Medication·Interactions & depletion·Reviewed June 9, 2026
Zonisamide interactions.
Zonisamide has 4 documented interactions in the NutriStack database. Prolonged use is also associated with lower Bicarbonate and Folate. The full interaction list, depletion table, and replacement suggestions are below. None of this is a substitute for your prescriber's advice.
Zonisamide at a glance.
A quick, data-grounded summary. The full tables are below.
Zonisamide has 4 documented interactions in the NutriStack database. Prolonged use is also associated with lower Bicarbonate and Folate. 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 zonisamide.
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 | Caution | Ginkgo has seizure case reports and may undermine antiseizure therapy. |
| Melatonin | Caution | Melatonin can add to zonisamide-related somnolence, dizziness, or cognitive slowing. |
| Potassium | Caution | Potassium citrate or alkali therapy may be used medically for acidosis or stones, but unsupervised potassium can be unsafe. |
| Vitamin C | Caution | High-dose vitamin C can increase urinary oxalate in some patients. Zonisamide increases kidney stone risk. |
What zonisamide 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 |
|---|---|---|---|---|
| Bicarbonate | Significant | Carbonic anhydrase inhibition increases renal bicarbonate loss, producing a non-anion-gap metabolic acidosis with reduced serum bicarbonate. | Clinician-directed alkali therapy such as potassium citrate only when indicated | Serum bicarbonate and electrolytes |
| Folate | Mild | Long-term antiseizure therapy has been associated with reduced folate status in some patients; the evidence is stronger for older enzyme-inducing... | Methylfolate | CBC, serum folate, red blood cell folate, and homocysteine |
The full zonisamide profile.
Uses, typical dosing, side effects, and the cited evidence for this medication.
Common zonisamide questions.
Quick answers drawn from the tables above.
What interacts with Zonisamide?
In the NutriStack database, Zonisamide has 4 documented interactions. The most notable include Ginkgo Biloba, Melatonin, Potassium, and Vitamin C. Check any specific combination before taking it and confirm with your prescriber.
Does Zonisamide deplete any nutrients?
Zonisamide is associated with lowering Bicarbonate and Folate with prolonged use. Useful biomarkers to monitor include Serum bicarbonate and electrolytes and CBC, serum folate, red blood cell folate, and homocysteine. Ask your prescriber before adding any replacement supplement.
Is it safe to take Ginkgo Biloba with Zonisamide?
NutriStack classifies the Ginkgo Biloba and Zonisamide pairing as caution: Ginkgo has seizure case reports and may undermine antiseizure therapy. Avoid ginkgo in people using zonisamide for seizures unless the neurologist approves. Always confirm with your prescriber.
Check your whole stack
See how zonisamide fits your supplements.
NutriStack screens your full routine for interactions and depletions, and updates the moment you change it.