Ascorbic acid/cholecalciferol/elderberry/melatonin/zinc citrate and Alcohol/Food Interactions
There are 2 alcohol/food/lifestyle interactions with ascorbic acid / cholecalciferol / elderberry / melatonin / zinc citrate.
Melatonin Food
Moderate Food Interaction
Consumer information for this interaction is not currently available.
MONITOR: Oral caffeine may significantly increase the bioavailability of melatonin. The proposed mechanism is inhibition of CYP450 1A2 first-pass metabolism. After administration of melatonin 6 mg and caffeine 200 mg orally (approximately equivalent to 1 large cup of coffee) to 12 healthy subjects, the mean peak plasma concentration (Cmax) of melatonin increased by 137% and the area under the concentration-time curve (AUC) increased by 120%. The metabolic inhibition was greater in nonsmokers (n=6) than in smokers (n=6). The greatest effect was seen in subjects with the *1F/*1F genotype (n=7), whose melatonin Cmax increased by 202%. The half-life did not change significantly. The clinical significance of this interaction is unknown.
According to some authorities, alcohol may reduce the effect of melatonin on sleep. The mechanism of this interaction is not fully understood.
In addition, CYP450 1A2 inducers like cigarette smoking may reduce exogenous melatonin plasma levels. In a small clinical trial (n=8), habitual smokers had their melatonin plasma levels measured two times, each after a single oral dose of 25 mg of melatonin. They had smoked prior to the first measurement but had not smoked for 7 days prior to the second. Cigarette smoking significantly reduced melatonin plasma exposure (AUC) as compared to melatonin levels after 7 days of smoking abstinence (7.34 +/- 1.85 versus 21.07 +/- 7.28 nmol/L*h, respectively).
MANAGEMENT: Caution and monitoring are recommended if melatonin is used with inhibitors of CYP450 1A2 like caffeine or inducers of CYP450 1A2 like cigarette smoking. Consumption of alcohol should be avoided when taking melatonin.
References
- Hartter S, Nordmark A, Rose DM, Bertilsson L, Tybring G, Laine K (2003) "Effects of caffeine intake on the pharmacokinetics of melatonin, a probe drug for CYP1A2 activity." Br J Clin Pharmacol, 56, p. 679-682
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- Ursing C, Bahr CV, Brismar K, Rojdmark S (2005) "Influence of cigarette smoking on melatonin levels in man" Eur J Clin Pharmacol, 61, p. 197-201
Ascorbic Acid High Blood Pressure (Hypertension)
Moderate Potential Hazard, Moderate plausibility
ascorbic acid (vitamin C) - sodium
Ascorbic acid preparations contain sodium. The sodium content should be considered when used in patients with sodium restricted diets and conditions require sodium restriction, such as congestive heart failure, hypertension, and fluid retention.
References
- "Product Information. Cemill 500 (ascorbic acid)." Abbott Pharmaceutical
Ascorbic acid/cholecalciferol/elderberry/melatonin/zinc citrate drug interactions
There are 524 drug interactions with ascorbic acid / cholecalciferol / elderberry / melatonin / zinc citrate.
Ascorbic acid/cholecalciferol/elderberry/melatonin/zinc citrate disease interactions
There are 14 disease interactions with ascorbic acid / cholecalciferol / elderberry / melatonin / zinc citrate which include:
- depression
- arrhythmia
- electrolyte imbalance
- hypercalcemia
- renal dysfunction
- glaucoma
- liver disease
- hemolysis
- kidney stones
- sodium
- renal dysfunction
- malabsorption syndromes
- hepatobiliary dysfunction
- dialysis
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
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. | |
No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.