.
Tetracycline is a member of the tetracycline family of antibiotics. Tetracycline is used to treat a wide variety of infections and severe acne.
Interactions with Dietary Supplements
Minerals
Many minerals can decrease the absorption of tetracycline, thus reducing its effectiveness.
These minerals include aluminum (in antacids), calcium (in antacids, dairy
products, and supplements), magnesium (in antacids and
supplements), iron (in food and supplements), zinc (in food and supplements), and others.
Probiotics
A common side effect of antibiotics is diarrhea, which
may be caused by the elimination of beneficial bacteria normally found in the colon.
Controlled studies have shown that taking probiotic microorganisms—such as
Lactobacillus casei, Lactobacillus acidophilus, Bifidobacterium longum,
or Saccharomyces boulardii—helps prevent antibiotic-induced
diarrhea.1
The diarrhea experienced by some people who take antibiotics also might be due to an overgrowth of the bacterium Clostridium difficile, which causes a disease known as pseudomembranous colitis. Controlled studies have shown that supplementation with harmless yeast—such as Saccharomyces boulardii2 or Saccharomyces cerevisiae (baker’s or brewer’s yeast)3 —helps prevent recurrence of this infection. In one study, taking 500 mg of Saccharomyces boulardii twice daily enhanced the effectiveness of the antibiotic vancomycin in preventing recurrent clostridium infection.4 Therefore, people taking antibiotics who later develop diarrhea might benefit from supplementing with saccharomyces organisms.
Treatment with antibiotics also commonly leads to an overgrowth of yeast (Candida albicans) in the vagina (candida vaginitis) and the intestines (sometimes referred to as “dysbiosis”). Controlled studies have shown that Lactobacillus acidophilus might prevent candida vaginitis.5
Vitamins
Tetracycline can interfere with the activity of folic
acid, potassium, and
vitamin B2, vitamin B6, vitamin B12, vitamin C, and
vitamin K.6 This is generally not a problem
when taking tetracycline for two weeks or less. People taking tetracycline for longer than two
weeks should ask their doctor about vitamin and mineral supplementation. Taking 500 mg vitamin
C simultaneously with tetracycline was shown to increase blood levels of tetracycline in one
study.7 The importance of this interaction is unknown.
Taking large amounts of niacinamide, a form of vitamin B3, can suppress inflammation in the body. According to numerous preliminary reports, niacinamide, given in combination with tetracycline or minocycline, may be effective against bullous pemphigoid, a benign, autoimmune blistering disease of the skin.8 9 10 11 12 13 14 Preliminary evidence also suggests a similar beneficial interaction may exist between tetracycline and niacinamide in the treatment of dermatitis herpetiformis.15 16
Vitamin K
Several cases of excessive bleeding have been reported in people who take
antibiotics.17 18 19 20 This side effect may be
the result of reduced vitamin K activity and/or reduced vitamin K production by bacteria in
the colon. One study showed that people who had taken broad-spectrum antibiotics had lower
liver concentrations of vitamin K2 (menaquinone), though vitamin K1 (phylloquinone) levels
remained normal.21 Several antibiotics appear to exert a strong effect on vitamin K
activity, while others may not have any effect. Therefore, one should refer to a specific
antibiotic for information on whether it interacts with vitamin K. Doctors of natural medicine
sometimes recommend vitamin K supplementation to people taking antibiotics. Additional
research is needed to determine whether the amount of vitamin K1 found in some multivitamins
is sufficient to prevent antibiotic-induced bleeding. Moreover, most multivitamins do not
contain vitamin K.
Interactions with Herbs
Berberine-containing herbs
Berberine, a chemical extracted from goldenseal
(Hydrastis canadensis),barberry (Berberis
vulgaris), and Oregon grape (Berberis
aquifolium), has been shown to have antibacterial activity. One double-blind study found
that giving 100 mg of berberine at the same time as 500 mg of tetracycline four times daily
led to a reduction of the efficacy of tetracycline in people with cholera.22
Berberine may have decreased the absorption of tetracycline in this study. Another
double-blind trial did not find that berberine interfered with tetracycline in cholera
patients.23 Until more studies are completed to clarify this issue,
berberine-containing herbs should not be taken simultaneously with tetracycline.
Interactions with Foods and Other Compounds
Food
Tetracycline should be taken on an empty stomach, one hour before or two hours after any other
food, drugs, or supplements, with a full glass of water.24
Summary of Interactions for Tetracycline
| Depletion or interference | Folic acid Potassium Vitamin B12 Vitamin B2 Vitamin B6 Vitamin C Vitamin K* |
|---|---|
| Adverse interaction | Berberine-containing herbs such as Goldenseal, Barberry, and Oregon grape |
| Side effect reduction/prevention | Bifidobacterium
longum* Lactobacillus acidophilus* Lactobacillus casei* Probiotics* Saccharomyces boulardii* Saccharomyces cerevisiae* Vitamin K* |
| Supportive interaction | Probiotics* Saccharomyces boulardii* Vitamin B3 (Niacinamide only, for bullous pemphigoid and dermatitis herpetiformis) Vitamin C* |
| Reduced drug absorption/bioavailability | Minerals (Aluminum, Calcium, Iron, Magnesium, Zinc) |
For the convenience of the reader, the information in the summary is categorized as follows: “Depletion or interference” indicates the drug may deplete or interfere with the absorption or function of the supplement or herb. “Adverse interaction” indicates that the supplement or herb used together with the drug may result in undesirable effects. “Side effect reduction/prevention” indicates the supplement or herb may reduce the likelihood and/or severity of a potential side effect caused by the drug. “Supportive interaction” indicates the supplement or herb may support or aid the function of the drug. “Reduced drug absorption/bioavailability” indicates that the supplement or herb may decrease the absorption and/or activity of the drug in the body. An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.
