Medication·Interactions & depletion·Reviewed June 9, 2026
Carbamazepine interactions.
Carbamazepine has 8 documented interactions in the NutriStack database, including 2 flagged to avoid or as a serious conflict. Prolonged use is also associated with lower Folate, Vitamin D, Calcium, and Vitamin K. The full interaction list, depletion table, and replacement suggestions are below. None of this is a substitute for your prescriber's advice.
Carbamazepine at a glance.
A quick, data-grounded summary. The full tables are below.
Carbamazepine has 8 documented interactions in the NutriStack database, including 2 flagged to avoid or as a serious conflict. Prolonged use is also associated with lower Folate, Vitamin D, Calcium, and Vitamin K. The full interaction list, depletion table, and replacement suggestions are below. None of this is a substitute for your prescriber's advice.
Substances that interact with carbamazepine.
Every supplement and medication in the NutriStack database with a documented interaction with this drug, highest-severity first. Open any pair for the mechanism and sources.
| Substance | Interaction | What happens |
|---|---|---|
| Ginkgo Biloba | Conflict | Ginkgo biloba has case reports of precipitating seizures in people with previously controlled epilepsy. That directly conflicts with carbamazepine's... |
| St. John's Wort | Conflict | Both carbamazepine and St. John's Wort are potent CYP3A4 inducers. Combining them creates unpredictable effects on drug metabolism, potentially... details → |
| Phenytoin | Caution | Both are potent CYP enzyme inducers that affect each other's metabolism. Phenytoin can decrease carbamazepine levels, while carbamazepine can... details → |
| Vitamin B9 | Caution | Carbamazepine reduces folate levels by inhibiting intestinal absorption and increasing hepatic folate catabolism. Folate deficiency can cause... details → |
| Calcium | Synergy | Long-term carbamazepine therapy is associated with adverse bone-mineral effects and higher fracture risk, especially when vitamin D or calcium... details → |
| Methylfolate | Synergy | Carbamazepine depletes folate through enzyme induction effects on folate metabolism. Folate deficiency during carbamazepine therapy can cause... details → |
| Vitamin B6 | Synergy | Carbamazepine and other enzyme-inducing antiseizure drugs have been linked with lower vitamin B6 status. Low B6 can contribute to high homocysteine... details → |
| Vitamin D3 | Synergy | Carbamazepine induces CYP enzymes that accelerate vitamin D metabolism, leading to deficiency, reduced calcium absorption, and increased... details → |
What carbamazepine can deplete.
Nutrients this medication is associated with lowering over time, with the mechanism, a suggested replacement where one applies, and the biomarker to monitor. Discuss any replacement with your prescriber first.
| Nutrient | Severity | How it happens | Replace with | Monitor |
|---|---|---|---|---|
| Folate | Significant | Carbamazepine lowers folate through enzyme induction and altered intestinal handling during chronic therapy. | Methylfolate | Serum folate or RBC folate |
| Vitamin D | Significant | Enzyme induction increases vitamin D breakdown, contributing to osteopenia with long-term use. | Vitamin D3 | 25-OH vitamin D |
| Calcium | Significant | Reduced vitamin D activity and chronic anticonvulsant use lower calcium balance and bone density. | Calcium | Serum calcium or bone density trend |
| Vitamin K | Moderate | Long-term anticonvulsant enzyme induction may impair vitamin K-dependent pathways in susceptible users. | Vitamin K2 | Undercarboxylated osteocalcin or clinical assessment |
| Biotin | Moderate | Chronic carbamazepine use has been associated with lower biotin status. | Vitamin B7 | Clinical assessment |
The full carbamazepine profile.
Uses, typical dosing, side effects, and the cited evidence for this medication.
Common carbamazepine questions.
Quick answers drawn from the tables above.
What interacts with Carbamazepine?
In the NutriStack database, Carbamazepine has 8 documented interactions. The most notable include Ginkgo Biloba, St. John's Wort, Phenytoin, Vitamin B9, and Calcium. Check any specific combination before taking it and confirm with your prescriber.
Which substances should I avoid with Carbamazepine?
Carbamazepine is flagged against 2 substances in the database, including Ginkgo Biloba and St. John's Wort. These pairings carry a higher risk and should be reviewed with a clinician before combining.
Does Carbamazepine deplete any nutrients?
Carbamazepine is associated with lowering Folate, Vitamin D, Calcium, Vitamin K, and Biotin with prolonged use. Useful biomarkers to monitor include Serum folate or RBC folate, 25-OH vitamin D, and Serum calcium or bone density trend. Ask your prescriber before adding any replacement supplement.
Is it safe to take Ginkgo Biloba with Carbamazepine?
NutriStack classifies the Ginkgo Biloba and Carbamazepine pairing as conflict: Ginkgo biloba has case reports of precipitating seizures in people with previously controlled epilepsy. That directly conflicts with carbamazepine's purpose when it is... Avoid ginkgo biloba if you take carbamazepine for epilepsy or have any seizure history. If you already started ginkgo and notice breakthrough... Always confirm with your prescriber.
Check your whole stack
See how carbamazepine fits your supplements.
NutriStack screens your full routine for interactions and depletions, and updates the moment you change it.