Vitamin C + Vitamin D3 + Folic acid interactions

Food & lifestyle

• alcohol

  Moderate

  Synergy

  Ethanol may increase folic acid elimination and folic acid absorption is decreased in chronic alcoholics. Excessive alcohol consumption may lead to folate deficiency.

  What to do: Monitoring of patient response to folic acid supplementation if they also consume alcohol regularly may be recommended.

  5 sources

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  2. Cerner Multum, Inc. "Australian Product Information." O 0
  3. Agencia Espa?ola de Medicamentos y Productos Sanitarios Healthcare "Centro de informaci��n online de medicamentos de la AEMPS - CIMA. https://cima.aemps.es/cima/publico/home.html" (2008):
  4. Cerner Multum, Inc "ANVISA Bul��rio Eletr?nico." O 0 (2015):
  5. "Product Information. Folic Acid (folic acid)." Method Pharmaceuticals, LLC (2017):

Conditions

Conditions in which Vitamin C + Vitamin D3 + Folic acid needs care, as documented in this source.

• Anemia

  Major

  The use of folic acid is contraindicated in patients with undiagnosed anemia. Folic acid in dosages above 1 mg/day can obscure the diagnosis of pernicious anemia by alleviating the hematologic abnormalities while allowing the progression of neurologic complications. In addition, folic acid alone is improper therapy in the treatment of pernicious anemia and other megaloblastic anemias where vitamin B12 is deficient.

  3 sources

  1. Butterworth CE Jr, Tamura T "Folic acid safety and toxicity: a brief review." Am J Clin Nutr 50 (1989): 353-8
  2. Katz M "Potential danger of self-medication with folic acid." N Engl J Med 289 (1973): 1095
  3. "Product Information. Renal Multivitamin Formula Rx (folic acid)." Vitaline Corporation, Ashland, OR.

• Arrhythmias, Cardiac

  Major

  Vitamin D analogs function to increase serum calcium concentrations and can exacerbate arrhythmias, particularly in patients receiving cardiac glycosides. Therapy with vitamin D analogs should be administered cautiously in patients with or predisposed to cardiac arrhythmias. Clinical monitoring of serum electrolyte concentrations and cardiac function is recommended.

  3 sources

  1. "Product Information. Calciferol (ergocalciferol)." Schwarz Pharma (2001):
  2. "Product Information. Rocaltrol (calcitriol)." Roche Laboratories (2001):
  3. "Product Information. Calderol (calcifediol)." Organon (2001):

• Hypercalcemia

  Major

  Vitamin D analogs such as calciferol and ergocalciferol should not be given to patients with hypercalcemia, malabsorption syndrome, or evidence of vitamin D toxicity.

  4 sources

  1. "Product Information. Rocaltrol (calcitriol)." Roche Laboratories (2001):
  2. "Product Information. Zemplar (paricalcitol)." Abbott Pharmaceutical (2001):
  3. "Product Information. Delta D3 (cholecalciferol)." Freeda Vitamins Inc (2002):
  4. "Product Information. Drisdol (ergocalciferol)." sanofi-aventis (2016):

• Kidney Diseases

  Major

  Ergocalciferol, cholecalciferol, and calcifediol undergo renal biotransformation during metabolic activation. Renal impairment can alter metabolic and therapeutic activity of certain vitamin D analogs. Alternative vitamin D analogs such as dihydrotachysterol (hepatic activation) and calcitriol (active form) may be considered in patients with compromised renal function.

  3 sources

  1. "Product Information. Calciferol (ergocalciferol)." Schwarz Pharma (2001):
  2. "Product Information. Rocaltrol (calcitriol)." Roche Laboratories (2001):
  3. "Product Information. Calderol (calcifediol)." Organon (2001):

• Water-Electrolyte Imbalance

  Major

  Vitamin D analogs administered in the presence of hyperphosphatemia can result in precipitation of calcium-phosphate deposits within the vascular or renal systems or other soft tissue calcifications. A solubility product (Serum Calcium X Phosphate) should not exceed 70. Serum electrolyte concentrations should be corrected prior to vitamin D analog therapy and monitored during therapy.

  4 sources

  1. "Product Information. Calciferol (ergocalciferol)." Schwarz Pharma (2001):
  2. "Product Information. Rocaltrol (calcitriol)." Roche Laboratories (2001):
  3. "Product Information. Calderol (calcifediol)." Organon (2001):
  4. "Product Information. Zemplar (paricalcitol)." Abbott Pharmaceutical (2001):

• Liver Diseases

  Moderate

  Vitamin D analogs are fat soluble and oral formulations require bile for adequate intestinal absorption. Hepatic and/or biliary dysfunction decrease the absorption of vitamin D analogs. Metabolites of vitamin D analogs are primarily excreted in bile and feces. Ergocalciferol, cholecalciferol, and dihydrotachysterol undergo hepatic hydroxylation during metabolic activation. Hepatic impairment can alter the metabolic and therapeutic activity of certain vitamin D analogs. Alternative vitamin D analogs such as calcifediol (requires renal activation) and calcitriol (active form) may be considered in patients with compromised hepatic function.

  3 sources

  1. "Product Information. Calciferol (ergocalciferol)." Schwarz Pharma (2001):
  2. "Product Information. Rocaltrol (calcitriol)." Roche Laboratories (2001):
  3. "Product Information. Calderol (calcifediol)." Organon (2001):

Therapeutic duplication

Drug classes that overlap with Vitamin C + Vitamin D3 + Folic acid, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.

• vitamin d analogs

  The recommended maximum number of medicines in the 'vitamin d analogs' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'vitamin d analogs' category.

  Example product in the source data (US market): Os-cal extra d3