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Drug Interactions between dexamethasone and Vitamin D3

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

dexAMETHasone cholecalciferol

Applies to: dexamethasone and Vitamin D3 (cholecalciferol)

Consumer information for this interaction is not currently available.

MONITOR: Use of systemic corticosteroids may reduce the effects of vitamin D and its analogs, though the exact mechanism is likely multifaceted. In general, corticosteroid use leads to increased excretion of calcium, whereas vitamin D promotes calcium absorption and is often administered with calcium to increase the absorption. Another potential mechanism involved is that long-term steroid use can contribute to weight gain and vitamin D is a fat-soluble vitamin; therefore, the bioavailability of vitamin D may be reduced in overweight and/or obese patients. Additionally, some studies have suggested that corticosteroid use increases the breakdown of 25-hydroxyvitamin D (25(OH)D), the active metabolite of vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). However, several studies examining this theory found no significant differences when the levels of 25(OH)D in patients treated with corticosteroids were compared to the levels measured either pretreatment or in control groups. The results may be demonstrating a lack of effect on 25(OH)D or could be related to limitations in the studies themselves. Regardless of the exact mechanism, the 2001-2006 National Health and Nutrition Examination Survey from the United States reported that 25(OH)D deficiency (levels less than 25 nmol/L or 10 ng/mL) was more than twice as common among children and adults who reported oral steroid use (11%) than in nonusers (5%).

MANAGEMENT: Increased monitoring of calcium and vitamin D levels may be advisable in patients on systemic corticosteroids. Depending on the patient's levels, increased vitamin D supplementation may be required during coadministration. The severity of this interaction is likely impacted by the dosage and/or duration of the systemic corticosteroid. Consultation with relevant local and/or national guidelines may be helpful when deciding on vitamin D dosing as well as goal vitamin D levels.

Drug and food interactions

Moderate

cholecalciferol food

Applies to: Vitamin D3 (cholecalciferol)

Consumer information for this interaction is not currently available.

MONITOR: Additive effects and possible toxicity (e.g., hypercalcemia, hypercalciuria, and/or hyperphosphatemia) may occur when patients using vitamin D and/or vitamin D analogs ingest a diet high in vitamin D, calcium, and/or phosphorus. The biologically active forms of vitamin D stimulate intestinal absorption of calcium and phosphorus. This may be helpful in patients with hypocalcemia and/or hypophosphatemia. However, sudden increases in calcium or phosphorus consumption due to dietary changes could precipitate hypercalcemia and/or hyperphosphatemia. Patients with certain disease states, such as impaired renal function, may be more susceptible to toxic side effects like ectopic calcification. On the other hand, if dietary calcium is inadequate for the body's needs, the active form of vitamin D will stimulate osteoclasts to pull calcium from the bones. This may be detrimental in a patient with reduced bone density.

MANAGEMENT: Given the narrow therapeutic index of vitamin D and vitamin D analogs, the amounts of calcium, phosphorus, and vitamin D present in the patient's diet may need to be taken into consideration. Specific dietary guidance should be discussed with the patient and regular lab work should be monitored as indicated. Calcium, phosphorus, and vitamin D levels should be kept within the desired ranges, which may differ depending on the patient's condition. Patients should also be counseled on the signs and symptoms of hypervitaminosis D, hypercalcemia, and/or hyperphosphatemia.

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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