Drug Information
Common brand names:
Beta-Val, Luxiq, Psorion CreamSummary of Interactions with Vitamins, Herbs, & Foods
Types of interactions:BeneficialAdverseCheck
Replenish Depleted Nutrients
- Calcium
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.
The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
- Chromium
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.
- Vitamin B6
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
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.
- Chromium
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.
Support Medicine
- Licorice
When applied to the skin, glycyrrhetinic acid (a chemical found in licorice (Glycyrrhiza glabra)) increases the activity of hydrocortisone. This effect might allow for less hydrocortisone to be used when combined with glycyrrhetinic acid, but further study is needed to test this possibility.
Children with alopecia areata who supplemented 100 mg of zinc and 20 mg biotin each day, combined with topical clobetasol, showed more improvement compared to children who took oral corticosteroid drugs. Controlled research is needed to determine whether adding oral zinc and biotin to topical clobetasol therapy is more effective than clobetasol alone. However, until more information is available, caregivers should consider that children with alopecia who are currently taking oral corticosteroids might benefit from switching to supplements of zinc and biotin along with topical clobetasol.
The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Potential Negative Interaction
Explanation Required
- Aloe
In animal research, applying aloe (Aloe vera) gel topically along with a topical corticosteroid enhanced the hormone’s anti-inflammatory activity in the skin. No human research has investigated this effect.
The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
- Magnesium
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.
The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.
