This is a typical example of the situation where a lack of “hard evidence” is not synonymous with the possible lack of adverse effects. The phenomenon of drugs and vitamin D interactions is observed first and foremost in patients with comorbidity. The known factors affecting vitamin D metabolism interfere with cytochrome CYP3A4 activity. Therefore, all factors interfering with individual metabolic stages may affect 25-hydroxyvitamin D plasma concentration. Vitamin D status in geriatric population is an effect of joint interaction of all vitamin D metabolic pathways, aging processes and multimorbidity. In this group, low vitamin D plasma concentration is related to osteoporosis, osteomalacia, sarcopenia and myalgia. Vitamin D deficiency is common in elderly people, especially in patients with comorbidity and polypharmcy.
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