References:
1. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870–6 [review].
2. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870–6 [review].
3. Schellenberg D, Bonington A, Champion CM, et al. Treatment of Clostridium difficile diarrhoea with brewer’s yeast. Lancet 1994;343:171–2.
4. Surawicz CM, Elmer GW, Speelman P, et al. Prevention of antibiotic-associated diarrhea by Saccharomyces boulardii: A prospective study. Gastroenterol 1989;96:981–8.
5. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870–6 [review].
6. Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 256–8.
7. Freinberg N, Lite T. Adjunctive ascorbic acid administration in antibiotic therapy. J Dent Res 1957;36:260–2.
8. Yomoda M, Komai A, Hasimoto T. Sublamina densa-type linear IgA bullous dermatosis successfully treated with oral tetracycline and niacinamide. Br J Dermatol 1999;141:608–9.
9. Dragan L, Eng AM, Lam S, Persson T. Tetracycline and niacinamide: treatment alternatives in ocular cicatricial pemphigoid. Cutis 1999;63:181–3.
10. Berk MA, Lorincz AL. The treatment of bullous pemphigoid with tetracycline and niacinamide. A preliminary report. Arch Dermatol 1986;122:670–4.
11. Kawahara Y, Hashimoto T, Ohata K, Nishikawa T. Eleven cases of bullous pemphigoid treated with combination of minocycline and nicotinamide. Eur J Dermatol 1996;6:427–9.
12. Reiche L, Wojnarowska F, Mallon E. Combination therapy with nicotinamide and tetracyclines for cicatricial pemphigoid: further support for its efficacy. Clin Exp Dermatol 1998;23:254–7.
13. Peoples D, Fivenson DP. Linear IgA bullous dermatosis: successful treatment with tetracycline and nicotinamide. J Am Acad Dermatol 1992;26:498–9.
14. Chaffins ML, Collison D, Fivenson DP. Treatment of pemphigus and linear IgA dermatosis with nicotinamide and tetracycline: a review of 13 cases. J Am Acad Dermatol 1993;28:998–1000.
15. Shah SA, Ormerod AD. Dermatitis herpetiformis effectively treated with heparin, tetracycline and nicotinamide. Clin Exp Dermatol 2000;25:204–5.
16. Zemtsov A, Neldner KH. Successful treatment of dermatitis herpetiformis with tetracycline and nicotinamide in a patient unable to tolerate dapsone. J Am Acad Dermatol 1993;28:505–6.
17. Suzuki K, Fukushima T, Meguro K, et al. Intracranial hemorrhage in an infant owing to vitamin K deficiency despite prophylaxis. Childs Nerv Syst 1999;15:292–4.
18. Huilgol VR, Markus SL, Vakil NB. Antibiotic-induced iatrogenic hemobilia. Am J Gastroenterol 1997;92:706–7.
19. Bandrowsky T, Vorono AA, Borris TJ, Marcantoni HW. Amoxicllin-related postextraction bleeding in an anticoagulated patient with tranexamic acid rinses. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;82:610–2.
20. Kaiser CW, McAuliffe JD, Barth RJ, Lynch JA. Hypoprothrombinemia and hemorrhage in a surgical patient treated with cefotetan. Arch Surg 1991;126:524–5.
21. Conly J, Stein K. Reduction of vitamin K2 concentration in human liver associated with the use of broad spectrum antimicrobials. Clin Invest Med 1994;17:531–9.
22. Khin-Maung-U, Myo-Khin, Nyunt-Nyunt-Wai, et al. Clinical trial of berberine in acute watery diarrhoea. Br Med J 1985;291:1601–5.
23. Rabbani GH, Butler T, Knight J, et al. Randomized controlled trial of berberine sulfate therapy for diarrhea due to enterotoxigenic Escherichia coli and Vibrio cholerae. J Infect Dis 1987;155:979–84.
24. Threlkeld DS, ed. Anti-Infectives, Tetracyclines. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Dec 1989, 341–2f.
Copyright © 2002 VitaminLore, Inc. All rights reserved. www.VitaminLore.com
Please read the disclaimer about the limitations of the information provided here. Do NOT rely solely on the information in this article.
Click here Buy Vitamins and Nutritional Supplements at very low prices..
Buy Brand name Vitamins for less from www.vitaminlore.com. Safetychecker.
The information presented in VitaminLore is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.