An atlas of drug-nutrient interactions at the scale of a national pharmacopoeia: a protocol for classifying 664 molecules into three supplementation outcomes

This atlas links every long-term medication in the French national formulary to a documented conclusion on whether nutritional supplementation is warranted. The 8,193 product names in the ANSM repository were normalised and reduced to 664 molecules identified by their International Nonproprietary Name. Each molecule was assessed through an ordered cascade of five criteria: mechanistic plausibility, depletion measured in treated humans, magnitude and clinical relevance, quality of evidence, and the existence of a documented corrective form and dose. The literature reviewed covers PubMed and PubMed Central, systematic reviews and the positions of authorities (FDA, NIH ODS, EFSA). Each molecule receives a single, mutually exclusive outcome: our reference (31 molecules, 4.7%), third-party guidance (59 molecules, 8.9%, with the active ingredient and form indicated without any commercial link) or nothing to add (574 molecules, 86.4%). The dominance of the negative conclusion is the main result: applied with demanding criteria, the exercise concludes that no supplementation is warranted in 86.4% of cases. The article also shows that the boundary between the two positive outcomes is commercial rather than evidential, and submits the method to criticism.