NutriStack
Carbamazepine and Vitamin D3, a synergy.
Carbamazepine induces CYP enzymes that accelerate vitamin D metabolism, leading to deficiency, reduced calcium absorption, and increased osteoporosis risk. Vitamin D supplementation is recommended for all patients on chronic carbamazepine therapy.
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 D3
- Pair type
- Synergy
- Evidence (highest tier)
- Strong
- Source citations
- 4 sources
- Stack Score effect
- +2 to your Stack Score (per scored synergy row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Synergy · Strong evidence
Synergy
What is happening. Carbamazepine induces CYP enzymes that accelerate vitamin D metabolism, leading to deficiency, reduced calcium absorption, and increased osteoporosis risk. Vitamin D supplementation is recommended for all patients on chronic carbamazepine therapy.
Mechanism. Carbamazepine induces CYP3A4 and CYP24A1, increasing the catabolism of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D to inactive polar metabolites. This enzyme induction can reduce vitamin D half-life significantly, requiring higher supplemental doses to maintain adequate levels.
Recommendation. Supplement with vitamin D3 (1000-4000 IU/day) during long-term carbamazepine therapy. Monitor 25-OH vitamin D levels and adjust doses accordingly. Higher doses may be needed due to accelerated vitamin D catabolism.
Sources (4)
- Pack AM, Morrell MJ. Epilepsy and bone health in adults. Epilepsy Behav. 2004;5(Suppl 2):S24-S29. PMID 15123009
- Zhang Y, Fang F, Tang J et al.. Association between vitamin D supplementation and mortality: systematic review and meta-analysis.. BMJ. 2019. PMID 31405892
- Chang MC, Choo YJ. Effects of Whey Protein, Leucine, and Vitamin D Supplementation in Patients with Sarcopenia: A Systematic Review and Meta-Analysis.. Nutrients. 2023. PMID 36771225
- Fiamenghi VI, Mello ED. Vitamin D deficiency in children and adolescents with obesity: a meta-analysis.. Jornal de pediatria. 2021. PMID 33022267
Stack Score
How this pair moves the number.
Effect on the composite score
If both Carbamazepine and Vitamin D3 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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