotherapy May be beneficial

Cisplatin May be beneficial

Colestipol May be beneficial

Cyclosphosphamide May be beneficial

Cyclosporine May be beneficial

Dapsone May be beneficial

Docetaxel May be beneficial

Doxorubicin May be beneficial

Fenofibrate May be beneficial

Flourouracil May be beneficial

Gemfibrozil May be beneficial

117 Supplement Generic Drug Comments VITAMIN E Glyburide Further information (TOCOPHEROL) (cont.) Griseofulvin May be beneficial

Haloperidol May be beneficial

Insulin May be beneficial

Isoniazid May be beneficial

Isotretinoin May be beneficial

Lindane May be beneficial

Lovastatin Further information

Mineral oil May be beneficial

Orlistat May be beneficial

Paclitaxel May be beneficial

Pentoxifylline May be beneficial

Risperidone May be beneficial

Simvastatin Further information

Sodium fluoride May be beneficial

Valproic acid Further information

Warfarin Further information

118 Supplement Generic Drug Comments VITAMIN K Aminoglycoside May be beneficial (PHYLLOQUINONE) antibiotics

Needed for proper bone Amoxicillin May be beneficial formation and blood clotting, in both cases Ampicillin May be beneficial by helping the body transport calcium. Antibiotics May be beneficial

Anticonvulsants May be beneficial

Azithromycin May be beneficial

Bile acid sequestrants May be beneficial

Cephalosporins May be beneficial

Chlorhexidine May be beneficial

Ciprofloxacin May be beneficial

Clarithromycin May be beneficial

Clindamycin oral May be beneficial

Colestipol May be beneficial

Cycloserine May be beneficial

Dapsone May be beneficial

Dicloxacillin May be beneficial

Doxycycline May be beneficial

119 Supplement Generic Drug Comments VITAMIN K Erythromycin May be beneficial (PHYLLOQUINONE) (cont.) Gabapentin May be beneficial

Gentamicin May be beneficial

Isoniazid May be beneficial

Levofloxacin May be beneficial

Loracarbef May be beneficial

Macrolides May be beneficial

Mineral oil May be beneficial

Minocycline May be beneficial

Neomycin May be beneficial

Nitrofurantoin May be beneficial

Ofloxacin May be beneficial

Oral corticosteroids Further information

Penicillin V May be beneficial

Penicillins May be beneficial

Phenobarbital May be beneficial

Quinolones May be beneficial

120 Supplement Generic Drug Comments VITAMIN K Sulfamethoxazole May be beneficial (PHYLLOQUINONE) (cont.) Sulfasalazine May be beneficial

Sulfonamides May be beneficial

Tetracycline May be beneficial

Tetracyclines May be beneficial

Tobramycin May be beneficial

Trimethoprim May be beneficial

Trimethrprim/ May be beneficial Sulfamethoxazole

Valproic acid May be beneficial

Warfarin Avoid

121 Supplement Generic Drug Comments ZINC Aspirin May be beneficial

A component of more AZT May be beneficial than 300 enzymes that are needed to repair Benazepril May be beneficial wounds, maintain fertility, synthesize protein, help Benzamycin May be beneficial cells reproduce, preserve vision, boost immunity Bile acid sequestrants May be beneficial and protect against free radicals, among other Calcium acetate May be beneficial functions. Captopril May be beneficial

Chemotherapy May be beneficial

Chlorhexidine Further information

Ciprofloxacin Avoid

Cisplatin May be beneficial

Clindamycin topical May be beneficial

Colestipol May be beneficial

Cyclophosphamide May be beneficial

Docetaxel May be beneficial

Doxycycline Avoid

122 Supplement Generic Drug Comments ZINC (cont.) Estrogens (combined) Further information

Folic acid May be beneficial

Lisinopril May be beneficial

Medroxyprogesterone Further information

Methodtrexate May be beneficial

Methyltestosterone Avoid

Metronidazole (vaginal) May be beneficial

Minocycline Further information

Ofloxacin Avoid

Oral contraceptives May be beneficial

Oral corticosteroids Further information

Penicillamine Avoid

Quinapril May be beneficial

Ramipril May be beneficial

Risedronate Avoid

Sodium fluoride May be beneficial

Tetracycline Avoid

123 Supplement Generic Drug Comments ZINC (cont.) Tetracyclines Avoid

Thiazide diuretics May be beneficial

Topical corticosteroids May be beneficial

Valproic acid Further information

Warfarin Avoid

124 VITAMIN & SUPPLEMENTS WHICH HAVE NO SIGNIFICANTINTERACTIONS WITH DRUGS (At the time of writing this guide)

7 – Keto DMAE Acetyl – L – Carnitine DMSO Adrenal Extract Docosahexaenoic Acid Alanina Flaxseed and Flaxseed Oil Alpha Lipoic Acid Fluoride Amylase Inhibitors Fumaric Acids Arginine GABA Beta – Glucan Gamma Oryzanol Beta – Sitosterol Glucomannan Betaine (Trimethylglycine) Glucosamine Blue – Green Algae Glutamic Acid Borage Oil Grapefruit Seed Extract Boric Acid Green – Lipped Mussel Boron HMB Bovine Colostrum Hydrooycitric Acid Branched – Chain Amino Acids Indole – 3 – Carbinol Calcium D – Glucarate Inosine Carnosine Iodine Cartilage and Collagen IP – 6 Cetyl Myristoleate Kelp Chitosan Lactase Chlorophyll Lecithin / Phosphatidyl Choline Chondroitin Sulfate Lipase Coconut Oil Liver Extracts Colloidal Silver Lutein Creatine Monohydrate Lycopene Cysteine Lysine D – Mannose Malic Acid

125 Methionine Progesterone Methoxyisoflavone Propolis Methylsulfonylmethane Pyruvate Molybdenum Resveratrol N – Acetyl – Glucosamine Ribose NADH Royal Jelly Octacosanol Silica Hydride Oligosaccharides Strontium Ornithine Sulforaphane Phenylalanine Sulfur Policosanol Thyroid Extracts Pollen Vanadium Pregnenolone Whey Protein Proanthocyanidins Xylitol

126 USEFUL WEB SITES FOR HEALTH CARE PROFESSIONALS

Alternative Medicine Foundation www.herbmed.org

American Pharmacist Association www.aphanet.org

American Nutraceutical Association www.americanutra.com

Association of Natural Medicine Pharmacists www.anmp.org

Canadian Health Food Association www.chfa.ca

Canadian Health Network www.canadian-health-network.ca

Prescription Drug Information www.drugs.com

National Center for Complementary & Alternative Medicine www.nccam.nih.gov

Natural Products Association www.naturalproductsassoc.org

127 To order more copies of DRUG / VITAMIN SUPPLEMENT INTERACTIONS

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