Prevalence of Medication-Dietary Supplement Combined Use and Associated Factors

Nutrients. 2019 Oct 15;11(10):2466. doi: 10.3390/nu11102466.


Introduction: The use of medication has increased in recent years in the US while the use of dietary supplements has remained stable but high. Interactions between these two kinds of products may have important consequences, especially in the case of widely used medications such as antihypertensives and antibiotics. The aim of this paper is to estimate the prevalence of potentially serious drug-dietary supplement interactions among tetracyclines, thiazides, and angiotensin II receptor blocker users by means of the NHANES 2013-2014 dataset.

Methods: Data from 2013-2014 NHANES were obtained. Potential interactions analysed were tetracyclines with calcium, magnesium, and zinc, thiazides with vitamin D, and angiotensin II receptors blockers with potassium. Prevalence was calculated for each potential interaction. Logistic regression was used to assess associated factors.

Results: 864 prescriptions issued to 820 patients were analysed. Overall prevalence of potential interaction was 49%. Older age and higher educational level were strongly associated with being at risk of a potential interaction. Factors such as age, race, civil status, citizenship, country of birth, BMI, and physical activity did not show notable associations.

Conclusions: Healthcare professionals should be aware of other medical products when they prescribe or dispense a medication or a dietary supplement, especially to the older population and people with a higher educational level.

Keywords: antibiotics; antihypertensive medication; dietary supplements; interactions; prevalence.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Angiotensin Receptor Antagonists / adverse effects*
  • Anti-Bacterial Agents / adverse effects*
  • Antihypertensive Agents / adverse effects*
  • Cross-Sectional Studies
  • Dietary Supplements / adverse effects*
  • Drug Interactions
  • Drug-Related Side Effects and Adverse Reactions / diagnosis
  • Drug-Related Side Effects and Adverse Reactions / epidemiology*
  • Educational Status
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nutrition Surveys
  • Prevalence
  • Risk Assessment
  • Risk Factors
  • Sodium Chloride Symporter Inhibitors / adverse effects*
  • Tetracyclines / adverse effects*
  • Time Factors
  • United States / epidemiology
  • Young Adult


  • Angiotensin Receptor Antagonists
  • Anti-Bacterial Agents
  • Antihypertensive Agents
  • Sodium Chloride Symporter Inhibitors
  • Tetracyclines