Introduction
In today’s health-conscious world, understanding the interactions between drugs and vitamins is critical for maintaining optimal health. This guide explores the prevalence of Natural Health Products (NHPs), their interactions with pharmaceuticals, and how to navigate these complexities to support your wellness journey. Our passion for people, health, and well-being drives us to uphold the highest standards in clean formulations, evidence-based medicine, and personalized nutritional support.
Why a Drug Interaction Guide?
Summary of Current State of NHP and Rx Usage in Canadian Households
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Upwards of 71% of Canadians use Natural Health Products (NHPs).
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Canadians widely use NHPs alongside pharmaceutical medications.
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Consumer knowledge and confidence about NHPs continues to increase.
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Reliable data collection on NHP usage combined with Rx usage is weak if not non-existent.
Who Buys and Uses NHPs, and How Much?
The Gold Standard survey, prepared for Health Canada by Ipsos Reid in 2011, provides insights into NHP usage:
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Prevalence of Use in Patients with Acute Cardiovascular Disease: The most commonly used NHP category includes:
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Vitamins and Minerals (73%)
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Herbal Products (20%)
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Traditional Medicines (9%)
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Homeopathic Preparations (1%)
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Amino Acids, Essential Fatty Acids, and Probiotics (35%)
Older age groups were associated with increased NHP use (1.5x increase per age decile). Pharmacists documented NHP use in 41% of patients, compared to 22% by physicians and 19% by nurses. The studies show that concurrent use of NHPs with drugs is very high, and consumers often persist in their use despite professional recommendations.
Trends in Drug Use
Below is Health Canada’s data on drug sales growth:
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Canada accounts for 2.1% of pharmaceutical drug sales worldwide.
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Patented medicine sales reached $17.5 billion in 2020, with a 3% growth over the past five years.
(Source: PMPRB Annual Report, 2020)
The Current State of NHP and Pharmaceutical Use in Canada
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NHP Usage: Over 71% of Canadians use NHPs. These products, including vitamins, minerals, and herbal remedies, are often used alongside pharmaceutical medications.
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Consumer Trends: While confidence in NHPs is increasing, reliable data on their combined usage with pharmaceuticals is limited.
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Demographics: Older Canadians are more likely to use NHPs, and women use nutritional supplements more frequently than men, particularly in the 51-70 age group. Western Canada sees higher NHP usage compared to the East.
Key Findings
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Most Common NHPs: Multivitamins remain the most widely used, though their usage has declined slightly over the years. Vitamin D usage has significantly increased, especially among those aged 70 and older.
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Trends in Pharmaceuticals: Canada accounts for 2.1% of global pharmaceutical sales, with patented medicine sales reaching $17.5 billion in 2020. This reflects a steady growth in drug usage.
Chart: Top 10 Drug Classes by Public Drug Program Spending (2019)
Drug Class |
TPS ($ Millions) |
Proportion of TPS (%) |
Common Uses |
Tumor Necrosis Factor Alpha Inhibitors (Anti-TNF Drugs) |
576.7 |
7.4 |
Rheumatoid Arthritis, Crohn’s Disease |
Antineovascularization Agents |
337.3 |
4.3 |
Age-Related Macular Degeneration |
HMG-CoA Reductase Inhibitors (Statins) |
295.6 |
3.8 |
High Cholesterol |
Proton Pump Inhibitors (PPIs) |
249.6 |
3.2 |
Gastroesophageal Reflux Disease |
Adrenergics with Corticosteroids |
217.3 |
2.8 |
Asthma, Chronic Bronchitis |
ACE Inhibitors |
190.7 |
2.5 |
Heart Failure, High Blood Pressure |
Selective Serotonin Reuptake Inhibitors (SSRIs) |
185.8 |
2.4 |
Depression |
Natural Opium Alkaloids |
180.5 |
2.3 |
Pain Management |
Other Antidepressants |
171.5 |
2.2 |
Depression |
Diazepines, Oxazepines, Thiazepines |
155.9 |
2.0 |
Schizophrenia, Bipolar Disorder |
Combined Total |
2,560.9 |
32.9 |
Common Drug Classes and Their Interactions
Acid Inhibitors and Antibiotics
Drug Class |
Examples |
Nutrients Depleted |
Interactions |
Acid Inhibitors |
Omeprazole, Lansoprazole |
Calcium, Magnesium, Vitamin B12 |
Long-term use may lead to nutrient depletion; separate calcium and magnesium supplementation. |
Antibiotics |
Amoxicillin, Ciprofloxacin, Tetracyclines |
Vitamin K, B-Vitamins, Probiotics |
Antibiotics disrupt gut flora; probiotics should be taken 4-6 hours after to restore balance. |
H2 Antagonists |
Ranitidine, Cimetidine |
Zinc, Calcium |
Decreased absorption of zinc and calcium; supplementation should be spaced. |
Anticonvulsants
Drug Class |
Examples |
Nutrients Depleted |
Interactions |
Anticonvulsants |
Phenytoin, Carbamazepine |
Vitamin D, Calcium, Folate, B12 |
Grapefruit juice may increase drug levels; folate supplementation may reduce drug efficacy. |
Valproic Acid |
Depakote |
Carnitine, Selenium |
High doses of vitamin A may increase the risk of birth defects in pregnant women. |
Benzodiazepines |
Lorazepam, Diazepam |
Coenzyme Q10, Riboflavin |
Avoid sedating herbs like Kava or Valerian; these may cause excessive drowsiness. |
Cardiovascular Medications
Drug Class |
Examples |
Nutrients Depleted |
Interactions |
ACE Inhibitors |
Captopril, Enalapril, Ramipril |
Zinc Glycinate |
Should not be combined with potassium; may cause hyperkalemia. |
Beta Blockers |
Atenolol, Metoprolol |
Coenzyme Q10 |
Calcium supplements may lower drug levels, decreasing efficacy. |
Calcium Channel Blockers |
Nifedipine, Verapamil |
None Known |
Avoid peppermint oil, which may reduce the drug’s effectiveness. |
Cardiac Glycosides |
Digoxin |
Calcium Citrate, Magnesium |
St. John’s Wort may reduce drug efficacy, and magnesium may decrease absorption; take 2 hrs apart. |
Simple Supplement Tips
1. Take Vitamin C to enhance iron absorption.
2. Space probiotics and antibiotics by 4-6 hours for efficacy.
3. Avoid taking fatty acids with fatty meals to optimize absorption.
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