does vitamin c interfere with chemotherapy

Erroneous interpretation of point-of-care blood glucometer readings were attributed to interference from high-dose IV vitamin C, resulting in a patient death and highlighting the potential for incorrect diagnosis of pseudohyperglycemia or pseudohypoglycemia(97). Pharmacologic doses of ascorbic acid repress specificity protein (Sp) transcription factors and Sp-regulated genes in colon cancer cells. Clinical research is needed to confirm if there are any PK interactions between imatinib and ginseng. : Randomized trial of antioxidant vitamins to prevent acute adverse effects of radiation therapy in head and neck cancer patients. : Effect of St John's wort on imatinib mesylate pharmacokinetics. Certain constituents of foods and dietary supplements (e.g., Some research has shown a dietary supplement/food and drug PK interaction between grapefruit juice and. WebChemotherapy drugs-- As an antioxidant, vitamin C may interfere with the effects of some drugs taken for chemotherapy. Vitamin C: Doxorubicin, cisplatin, vincristine, methotrexate, and imatinib: Dose-dependent decrease in apoptosis with all chemotherapeutic drugs tested: Animal study : Vitamin C: Bortezomib: Decreased bortezomibs anticancer activities: Animal study : Dl-alpha-tocopherol (vitamin E) Radiation therapy Vitamin C can affect the way this medication acts in your body. Int J Cardiol 49 (2): 173-7, 1995. What are the relevant mechanisms of action Improvements in physical, role, cognitive, emotional, and social functioning, as well as an improvement in overall health, were also Overall, the evidence is mixed and inconclusive. In addition, EGCG significantly impacted the formation of 4-hydroxytamoxifen. Another component involved in the metabolism and excretion of many drugs is the transport protein, P-glycoprotein (P-gp). Vitamin C is generally safe. 46) Focuses on the Drug Safety of Triptolide Preparations. The hypothesized mechanism for this interaction was inhibition of hepatic CYP3A4, the enzyme primarily responsible for metabolizing imatinib. Tell your healthcare providers about any dietary supplements youre taking, such as herbs, vitamins, minerals, and natural or home remedies. Does IVC interfere with chemotherapy or radiotherapy? Informa Healthcare, 2010, pp 402-10. To increase overall well-being and concentration. Oxalate Nephropathy Caused by Excessive Vitamin C Administration in 2 Patients With COVID-19. It is not clear whether vitamin C might have the unwanted effect of protecting tumor cells from cancer treatments or whether it might help protect normal tissues from getting damaged. In addition to the in vitro and in vivo EGCG and sunitinib study mentioned above, the same researchers published a case study that might demonstrate a possible adverse effect of green tea consumption with sunitinib treatment. Vitamin C: intravenous use by complementary and alternative medicine practitioners and adverse effects. Case reports: Intravenous During infusion (74)Common: Thirst and increased urinary flow.Isolated incidences: nausea/vomiting, rumbling or unpleasant fluttering in abdomen, chills, and/or headache.Post-infusion (74)Isolated incidences: Mental haze, increased leg edema lasting for a few days.Oxalate nephropathy: In critically ill patients who received intravenous vitamin C as supportive sepsis therapy(93)(94)(95).Factitious hyperglycemia: In a peritoneal dialysis patient receiving high-dose vitamin-C that persisted for 6 days after therapy discontinuation(96).Intratubular oxalate deposits: Attributed to high-dose vitamin C used as an immune booster in a kidney transplant patient who also had COVID-19(98).Methemoglobinemia and hemolytic anemia: In a 75-year-old woman with previously unrecognized G6PD deficiency, who had jaundice, dark urine, and shortness of breath after receiving 30 g of vitamin C infusion as an unconventional therapy for hemifacial spasm(99). The Effect of High-Dose Vitamin C on Biochemical Markers of Myocardial Injury in Coronary Artery Bypass Surgery. Antioxidants may protect cancer cells from being damaged by chemotherapy and radiation therapy. Dehydroascorbic acid, the oxidized form of vitamin C, may have cytoprotective effects by preserving mitochondrial membrane potential(38). Effect of High-Dose Zinc and Ascorbic Acid Supplementation vs Usual Care on Symptom Length and Reduction Among Ambulatory Patients With SARS-CoV-2 Infection: The COVID A to Z Randomized Clinical Trial. High-dose vitamin C has been touted by some as