Reduced serum 25(OH)D levels, leading to vitamin D deficiency, hypocalcemia, and osteomalacia/rickets with long-term use.
Monitor serum 25(OH)D and calcium levels. Higher doses of vitamin D3 supplementation may be required.
Vitamin
Vitamin D deficiency is a cofactor of chemotherapy-induced mucocutaneous toxicity and dysgeusia.
Reduced serum 25(OH)D levels, leading to vitamin D deficiency, hypocalcemia, and osteomalacia/rickets with long-term use.
Monitor serum 25(OH)D and calcium levels. Higher doses of vitamin D3 supplementation may be required.
Reduced serum 25(OH)D levels, leading to vitamin D deficiency, hypocalcemia, and osteomalacia/rickets with long-term use.
Monitor serum 25(OH)D and calcium levels. Higher doses of vitamin D3 supplementation may be required. Consider active vitamin D metabolites in severe cases.
Reduced absorption of vitamin D3, leading to vitamin D deficiency.
Administer vitamin D3 at least 1 hour before or 4-6 hours after cholestyramine to minimize interaction. Monitor serum 25(OH)D levels and adjust vitamin D3 dose as needed.
Reduced calcium absorption, increased calcium loss, and potential for vitamin D deficiency, leading to bone loss and osteoporosis.
Monitor serum 25(OH)D and calcium levels. Supplementation with vitamin D3 and calcium is often recommended in patients on long-term corticosteroid therapy. Higher doses of vitamin D3 may be needed.
Increased risk of digoxin toxicity (e.g., arrhythmias, nausea, vomiting) due to hypercalcemia.
Avoid excessive vitamin D3 supplementation in patients on digoxin. Monitor serum calcium and digoxin levels closely. If hypercalcemia occurs, discontinue vitamin D3 and manage hypercalcemia promptly.
Reduced conversion of 25(OH)D to active calcitriol, potentially leading to reduced efficacy of vitamin D3 supplementation.
Monitor serum 25(OH)D and calcium levels. Higher doses of vitamin D3 or consideration of active vitamin D metabolites may be necessary.
Reduced absorption of vitamin D3, leading to vitamin D deficiency.
Administer vitamin D3 at a different time than orlistat (e.g., at bedtime) or consider supplementing with a water-miscible form of vitamin D. Monitor serum 25(OH)D levels and adjust vitamin D3 dose as needed.
Reduced serum 25(OH)D levels, leading to vitamin D deficiency, hypocalcemia, and osteomalacia/rickets with long-term use.
Monitor serum 25(OH)D and calcium levels. Higher doses of vitamin D3 supplementation may be required. Consider active vitamin D metabolites (e.g., calcitriol) in severe cases or if standard vitamin D3 is ineffective.
Reduced serum 25(OH)D levels, leading to vitamin D deficiency and potential for bone demineralization.
Monitor serum 25(OH)D and calcium levels. Higher doses of vitamin D3 supplementation may be required during and after rifampicin therapy.
Increased risk of hypercalcemia, especially in susceptible individuals or with high doses of vitamin D3.
Monitor serum calcium levels, especially at the initiation of therapy or with dose adjustments of either drug. Adjust vitamin D3 dose downwards if hypercalcemia develops.
Reduced absorption of vitamin D3, potentially leading to vitamin D deficiency with chronic use.
Advise patients to take vitamin D3 at a different time than mineral oil (e.g., several hours apart). Monitor serum 25(OH)D levels with long-term concomitant use.
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Sources: Harrison 22e·Verified: 2026-05-10 · House clinical team