Review Article

Nutritional and Pharmacological Effects on Oxidative Stress in Soft Tissue and Bone Remodeling

Table 1

Effects of prescription and over-the-counter medications on micronutrient levels in patients, including vitamins, minerals, and antioxidants ([16, 17] and references in each).

Drug classNutrients depleted

Prescription medications
Antibiotics (fluoroquinolones): Levaquin, Avelox, Cipro, Floxin, Noroxin, Penetrex, TrovanBiotin, B1, B2, B3, B6, B12, zinc, and healthy intestinal bacteria
Antibiotics (macrolides): erythromycin, azithromycin, Biaxin, ZithromaxHealthy intestinal bacteria, B1, B2, B3, B6, and B12
Antibiotics (penicillins): amoxicillin, Amoxil, Trimox, penicillinHealthy intestinal bacteria, B1, B2, B3, B6, B12, vitamin k, folic acid, biotin, and inositol
ACE inhibitors: lisinopril, Altace, Accupril, Capoten, Prinivil, Zestril, VasotecZinc
Beta-2 adrenergic receptor agonists: albuterol aerosol, Brethine, Proventil, Tornalate, Ventolin, XopenexPotassium and possibly calcium-magnesium and phosphorus
Beta-blockers: atenolol, Corgard, Lopressor, Tenormin, Toprol XL, metoprololCoenzyme Q10, chromium, and melatonin
Biguanides: metformin, GlucophageFolic acid, B12
Bisphosphonates: Fosamax, Actonel, Boniva, Didronel, SkelidCalcium-magnesium and phosphorus
Calcium channel blockers: amlodipine, felodipine, nifedipine, nimodipine, nisoldipineVitamin D
Cardiac glycosides: digoxin, Digitek, Lanoxin, LanoxicapsCalcium-magnesium, phosphorus, potassium, and B1
Conjugated estrogens: Premarin hormone replacement therapy, birth control pillsB6, vitamin D, calcium-magnesium, zinc, folic acid, and B12
Corticosteroids: Flonase, Beclovent, Beconase, QVar, Vancenase, Vanceril, prednisone, Deltasone, Celestone, Cortisone, Cortef, Cortone, dexamethasone, Decadron, Hydrocortone, Medrol, methylprednisoloneBeta-carotene, B6, folic acid, vitamin C, vitamin D, calcium-magnesium, potassium, selenium, zinc, and melatonin
Loop diuretics: furosemide, Lasix, ethacrynic acid, Edecrin, BumexB1, B6, vitamin C, calcium-magnesium, phosphorus, potassium, and zinc
Opiates: hydrocodone/acetaminophen, oxycodoneFolic acid, vitamin C, iron, and potassium
Potassium sparing diuretics: amiloride, spironolactone, triamterene, aldactone, dyazide, Dyrenium, MaxzideCalcium, magnesium, and phosphorus
Proton pump inhibitors: omeprazole, Prilosec, Prevacid, Nexium, Protonix, AciphexBeta-carotene, B1, B12, folic acid, calcium, and zinc
Statins: Lipitor, Crestor, Lescol, Pravachol, Zocor, MevacorCoenzyme Q10
Sulfonylurea: glyburide, glipizide, glimepiride, Amaryl, Diabeta, Glucotrol, Glynase, MicronaseCoenzyme Q10
Thiazide diuretics: hydrochlorothiazideVitamin D, calcium-magnesium, phosphorus, potassium, zinc, and coenzyme Q10
Tricyclic antidepressants: Amitriptyline, clomipramine, doxepin, imipramine, Anafranil, Asendin, Elavil, Tofranil, VivactilCoenzyme Q10, B2, and sodium

Over-the-counter medications
Acetaminophen: TylenolCoenzyme Q10 and glutathione
Antacids: Amphojel, Basaljel, aluminum hydroxide plus magnesium, Gaviscon, Gelusil, Maalox, MylantaBeta-carotene, folic acid, vitamin D, calcium-magnesium, chromium, iron, zinc, and phosphorus
AspirinFolic acid, vitamin C, iron, potassium, and zinc
Laxatives with bisacodyl: Carter’s little pills, Correctol, Dulcolax, Feen-A-Mint, PMS-BisacodylCalcium and potassium
NSAIDs: ibuprofen, naproxenFolic acid
OTC proton-pump inhibitors: famotidine, pepcid, Tagamet, ZantacFolic acid, B1, B12, vitamin D, calcium, iron, and zinc