an effective alternative cancer treatment. Pharmacotherapy 24 (11): 1508-14, 2004. Ann Pharmacother 44 (5): 926-8, 2010. Expert Opin Drug Metab Toxicol 10 (3): 359-77, 2014. Hung WL, Suh JH, Wang Y: Chemistry and health effects of furanocoumarins in grapefruit. Effect of ascorbic acid on inflammatory markers after cardiothoracic surgery. Common treatment options for cancer, such as chemotherapy and radiation therapy, can be expensive and sometimes ineffective. Field HL, Monti DA, Greeson JM, et al. In large randomized trials, supplemental vitamin C did not reduce coronary heart disease risk(4)(5). Emadi N, Nemati MH, Ghorbani M, Allahyari E. Batista GMS, Rocha HNM, Storch AS, et al. Front Pharmacol 7: 402, 2016. Call us at 833-347-1665 to make an appointment. This is possibly because of EGCGs inhibitory effects on P-glycoprotein (Pgp). National Cancer Institute Mouly S, Lloret-Linares C, Sellier PO, et al. Cancer Chemother Pharmacol 68 (5): 1145-54, 2011. This regulates cell metabolism, epigenetics, growth, survival pathways, and even stem cell [PMID: 33079503]. Intravenously administered vitamin C as cancer therapy: three cases. There are several types of ginsengs. Images in this summary are used with permission of the author(s), artist, and/or publisher for use within the PDQ summaries only. These questions include: Do oncology patients have compromised vitamin C status? Pursuing basic and translational research across 9 programs and 100+ labs, Focusing on clinical cancer research and population health, Bridging the lab and the clinic through translational research, Fostering interdisciplinary collaborations between laboratory scientists and clinicians, Partnering with other academic and research institutions, Offering state-of-the-art resources for our researchers, Offering a curriculum with a focus on cancer, Connecting college seniors to future careers in biomedicine. A 2014 study with ten cancer patients investigated the PK interactions of docetaxel (135 mg IV for 60 min) in combination with SJW (300 mg orally for 14 days). Cancer Res 68 (19): 8031-8, 2008. Our highly-specialized educational programs shape leaders to be at the forefront of cancer care and research. : Ascorbic acid inhibits antitumor activity of bortezomib in vivo. The impact of green tea and EGCG on fluorouracil PK was studied in rats. Vitamin C PDQ is a registered trademark. Clairet AL, Boiteux-Jurain M, Curtit E, et al. Comparative effect of grape seed extract (. High-dose vitamin-C induced prolonged factitious hyperglycemia in a peritoneal dialysis patient: a case report. Chemotherapy alone vs. chemotherapy plus high dose multiple antioxidants in patients with advanced non small cell lung cancer. Deaths associated with ingesting these materials have been frequently reported. Vitamin C can worsen your condition. It is believed that this reaction was caused by EGCGs inhibitory effect on Pgp and CYP3A. [24] Specifically, celastrol inhibits five cytochrome P450 isoenzymes (CYP1A2, CYP2C19, CYP2D6, CYP2E1, and CYP3A4) in vitro. Pseudohyperglycemia Secondary to High-Dose Intravenous Vitamin C Managed as Diabetic Ketoacidosis: An Endocrinological Catastrophe. Added text to state that a 2016 study investigated the effects of a Scutellariae radix decoction on methotrexate pharmacokinetics in rats. Effects of Vitamin C on Organ Function in Cardiac Surgery Patients: A Systematic Review and Meta-Analysis. information about summary policies and the role of the PDQ Editorial Boards in Many drug interactions occur from the effects of the supplement on specific enzymes or on components involved in the PK of the drug, such as how the drug is metabolized and transported. [12], A 2012 study observed the effects of SJW on the PK of methotrexate in a rat animal model. More information about contacting us or receiving help with the Cancer.gov website can be found on our Contact Us for Help page. The study revealed an increased systemic methotrexate exposure when given together with the Scutellariae radix decoction. Vitamin C Vitamin C Vitamin B12 effectively reduced the toxic side effects of the main chemotherapy. [4], Some research has shown a dietary supplement/food and drug PK interaction between grapefruit juice and imatinib. Paine MF, Widmer WW, Hart HL, et al. Significant in patients with hematochromatosis(61).Chemotherapy drugs: Vitamin C may reduce the effectiveness of some antineoplastic agentsincluding vincristine, doxorubicin, methotrexate, cisplatin, and imatinib(38).Bortezomib: Ascorbic acid intake