Potential Vitamin-Drug Interactions in Children
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Pediatr Drugs 2009; 11 (4): 251-257 1174-5878/09/0004-0251/$49.95/0
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Potential Vitamin-Drug Interactions in Children At a Pediatric Emergency Department Ran D. Goldman,1-3 Sunita Vohra4 and Alex L. Rogovik1,5 1 Pediatric Research in Emergency Therapeutics (PRETx) Program, Division of Pediatric Emergency Medicine, BC Children’s Hospital, Vancouver, British Columbia, Canada, and Division of Pediatric Emergency Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada 2 Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada 3 Child & Family Research Institute (CFRI), Vancouver, British Columbia, Canada 4 Complementary and Alternative Research and Education (CARE) Program, Department of Pediatrics, Stollery Children’s Hospital, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada 5 Clinical Nutrition & Risk Factor Modification Center, St. Michael’s Hospital, Toronto, Ontario, Canada
Abstract
Background: A significant increase in vitamin use has been observed in recent years and interactions between vitamins and medications have been reported. Objective: To determine the frequency and types of potential interactions between vitamins and medications in children arriving at a large tertiary, pediatric emergency department. We also compared family characteristics of children with potential interactions with those of children with no potential interactions, in order to determine children at a higher risk. Methods: A cross-sectional study in which a survey was conducted of parents/caregivers and/or patients aged 0–18 years registered at a large pediatric emergency department in Canada. A total of 1804 families underwent a face-to-face interview. The main outcome measure was the rate of potential vitamin interactions in the preceding 3 months. Results: A considerable number of patients (11% of our cohort) had potential vitamin-medication interactions in the preceding 3 months, which could theoretically result in adverse events, and over one-third of these children had more than one potential interaction. Patients with potential interactions and their parents were significantly older (p < 0.001 for the child and mother, p = 0.02 for the father), the children were much more likely to have a chronic illness (p < 0.001) and concurrently receive prescribed or over-the-counter medication (p < 0.001), and more children with potential interactions were completely immunized (p = 0.02). The child’s sex, parental education, employment status, family income, and primary language spoken at home were not associated with potential interactions. Conclusions: Taking into account the high rate of potential vitamin-drug interactions, especially among older children and patients with chronic illness, parents and healthcare providers need to balance the potential benefit of concurrent vitamin-medication use with its potential harms.
Background Significant growth in vitamin use has been documented in the literatu
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