Potential vitamin-drug interactions in children: at a pediatric emergency department

Paediatr Drugs. 2009;11(4):251-7. doi: 10.2165/00148581-200911040-00004.


Background: A significant increase in vitamin use has been observed in recent years and interactions between vitamins and medications have been reported.

Objective: To determine the frequency and types of potential interactions between vitamins and medications in children arriving at a large tertiary, pediatric emergency department. We also compared family characteristics of children with potential interactions with those of children with no potential interactions, in order to determine children at a higher risk.

Methods: A cross-sectional study in which a survey was conducted of parents/caregivers and/or patients aged 0-18 years registered at a large pediatric emergency department in Canada. A total of 1804 families underwent a face-to-face interview. The main outcome measure was the rate of potential vitamin interactions in the preceding 3 months.

Results: A considerable number of patients (11% of our cohort) had potential vitamin-medication interactions in the preceding 3 months, which could theoretically result in adverse events, and over one-third of these children had more than one potential interaction. Patients with potential interactions and their parents were significantly older (p < 0.001 for the child and mother, p = 0.02 for the father), the children were much more likely to have a chronic illness (p < 0.001) and concurrently receive prescribed or over-the-counter medication (p < 0.001), and more children with potential interactions were completely immunized (p = 0.02). The child's sex, parental education, employment status, family income, and primary language spoken at home were not associated with potential interactions.

Conclusions: Taking into account the high rate of potential vitamin-drug interactions, especially among older children and patients with chronic illness, parents and healthcare providers need to balance the potential benefit of concurrent vitamin-medication use with its potential harms.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Canada / epidemiology
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Drug Interactions*
  • Drug-Related Side Effects and Adverse Reactions*
  • Emergency Medical Services / statistics & numerical data*
  • Emergency Service, Hospital / statistics & numerical data
  • Family
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Risk Assessment
  • Vitamins / adverse effects*


  • Vitamins