Common brand names:Azmacort, Kenalog, Nasacort AQ, Kenalog in Orabase
Summary of Interactions with Vitamins, Herbs, & Foods
Replenish Depleted Nutrients
Most of an inhaled dose of beclomethasone is actually swallowed, which may lead to reduced absorption of calcium. Health practitioners may recommend calcium supplementation to individuals using beclomethasone inhalers.The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Preliminary data suggest that corticosteroid treatment increases chromium loss. Double-blind trials are needed to confirm these observations.The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Corticosteroids may increase the loss of vitamin B6. One double-blind study of people with asthma failed to show any added benefit from taking 300 mg per day of vitamin B6 along with inhaled steroids. Therefore, while small amounts of vitamin B6 may be needed to prevent deficiency, large amounts may not provide added benefit. Some doctors recommend that people taking corticosteroids for longer than two weeks supplement with at least 2 mg of vitamin B6 per day.The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Reduce Side Effects
Calcium and Vitamin D
Oral corticosteroids reduce absorption of calcium and interfere with the activation and metabolism of the vitamin, increasing the risk of bone loss. Doctors can measure levels of activated vitamin D (called 1,25 dihydroxycholecalciferol) to determine whether a deficiency exists; if so, activated vitamin D is only available by prescription. A study of rheumatoid arthritis patients treated with low amounts of prednisone found that those who received 1,000 mg of calcium per day plus 500 IU of vitamin D per day for two years experienced no bone loss during that time period. An analysis of properly conducted trials concluded that supplementation with vitamin D and calcium was more effective than placebo or calcium alone in protecting against corticosteroid-induced osteoporosis. Most doctors recommend 1,000 mg of calcium and 400–800 IU vitamin D per day for the prevention of osteoporosis.
Preliminary data suggest that supplementation with chromium (600 mcg per day in the form of chromium picolinate) may prevent corticosteroid-induced diabetes. Double-blind trials are needed to confirm these observations.
Potential Negative Interaction
Licorice (Glycyrrhiza glabra) extract was shown to decrease the elimination of prednisone in test tube studies. If this action happens in people, it might prolong prednisone activity and possibly increase prednisone-related side effects. A small, controlled study found that intravenous (iv) glycyrrhizin (an active constituent in licorice) given with iv prednisolone prolonged prednisolone action in healthy men. Whether this effect would occur with oral corticosteroids and licorice supplements is unknown.
An animal study has shown that glycyrrhizin prevents the immune-suppressing actions of cortisone—the natural corticosteroid hormone produced by the body. More research is necessary to determine if this action is significant in humans taking oral corticosteroids. Until more is known, people should not take licorice with corticosteroids without first consulting a doctor.
Corticosteroids may increase the body's loss of magnesium. Some doctors recommend that people taking corticosteroids for more than two weeks supplement with 300–400 mg of magnesium per day. Magnesium has also been reported to interfere with the absorption of dexamethasone.
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Last Review: 03-24-2015
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