- Acetohydroxamic acidAcetohydroxamic acid: According to secondary sources, acetohydroxamic acid (AHA, Lithostat®) is prescribed to decrease urinary ammonia and may be synergistic with antibiotics or other kidney stone treatment. Use with iron supplements may reduce the efficacy of both agents.
- AllopurinolAllopurinol: Allopurinol (Zyloprim®), a medication used to treat gout, may decrease iron storage in the liver (159).
- Aminosalicylic acidAminosalicylic acid: Aminosalicylic acid (para-aminosalicylic acid; PAS, Paser) may cause a malabsorption syndrome (weight loss, iron and vitamin depletion, steatorrhea) (160). A qualified healthcare provider should be contacted immediately if any of these symptoms are experienced.
- AntacidsAntacids: Concurrent administration with antacids may reduce iron absorption (162). Clinically significant effects are unlikely with adequate dietary iron intake.
- AspirinAspirin: Regular use of aspirin may contribute to iron deficiency in the elderly (165).
- Black teaBlack tea: Evidence suggests that black tea has no effects on iron status in people without risk for anemia but could potentially affect iron levels in anemic populations (186).
- CalciumCalcium: Human studies have shown that calcium (from calcium salts or dairy products) may inhibit iron absorption (187).
- ChloramphenicolChloramphenicol: Secondary sources suggest that chloramphenicol (Chloromycetin®) may reduce the efficacy of iron therapy in iron deficiency anemia.
- CholestyramineCholestyramine: Cholestyramine (Questran®) may bind iron in the gut, reducing its absorption (167).
- CopperCopper: Iron has been found to inhibit the uptake of copper, and vice versa (188).
- Dairy productsDairy products: Human studies have shown that calcium (from calcium salts or dairy products) may inhibit iron absorption (187). Lactoferrin, a major protein component of human milk, has been found to bind iron with high affinity (202).
- GrainsGrains: In human research, phytic acid, found in grains and legumes, may reduce serum iron levels (190).
- H2 blockersH2 blockers: H2 blockers such as cimetidine (Tagamet®), ranitidine (Zantac®), famotidine (Pepcid®), or nizatidine (Axid®) may reduce iron absorption. Iron supplements are not usually required unless high doses of H2 blockers are being used (168).
- Human recombinant erythropoietinHuman recombinant erythropoietin: Bone marrow iron deposits have been shown to decrease significantly in patients on human recombinant erythropoietin therapy (169).
- Iron chelatorsIron chelators: Desferrioxamine and deferiprone are both iron-chelating drugs that lower iron levels (104; 105; 106).
- LegumesLegumes: In human research, phytic acid, found in grains and legumes, may reduce serum iron levels (190).
- Nonsteroidal anti-inflammatory agents (NSAIDs)Nonsteroidal anti-inflammatory agents (NSAIDs): NSAIDs, such as ibuprofen (Advil®), naproxen (Aleve®), or ketorolac (Toradol®), may cause mucosal damage and bleeding throughout the gastrointestinal tract. Chronic blood loss associated with long-term use of these agents may contribute to iron deficiency anemia (177). Iron-rich food intake may be advised as an alternative.
- NutsNuts: In human research, polyphenols found in nuts have been shown to markedly inhibit the absorption of nonheme iron. This effect was overcome by 50mg of vitamin C (191).
- Pancreatic enzymesPancreatic enzymes: There is some evidence that pancreatic enzyme supplements, such as Cotazym®, Creon®, Pancrease®, Ultrase®, and Viokase®, may reduce iron absorption and contribute to iron deficiency (178).
- PolyphenolsPolyphenols: In humans, polyphenols found in nuts have shown to markedly inhibit the absorption of nonheme iron. This effect was overcome by 50mg of vitamin C (191).
- Proton pump inhibitorsProton pump inhibitors: Long-term therapy with proton pump inhibitors, such as omeprazole (Prilosec®), lansoprazole (Prevacid®), or esomeprazole (Nexium®), has been associated with iron deficiency (180).
- SeleniumSelenium: According to preliminary data, iron may decrease selenium levels. Further research is needed to confirm these results (192).
- SoySoy: In humans, soy proteins may reduce serum iron levels (190).
- Vitamin AVitamin A: Some evidence suggests that iron supplementation may induce vitamin A deficiency (197). However, other evidence suggests that concomitant vitamin A may enhance the response to iron supplements (193; 184; 194), possibly by increased iron absorption (195). Iron and zinc supplementation have also been shown to improve vitamin A status in children (196). The lack of consistent data warrants further research on this topic.
- ZincZinc: Joint supplementation with iron and zinc has been shown to be less efficacious than supplementing each agent alone (198; 82; 199). Evidence suggests that iron supplementation in pregnancy may reduce serum zinc levels (153). However, in iron-replete women, iron supplementation increases zinc absorption later in pregnancy (154). Supplementing iron in ileostomy patients has also been shown to inhibit zinc absorption (200). Theoretically, zinc supplementation may inhibit iron transport via decreased copper absorption (201).
Copyright © 2011 Natural Standard (www.naturalstandard.com)
The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.