reduces the activity of bortezomib(62). This summary is written and maintained by the PDQ Integrative, Alternative, and Complementary Therapies Editorial Board, which is Supplemental and dietary vitamin E, beta-carotene, and vitamin C intakes and prostate cancer risk. High-dose vitamin C has been touted by some as an effective alternative cancer treatment. Biomed Chromatogr : e4264, 2018. The study revealed an increased systemic methotrexate exposure when given together with the Scutellariae radix decoction. Paul D, Surendran S, Chandrakala P, et al. Several recent studies have indicated that intravenous (IV) vitamin C alleviates a number of cancer- and chemotherapy-related symptoms, such as fatigue, insomnia, loss of appetite, nausea, and pain. Mathijssen RH, Verweij J, de Bruijn P, et al. Vitamin C Effect of Vitamin C Infusion on Organ Failure and Biomarkers of Inflammation and Vascular Injury in Patients With Sepsis and Severe Acute Respiratory Failure: The CITRIS-ALI Randomized Clinical Trial. Our scientists pursue every aspect of cancer researchfrom exploring the biology of genes and cells, to developing immune-based treatments, uncovering the causes of metastasis, and more. For an explanation of the scores and additional information about levels of evidence analysis, see Levels of Evidence for Human Studies of Integrative, Alternative, and Complementary Therapies. the literature and does not represent a policy statement of NCI or NIH. This content does not have an English version. Vitamin C: Doxorubicin, cisplatin, vincristine, methotrexate, and imatinib: Dose-dependent decrease in apoptosis with all chemotherapeutic drugs tested: Animal study : Vitamin C: Bortezomib: Decreased bortezomibs anticancer activities: Animal study : Dl-alpha-tocopherol (vitamin E) Radiation therapy The orthomolecular treatment of cancer. : Relevance of in vitro and clinical data for predicting CYP3A4-mediated herb-drug interactions in cancer patients. [15] The second study found that SJW use caused a 43% increase in the clearance of imatinib and a 30% decrease in AUC. A few small trials suggest vitamin C along with other supplements may reduce some cancer therapy-induced side effects(75)(76), but older trials in advanced cancer patients using 10 g per day of oral vitamin C did not yield significant benefit(29)(30). Vitamin C transporter Slc23a1 links renal reabsorption, vitamin C tissue accumulation, and perinatal survival in mice. More research is needed with human clinical trials, but these results suggest a possible interaction between wogonin and docetaxel. Ascorbate decreases colon cancer cell proliferation by downregulating specificity proteins(48). In another small study, 9 people with advanced pancreatic cancer were given chemotherapy once a week for 3 weeks along with IV vitamin C twice a week for 4 weeks during each treatment cycle. : Pharmacokinetic properties of wogonin and its herb-drug interactions with docetaxel in rats with mammary tumors. The results showed that there was an increase in the bioavailability of imatinib with vitamins A, E , and D, and a decrease in the bioavailability of imatinib with vitamin C.[2], A study that examined the oxidized form of ascorbate, dehydroascorbate, as a complementary supplement with chemotherapeutic drugs (i.e., doxorubicin, cisplatin, vincristine, methotrexate, and imatinib) initially found that dehydroascorbate given before doxorubicin treatment caused a reduction of therapeutic efficacy in mice with lymphoma (RL) cellderived xenogeneic tumors, This form of ascorbate is not generally available as a dietary supplement and is not used clinically, and it has different properties and pharmacology from unoxidized or reduced ascorbate; thus, the potential clinical implications of these findings are unknown. Currently, research on dietary supplement and cancer drug PK interactions is limited, but there is evidence for several possible interactions and adverse reactions.