HEALTHCalcium-enriched OJ not for pill taking anymoreVitamin and mineral additives have generally been beneficial, but researchers are concerned that some may interfere with the effectiveness of medication, as shown in a study of ciprofloxacin.By Victoria Stagg Elliott, amednews staff. Oct. 14, 2002. Drug interactions are already a considerable concern in the practice of medicine. But the fortified-food trend may add an entirely new wrinkle to the challenges physicians face in educating patients about what might or might not mix with their medications. The latest rub results from the good-for-you vitamins and minerals that are added to everyday food and drink items in almost every kitchen -- in this case, orange juice -- and how these additions may impact certain antibiotics. In general, it is an issue that some experts say could become much more far-reaching. For now, researchers found that orange juice with added calcium may interfere with the effectiveness of specific germ killers. This finding results from several studies released over the past few months by a research group at Bassett Healthcare in Cooperstown, N.Y. The group published a study in the April Journal of Clinical Pharmacology finding that when ciprofloxacin was administered to healthy volunteers along with calcium-fortified orange juice, the amount of drug in the blood stream was decreased by more than 40%. Last month, the group presented two studies at the Interscience Conference on Antimicrobial Agents and Chemotherapy in San Diego finding that the breakfast drink could also impact absorption of two other quinolones -- gatifloxacin and levofloxacin -- although less dramatically. "You can look at the calcium itself and say, 'that's a great idea because most Americans don't get enough calcium,' " said Anne Nafziger, MD, MHS, who assisted with the research and is co-director of the clinical pharmacology research center at Bassett. "But if you don't look at the big picture and the fact that they're also taking their medicines with their orange juice with the calcium, they could really get into trouble."
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Copyright 2002 American Medical Association. All rights reserved.
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