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Calcium supplements: Do they interfere with blood pressure drugs?
By Mayo Clinic staffOriginal Article: http://www.mayoclinic.com/health/calcium-supplements/AN01871
- With Mayo Clinic emeritus hypertension specialist
Sheldon G. Sheps, M.D.
read biographyclose windowBiography of
Sheldon G. Sheps, M.D.
Sheldon Sheps, M.D.
Dr. Sheldon Sheps, emeritus professor of medicine and former chair of the Division of Nephrology and Hypertension in the Department of Medicine at Mayo Clinic, has been with Mayo Clinic since 1960.
Dr. Sheps, a Winnipeg, Manitoba, native, is board certified in internal medicine and specializes in hypertension and peripheral vascular diseases. He developed a multidisciplinary approach with specially trained nurses, dietitians, technicians and educators to help form a team approach to the treatment of patients with abnormal blood pressure.
"I have always believed in involving the patient and family in their health care," Dr. Sheps says. "I have asked for their understanding of the illness and issues and for participation in decisions. The Web is a natural extension of that, and now many more people can be informed."
Dr. Sheps chaired the sixth working group, and he participated in the fourth, fifth and seventh groups that developed the then-latest guidelines for hypertension under the auspices of the National Heart, Lung, and Blood Institute (NHLBI). He helped write the latest American Heart Association (AHA) report on blood pressure measurement. He chaired an AHA group that produced an online accreditation for blood pressure measurement for health professionals.
Dr. Sheps has co-authored books, newsletters, CD-ROMs and other Mayo Clinic health information material. He joined Mayo Clinic's Web team in 1998. He was medical editor-in-chief of both editions of the "Mayo Clinic on High Blood Pressure" book; the last edition was published in 2003. He was also medical editor-in-chief of "Mayo Clinic 5 Steps to Controlling High Blood Pressure," published in 2008.
In addition, Dr. Sheps was section editor for each of the first three editions of "Hypertension Primer" for the American Heart Association.
Dr. Sheps was also chairman of the Science Base Subcommittee and the National High Blood Pressure Education Program, and he was a consultant to the Hypertension Initiative of the World Health Organization. In 1997, he was honored with the Individual Achievement Award on the 25th anniversary of the National High Blood Pressure Education Program of NHLBI. In 2009, he was honored as a Distinguished Mayo Alumnus.
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Question
Calcium supplements: Do they interfere with blood pressure drugs?
Is it true that calcium supplements may interact with blood pressure medications?
Answer
from Sheldon G. Sheps, M.D.
Yes. In large amounts, calcium supplements may interact with some blood pressure medications. Interactions may occur with:
- Thiazide diuretics. Taking 1,500 milligrams (mg) or more of calcium with thiazide diuretics — such as chlorothiazide (Diuril), hydrochlorothiazide (Microzide, Oretic) and indapamide — can result in milk-alkali syndrome, a serious condition. In general, avoid taking more than 1,500 mg of calcium (supplements and food sources combined) a day if you're taking a thiazide diuretic (also referred to as water pills). If you take calcium supplements while taking a thiazide diuretic, talk to your doctor about the appropriate dose and have your blood pressure and calcium levels checked.
- Calcium channel blockers. When given through an intravenous (IV) line, calcium may decrease the effects of calcium channel blockers, such as nifedipine (Adalat CC, Afeditab CR, Procardia), verapamil (Calan, Covera HS, Veralan), diltiazem (Cardizem, Cartia XT, Dilacor XR, others) and others. In fact, IV calcium is used to help reverse calcium channel blocker overdose. There's no evidence that oral calcium supplements interfere with calcium channel blockers. To be safe, check your blood pressure regularly if taking calcium channel blockers and calcium supplements at the same time.
Calcium supplements don't appear to interact with other commonly prescribed blood pressure medications, such as:
- Beta blockers bisoprolol (Zebeta), propranolol (Inderal, Innopran XL) and others
- Angiotensin-converting enzyme (ACE) inhibitors, such as captopril (Capoten), lisinopril (Prinivil, Zestril) and others
- Angiotensin II receptor blockers, such as losartan (Cozaar), valsartan (Diovan), and others
- Renin inhibitors, such as aliskiren (Tekturna)
Talk to your doctor if you take high blood pressure medications and calcium supplements and are concerned about interactions.
Next questionDiuretics: A cause of low potassium?
- Calcium. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed May 28, 2012.
- Calcium and egg shell. Micromedex Healthcare Series. http://www.micromedex.com. Accessed May 31, 2012.
- Bisoprolol. Micromedex Healthcare Series. http://www.micromedex.com. Accessed May 31, 2012.
- Propranolol. Micromedex Healthcare Series. http://www.micromedex.com. Accessed May 31, 2012.
- Captopril. Micromedex Healthcare Series. http://www.micromedex.com. Accessed May 31, 2012.
- Lisinopril. Micromedex Healthcare Series. http://www.micromedex.com. Accessed May 31, 2012.
- Losartan. Micromedex Healthcare Series. http://www.micromedex.com. Accessed May 31, 2012.
- Valsartan. Micromedex Healthcare Series. http://www.micromedex.com. Accessed May 31, 2012.
- Aliskiren. Micromedex Healthcare Series. http://www.micromedex.com. Accessed May 31, 2012.
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