[1-3]. J Chromatogr B Analyt Technol Biomed Life Sci 1049-1050: 30-40, 2017. Ascorbic-acid-induced haemolysis in G-6-PD deficiency. Effect of vitamin C on lipidperoxidation and antioxidant status in tamoxifen-treated breast cancer patients. Ascorbic acid reduces blood pressure and arterial stiffness in type 2 diabetes. Memorial Sloan Kettering Cancer Center makes no warranties nor express or implied representations whatsoever regarding the accuracy, completeness, timeliness, comparative or controversial nature, or usefulness of any information contained or referenced on this Web site. Vitamin C High-dose vitamin C also appeared to suppress metastasis of breast cancer cells by inhibiting epithelial-mesenchymal transition(82). : Epigallocatechin Gallate (EGCG) is the most effective cancer chemopreventive polyphenol in green tea. Interactions : CYP3A4 inducer and inhibitor strongly affect the pharmacokinetics of triptolide and its derivative in rats. Food Chem Toxicol 49 (6): 1410-5, 2011. Because dietary supplements are not formally reviewed for manufacturing consistency, ingredients may vary considerably from lot to lot and there is no guarantee that ingredients claimed on product labels are present (or are present in the specified amounts). This content does not have an Arabic version. : Effect of green tea on pharmacokinetics of 5-fluorouracil in rats and pharmacodynamics in human cell lines in vitro. WebChemotherapy drugs-- As an antioxidant, vitamin C may interfere with the effects of some drugs taken for chemotherapy. Experimental Design Although increased chemotherapy-associated adverse effects have been observed with inadequate vitamin C intake(41), there are also theories against the use of vitamin C supplements during treatment. Vitamin C-Induced Oxalate Nephropathy in a Septic Patient. Its effect on the common cold is generally minimal(2), and high-dose vitamin C alone or with high-dose zinc did not decrease SARS-CoV-2 symptoms(90). What food you eat and which supplements you take is a decision you make. These two interactions are between SJW and both irinotecan and imatinib. The investigators found that in rats receiving oral wogonin and docetaxel, the area under the concentration versus time curve (AUC), initial peak serum concentration (Cmax), and half-life for docetaxel increased. PHY906, a patented formula derived from Huang Qin Tang, is being studied as a potential adjuvant for cancer therapy; there is some evidence that this herbal mixture potentiates the anticancer effects of certain cancer drugs such as sorafenib. Experimental Design However, it's not clear whether this protective effect is related to the vitamin C content in the food. Dietary antioxidants and primary prevention of age related macular degeneration: systematic review and meta-analysis. High dose Vitamin C and/or a diet / nutrition rich in Vitamin C given along with chemotherapy may improve overall response and decrease chemotherapy associated side-effects in colorectal cancer or gastric cancer. However, high-dose IV vitamin C as an anticancer treatment(34)(36) should be considered an investigational drug used only in clinical trial settings, as it did not improve survival in patients with metastatic colorectal cancer(100), sepsis studies have not found benefit(84)(85)(91)(92), and adverse events(93)(94)(95)(101), and interference with glucometer readings(96)(97) have been reported. Do not contact the individual Board Members with questions or comments about the summaries. Though these hazard ratios are not statistically significant, they both trended in the same direction as those seen in the previous study. Vitamin C (Ascorbic acid What are the relevant mechanisms of action Reporting and studying these interactions is important, so health care professionals can help patients navigate CAM usage with standard cancer therapies, thus avoiding preventable adverse outcomes. Currently, the evidence for the clinical efficacy of SJW is varied, but there have been reports of interactions and adverse effects with several drugs. J Clin Oncol 23 (24): 5805-13, 2005. replace or update an existing article that is already cited. : A randomized trial of antioxidant vitamins to prevent second primary cancers in head and neck cancer patients. Vitamin C Bilgi N, Bell K, Ananthakrishnan AN, et al. Goey AK, Mooiman KD, Beijnen JH, et al. Vitamin C pharmacokinetics: implications for oral and intravenous use. Du GJ, Zhang Z, Wen XD, et al. Vitamin C Antioxidant vitamins intake and the risk of coronary heart disease: meta-analysis of cohort studies. These designations are intended to help readers assess the strength of the evidence supporting the use of specific interventions or approaches. This content does not have an Arabic version. [3-5], Ginseng was suspected of being responsible for an incident of hepatotoxicity that occurred in a 26-year-old male taking imatinib. Permission to use images outside the context of PDQ information must be obtained from the owner(s) and cannot be granted by the National Cancer Institute. Vitamin C can interfere Pharmacol Res 