Potential vitamin-drug interactions in children: at a pediatric emergency department.
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.
Goldman
Ran D
RD
Pediatric Ress in Emergency Ther. (PRETx) Program, Div. of Pediatric Emergency Med., BC Children's Hosp., Vancouver, British Columbia, Canada, and Division of Pediatric Emergency Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada. rgoldman@cw.bc.ca
Vohra
Sunita
S
Rogovik
Alex L
AL
D000293:Adolescent; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004347:Drug Interactions; D064420:Drug-Related Side Effects and Adverse Reactions; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005190:Family; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D018570:Risk Assessment; D014815:Vitamins / Q000009:adverse effects*
D014815:Vitamins