Drug-Induced Nutrient Depletion -

Acid-Suppressing Drugs and Antacids

Drug-induced nutrient depletion occurs when medications that we take for various health reasons block the absorption, storage, metabolism, or synthesis of

essential nutrients in the body. Over time, these depletions can lead to secondary problems. People on multiple medications may be more likely to have reduced levels of certain nutrients. Although these nutrients are in many foods, the amount of nutrients may not be sufficient, and you may need supplementation from a high-quality vitamin/supplement.

Different types of drugs can deplete different nutrients. This week we will look at acid-suppressing drugs and antacids. For a full list of drug-induced nutrient depletions, please click here.

What nutrients can be depleted with acid-suppressing drugs and antacids?

Drug Category	Drug Class Description	Drug-Induced Nutrient Depletions	Recommended Supplementation	Dietary Supplements with potential for interactions with drug or drug class
Acid-Suppressing Drugs and Antacids Examples: Nexium, Pepcid, Prisolec, etc	• H2 antagonists block histamine (H2) receptors on gastric mucosal cells and decrease the production and secretion of acid. • Proton-Pump Inhibitors block the acid transporter pump on the luminal surface preventing acid from entering the gastric lumen. • Antacids directly neutralize existing acid in the stomach	• H2 antagonists: ○ Calcium ○ Folic acid ○ Iron ○ Vitamin B12 ○ Vitamin D • Proton-pump inhibitors: ○ Magnesium ○ Vitamin B12.	• Vitamin B12 25–1000 mcg/day • Magnesium 250–400 mg/day Additional Supplementation: • Calcium: 500mg daily • Iron: discuss with healthcare provider. • Vitamin D: 1000–2000IU daily • Zinc: 11mg daily	• Goldenseal and Ginger: These supplements may increase stomach acid and thus might interfere with antacids, H2 antagonists, and proton pump inhibitors. • Green Tea: Cimetidine can inhibit the metabolism of caffeine in green tea and significantly reduce its clearance

At Compounding Solutions Pharmacy & Wellness, we offer a wide range of high-quality vitamins and supplements from brands like Pure Encapsulations, Thorne Health, our own private line, and more. For more information about vitamins and supplements, ask one of our knowledgeable pharmacists.

Sources:

https://www.uspharmacist.com/article/druginduced-nutrient-depletions-what-pharmacists-need-to-know

https://www.aafp.org/dam/AAFP/documents/about_us/sponsored_resources/Nature%20Made%20Handout.pdf