Gröber Uwe, Holick Michael F, Kisters Klaus
Akademie für Mikronährstoffmedizin, Zweigertstr. 55, 45130 Essen.
Med Monatsschr Pharm. 2011 Oct;34(10):377-87.
Interactions between drugs and vitamin D have received only little or no attention in the medical and pharmaceutical world in the past. Since more and more drugs are used for the treatment of patients, this topic is increasingly relevant. As such interactions impact the health of the patient and the action and side effects of the drug, physicians and pharmacists should pay more attention to such interactions in the future. A number of drugs can interfere with the vitamin D and bone metabolism. The drug-induced activation of the pregnane X receptor (PXR) is likely to enhance CYP24 expression and the catabolism of 25(OH)D, leading to vitamin D deficiency. PXR-ligands include a wide variety of pharmaceutical agents, such as antiepileptic drugs, taxol, rifampicin, and human immunodeficiency virus protease inhibitors such as ritonavir and saquinavir. Beside this, the medication oriented supplementation of vitamin D can also ameliorate the pharmacologic action of many drugs, such as bisphosphonates, statins and cytostatic drugs.
过去，药物与维生素D之间的相互作用在医学和制药领域很少受到关注或根本未受关注。由于越来越多的药物用于治疗患者，这个话题变得越来越重要。鉴于此类相互作用会影响患者的健康以及药物的作用和副作用，医生和药剂师未来应更加关注此类相互作用。许多药物会干扰维生素D和骨代谢。药物诱导的孕烷X受体（PXR）激活可能会增强CYP24表达和25（OH）D的分解代谢，导致维生素D缺乏。PXR配体包括多种药剂，如抗癫痫药物、紫杉醇、利福平以及诸如利托那韦和沙奎那韦等人类免疫缺陷病毒蛋白酶抑制剂。除此之外，以药物为导向的维生素D补充也可以改善许多药物的药理作用，如双膦酸盐、他汀类药物和细胞抑制药物。
