Drug-Induced Nutrient Depletion in Palliative Care Patients: Clinical Implications and Management

Drug-Induced Nutrient Deficiencies are an important but often underappreciated adverse effect of long-term pharmacotherapies. A wide variety of medications are known to affect the absorption, metabolism, distribution, or excretion of key vitamins and minerals, including proton pump inhibitors, metformin, diuretics, anticonvulsants, antibiotics, corticosteroids, and oral contraceptives. Disturbances in vitamin B12, folate, vitamin D, calcium, magnesium, potassium, and fat-soluble vitamins are among nutrients that commonly result in clinically significant deficiencies. Although these nutrient deficiencies often develop slowly, they have the potential to cause significant disease. Patients at highest risk include the elderly, individuals with chronic diseases, those receiving multiple medications, and patients on prolonged therapy with agents known to induce nutrient losses. It is important to ensure early identification by targeted screening, education of the patient, and routine monitoring to prevent complications. Nutrient assessment as part of therapeutic planning enables clinicians to predict the likelihood of deficiencies even before symptoms become evident. This review synthesizes current evidence of medications most commonly associated with nutrient depletion, outlines key mechanistic pathways, and discusses clinical implications related to patient care. It also underlines strategies for monitoring and managing nutrient deficiencies, putting particular emphasis on the healthcare professional's role, especially clinical pharmacists in optimizing therapy and avoiding adverse outcomes. Greater awareness regarding drug-induced nutrient deficiencies will lead to improved medication safety and management that is holistic in its approach to patients. Identifying at-risk individuals, instituting preventative measures, and incorporating nutritional considerations into pharmacotherapy may yield significant improvements in overall treatment outcomes. These deficiencies are particularly significant in palliative care settings, where polypharmacy and chronic illness increase vulnerability, making early recognition essential for improving quality of life.