118: 82-92, 2017. Vitamin C in Advanced-Stage Cancer Patients This interaction is also thought to be caused by the impact of SJW on CYP3A4, the major enzyme that metabolizes imatinib. vitamin C Vitamin C Xu Y, Zhang YF, Chen XY, et al. This Web site Information About Herbs, Botanicals and Other Products is for general health information only. 2023 Memorial Sloan Kettering Cancer Center, Human Oncology & Pathogenesis Program (HOPP), Gerstner Sloan Kettering Graduate School of Biomedical Sciences, High school & undergraduate summer programs, Integrative Medicine at Home Membership Program. Oral vitamin C supplementation to patients with myeloid cancer on azacitidine treatment: Normalization of plasma vitamin C induces epigenetic changes. EGCG blocked bortezomibs protease inhibitory function by binding to the boronic acid structure in bortezomib, causing the inability to induce cancer cell death and consequently blocking its anticancer abilities. WebTheoretically anything is possible, and it is certainly possible that taking vitamin C might prevent the toxic beneficial effect of chemotherapy. This will help them manage your care and keep you safe. new information becomes available. High-Dose Parenteral Ascorbate Enhanced Chemosensitivity of Ovarian Cancer and Reduced Toxicity of Chemotherapy. Investigation of the role of extracellular H2O2 and transition metal ions in the genotoxic action of ascorbic acid in cell culture models. : The effect of St John's wort on the pharmacokinetics of docetaxel. Jia L, Soldati F: Ginseng, Asian. Cancer. at the National Institutes of Health, An official website of the United States government, Complementary & Alternative Medicine (CAM), Cancer Therapy Interactions With Foods and Dietary Supplements (PDQ)Health Professional Version, Foods, Dietary Supplements, and Cancer Drug Interaction Tables, Summary of the Evidence for Cancer Therapy Interactions With Foods and Dietary Supplements, Levels of Evidence for Human Studies of Integrative, Alternative, and Complementary Therapies, PDQ Integrative, Alternative, and Complementary Therapies Editorial Board, PDQ Cancer Information for Health Professionals, https://www.cancer.gov/about-cancer/treatment/cam/hp/dietary-interactions-pdq, U.S. Department of Health and Human Services, Increased activity of CYP3A4 and decreased AUC of active, Increased clearance and decreased AUC of imatinib, Increased clearance and decreased AUC of docetaxel, Decreased AUC and oral bioavailability of erlotinib, Decreased AUC and oral bioavailability of lapatinib, Increased plasma concentration of irinotecan and decreased, May increase plasma levels of imatinib by inhibiting CYP3A4, Decreased AUC and bioavailability of etoposide, Increased AUC of drug and exposure to both drug and herb, AUC = area under the concentration versus time curve; C, Increased clearance and decrease AUC of docetaxel, Increased activity of CYP3A4 and decreased AUC of active metabolite SN38, Increased plasma concentration of irinotecan and decreased hepatobiliary excretion of drug and its metabolite SN-38, May decrease plasma concentrations of ixabepilone, Decreased oral bioavailability of palbociclib, Decreased drug absorption and bioavailability of sunitinib, Decreased bortezomibs anticancer activities, Decreased anticancer effect by neutralizing effects of bortezomib, Research on dietary supplement and cancer drug. changes made to this summary as of the date above. Some common dietary antioxidants include the following: Numerous anticancer agents generate reactive oxygen species, which cause decreased levels of antioxidants, deoxyribonucleic acid damage, and cancer cell death. Vitamin C Ready to start planning your care? We don't want to "protect" cancer cells. vitamin C Oncologist 11 (7): 742-52, 2006 Jul-Aug. Ozben T: Antioxidant supplementation on cancer risk and during cancer therapy: an update. Vitamin C for preventing and treating the common cold. For more information, read the What else do I need to know? section below. Vitamin C can interfere A randomized factorial trial of vitamins C and E and beta carotene in the secondary prevention of cardiovascular events in women: results from the Womens Antioxidant Cardiovascular Study. Ru Y, Luo Y, Zhou Y, et al. Failure of high-dose vitamin C (ascorbic acid) therapy to benefit patients with advanced cancer. In using this website you agree that neither Memorial Sloan Kettering nor any other party is or will be liable or otherwise responsible for any decision made or any action taken