NutriStack
Carbamazepine and Vitamin B6, a synergy.
Carbamazepine and other enzyme-inducing antiseizure drugs have been linked with lower vitamin B6 status. Low B6 can contribute to high homocysteine and may worsen neuropathy or other deficiency symptoms in vulnerable patients. The concern is greatest with long-term therapy, restricted diets, alcohol misuse, pregnancy, or multiple B-vitamin deficiencies.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
Same shape as the other 1,729 pairs in the public database.
From the interaction database
What the row says.
Every entry follows the same shape: what is happening, the mechanism, the recommendation, and the primary literature.
At a glance
- Substances
- Carbamazepine and Vitamin B6
- Pair type
- Synergy
- Evidence (highest tier)
- Moderate
- Source citations
- 2 sources
- Stack Score effect
- +2 to your Stack Score (per scored synergy row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Synergy · Moderate evidence
Synergy
What is happening. Carbamazepine and other enzyme-inducing antiseizure drugs have been linked with lower vitamin B6 status. Low B6 can contribute to high homocysteine and may worsen neuropathy or other deficiency symptoms in vulnerable patients. The concern is greatest with long-term therapy, restricted diets, alcohol misuse, pregnancy, or multiple B-vitamin deficiencies.
Mechanism. Carbamazepine is an enzyme-inducing antiseizure medication and has been associated with reduced pyridoxal-5-phosphate, the active form of vitamin B6. B6 is a cofactor in homocysteine metabolism, so deficiency can contribute to elevated homocysteine.
Recommendation. Ask about checking B-vitamin status or homocysteine if you take carbamazepine long term or have neuropathy, anemia, or cardiovascular risk factors. Use standard-dose B6 unless your clinician recommends otherwise. Avoid chronic high-dose B6 because it can itself cause nerve toxicity.
Sources (2)
- Mintzer S, Skidmore CT, Sperling MR. B-vitamin deficiency in patients treated with antiepileptic drugs. Epilepsy Behav. 2012;24(3):341-344. PMID 22658435
- Attilakos A, Papakonstantinou E, Schulpis K, Voudris K, Katsarou E, Mastroyianni S, et al. Early effect of sodium valproate and carbamazepine monotherapy on homocysteine metabolism in children with epilepsy. Epilepsy Res. 2006;71(2-3):229-232. PMID 16889940
Stack Score
How this pair moves the number.
Effect on the composite score
If both Carbamazepine and Vitamin B6 are in the same stack, this pair applies +2 to your Stack Score (per scored synergy row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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