NutriStack
Lamotrigine and Vitamin D3, a synergy.
Unlike enzyme-inducing anticonvulsants (carbamazepine, phenytoin), lamotrigine has minimal effects on CYP-mediated vitamin D catabolism and does not appear to significantly impair bone mineral density. However, vitamin D deficiency is common in epilepsy patients regardless of specific anticonvulsant. Routine supplementation is recommended as a preventive measure, and lamotrigine does not interfere with vitamin D absorption or metabolism.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
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What the row says.
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At a glance
- Substances
- Lamotrigine and Vitamin D3
- Pair type
- Synergy
- Evidence (highest tier)
- Moderate
- 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 · Moderate evidence
Synergy
What is happening. Unlike enzyme-inducing anticonvulsants (carbamazepine, phenytoin), lamotrigine has minimal effects on CYP-mediated vitamin D catabolism and does not appear to significantly impair bone mineral density. However, vitamin D deficiency is common in epilepsy patients regardless of specific anticonvulsant. Routine supplementation is recommended as a preventive measure, and lamotrigine does not interfere with vitamin D absorption or metabolism.
Mechanism. Lamotrigine is primarily metabolized by UGT glucuronidation, not CYP enzymes, and therefore does not induce CYP3A4 or CYP24A1 pathways responsible for vitamin D catabolism. This distinguishes it from enzyme-inducing anticonvulsants that accelerate vitamin D metabolism to inactive metabolites.
Recommendation. Vitamin D3 supplementation (1000-2000 IU/day) is recommended as general preventive care for patients on anticonvulsant therapy, including lamotrigine. No timing separation is needed. Periodic 25-OH vitamin D level monitoring is advisable.
Sources (4)
- Mintzer S et al. Vitamin D levels and bone turnover in epilepsy patients taking carbamazepine or oxcarbazepine. Epilepsia. 2006;47(3):510-515. PMID 16529617
- 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 Lamotrigine 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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