or any action not taken due to your use of any information presented at this website. Cancer Chemother Pharmacol 67 (3): 695-703, 2011. Smith P, Bullock JM, Booker BM, et al. : Adverse Events Associated With Treatment of Tripterygium wilfordii Hook F: A Quantitative Evidence Synthesis. Changes to This Summary (06/17/2022) About This PDQ Summary Overview This cancer information summary provides an overview of the use of intravenous (IV) vitamin C (also known as ascorbate or L- ascorbic acid) as a Experimental Design Lack of long-term effect of vitamin C supplementation on blood pressure. Restoration of TET2 Function Blocks Aberrant Self-Renewal and Leukemia Progression. Bortezomibs cancer cell apoptosis-inducing effect was completely prevented with intragastric EGCG administration (50 mg/kg). Your body cant make vitamin C on its own so you need to get it from food. What are the potential uses and benefits? Taking oral vitamin C supplements doesn't appear to offer the same benefit. Avicenna J Phytomed 6 (2): 149-64, 2016 Mar-Apr. This theory is supported by a 2019 study published in The American Journal of Clinical Nutrition. Vitamin C J Natl Cancer Inst 94 (16): 1247-9, 2002. Kidney transplant dysfunction in a patient with COVID -19 infection: role of concurrent Sars-Cov 2 nephropathy, chronic rejection and vitamin C-mediated hyperoxalosis: case report. At pharmacologic plasma concentrations of 0.320 mM via IV injection, ascorbic acid is oxidized to an ascorbate radical which acts as a prodrug for hydrogen peroxide formation within interstitial fluids(32)(33). [14], A 2019 study evaluated the effects of green tea extract on the PK of palbociclib in a rat animal model. Any questions regarding your own health should be addressed to your own physician or other healthcare provider. Abstract Purpose Vitamin C is an antioxidant vitamin that has been hypothesized to antagonize the effects of reactive oxygen species-generating antineoplastic drugs. : Influence of green tea consumption on endoxifen steady-state concentration in breast cancer patients treated with tamoxifen. In this review, we analyze the state of art of the effect of vitamin C on cancer cells in vitro and in vivo, and relate it to the capacity of cancer cells in acquiring, metabolize and compartmentalize this nutrient, with its implications on the potential therapeutic role of vitamin C in cancer. This content does not have an Arabic version. National Medical Products Administration, 2012. It does not provide formal guidelines or recommendations for making health care decisions. Vitamin C Vitamin C is concentrated in most immune cells which support essential immune functions such as enzyme cofactors for Fe- or Cu- containing oxygenase. Wang CZ, Yuan CS: Ginseng, American. Daily intake of 100 mg ascorbic acid as urinary tract infection prophylactic agent during pregnancy. Various herbs and dietary supplements are known to influence the PK of certain drugs, such as St. Johns wort. Drugs for preventing lung cancer in healthy people. Enhanced antitumor activity of vitamin C via p53 in cancer cells. : Encyclopedia of Dietary Supplements. [1] There is insufficient information for many specific antioxidant supplements to determine if they are safe and effective as a complementary therapy to standard cancer treatment. [5], An interaction has been observed between grapefruit juice and etoposide. Li T, Li N, Guo Q, et al. Is intravenous the optimal route of vitamin C administration? The summary reflects an independent review of High-dose intravenous vitamin C combined with cytotoxic chemotherapy in patients with advanced cancer: a phase I-II clinical trial. This summary contains the following key information: For adult cancer patients in the United States, the frequency of complementary and alternative medicine (CAM) use is approximately 36%. Int J Psychiatry Med 30 (3): 203-19, 2000. In the same way when one buys a lottery ticket, it is possible they may win. Taking oral vitamin C supplements doesn't appear to offer the same benefit. People confuse these two terms, which is why lotteries are so popular. Vitamin C can interfere Informa Healthcare, 2010, pp 348-62. Patients with a history of oxalate kidney stones, renal insufficiency, hematochromatosis, or those undergoing chemotherapy should consult their physicians before taking vitamin C supplements. Ziaei S, Halaby R: Immunosuppressive, anti-inflammatory and anti-cancer properties of triptolide: A mini review.
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