Dosing & Uses
Dosage Forms & Strengths
folic acid/cyanocobalamin/pyridoxine
capsule
- 1mg/0.4mg/50mg
tablet
- 2.5mg/1mg/25mg
- 2.3mg/2mg/24.5mg
- 2.2mg/1mg/25mg
- 2.5mg/2mg/25mg
- 2.2mg/0.5mg/25mg
- 0.8mg/0.115mg/10mg
Daily Dietary Supplement
1-2 tab/cap PO qDay, or as recommended by healthcare professional
Safety and efficacy not established
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (2)
- pafolacianine
folic acid decreases effects of pafolacianine by receptor binding competition. Avoid or Use Alternate Drug. Avoid coadministration with folic acid or folic acid-containing supplements for 48 hr before administering pafolacianine. Use of folate, folic acid, or folate-containing supplements may reduce binding of pafolacianine to folate receptors overexpressed on ovarian cancer cells and could reduce the detection of malignant lesions with. .
- selinexor
selinexor, pyridoxine. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.
Monitor Closely (14)
- azithromycin
azithromycin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.
- cisplatin
pyridoxine decreases effects of cisplatin by unknown mechanism. Use Caution/Monitor. Use of pyridoxine, vitamin B6 with cisplatin and altretamine (hexamethylmelamine) may not be advisable.
- clarithromycin
clarithromycin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.
- dichlorphenamide
dichlorphenamide and cyanocobalamin both decrease serum potassium. Use Caution/Monitor.
dichlorphenamide, pyridoxine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Both drugs can cause metabolic acidosis. - erythromycin base
erythromycin base will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.
- glucarpidase
glucarpidase will decrease the level or effect of folic acid by increasing metabolism. Modify Therapy/Monitor Closely. Leucorvorin, reduced folates, and folate antimetabolites are substrates for glucarpidase (hydrolyzes glutamate residue from folic acid and antifolates)
- erythromycin ethylsuccinate
erythromycin ethylsuccinate will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.
- erythromycin lactobionate
erythromycin lactobionate will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.
- erythromycin stearate
erythromycin stearate will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.
- green tea
green tea, folic acid. Other (see comment). Use Caution/Monitor. Comment: Concomitant consumption of green tea with folic acid is not recommended in pregnant women, megaloblastic anemia, or when a reduction in folic acid may have clinical consequences. A folate transporter interaction has been described, leading to decreases in bioavailability of folic acid.
- levodopa
pyridoxine decreases levels of levodopa by increasing metabolism. Use Caution/Monitor.
- omadacycline
cyanocobalamin will decrease the level or effect of omadacycline by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Multivalent cation-containing products may impair absorption of tetracyclines, which may decrease its efficacy. Separate dosing of tetracyclines from these products.
pyridoxine will decrease the level or effect of omadacycline by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Multivalent cation-containing products may impair absorption of tetracyclines, which may decrease its efficacy. Separate dosing of tetracyclines from these products.
folic acid will decrease the level or effect of omadacycline by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Multivalent cation-containing products may impair absorption of tetracyclines, which may decrease its efficacy. Separate dosing of tetracyclines from these products. - pancrelipase
pancrelipase decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. folic deficiency may occur.
- roxithromycin
roxithromycin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.
Minor (133)
- acetazolamide
acetazolamide decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- amikacin
amikacin decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
amikacin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown. - amiodarone
pyridoxine increases toxicity of amiodarone by unspecified interaction mechanism. Minor/Significance Unknown. Increased risk of photosensitivity.
- aspirin
aspirin decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
aspirin decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - aspirin rectal
aspirin rectal decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
aspirin rectal decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - aspirin/citric acid/sodium bicarbonate
aspirin/citric acid/sodium bicarbonate decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
aspirin/citric acid/sodium bicarbonate decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - aztreonam
aztreonam will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- balsalazide
balsalazide decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
balsalazide decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - bazedoxifene/conjugated estrogens
bazedoxifene/conjugated estrogens decreases levels of folic acid by altering metabolism. Minor/Significance Unknown.
bazedoxifene/conjugated estrogens decreases levels of pyridoxine by altering metabolism. Minor/Significance Unknown.
bazedoxifene/conjugated estrogens decreases levels of cyanocobalamin by altering metabolism. Minor/Significance Unknown. - bendroflumethiazide
bendroflumethiazide decreases levels of folic acid by increasing renal clearance. Minor/Significance Unknown.
- cefadroxil
cefadroxil will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- carbamazepine
carbamazepine decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- bumetanide
bumetanide decreases levels of folic acid by increasing renal clearance. Minor/Significance Unknown.
- carbamazepine
carbamazepine decreases levels of folic acid by unspecified interaction mechanism. Minor/Significance Unknown.
- cefamandole
cefamandole will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- cefotetan
cefotetan will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- cefpirome
cefpirome will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- ceftibuten
ceftibuten will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- cephalexin
cephalexin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- chloramphenicol
chloramphenicol decreases effects of folic acid by pharmacodynamic antagonism. Minor/Significance Unknown.
chloramphenicol decreases effects of cyanocobalamin by pharmacodynamic antagonism. Minor/Significance Unknown. - chlorhexidine oral
chlorhexidine oral will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- chlorothiazide
chlorothiazide decreases levels of folic acid by increasing renal clearance. Minor/Significance Unknown.
- choline magnesium trisalicylate
choline magnesium trisalicylate decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- chlorthalidone
chlorthalidone decreases levels of folic acid by increasing renal clearance. Minor/Significance Unknown.
- choline magnesium trisalicylate
choline magnesium trisalicylate decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- cimetidine
cimetidine decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- ciprofloxacin
ciprofloxacin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- clindamycin
clindamycin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- clonazepam
clonazepam decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- colchicine
colchicine decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- colestipol
colestipol decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
colestipol decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - conjugated estrogens
conjugated estrogens decreases levels of folic acid by altering metabolism. Minor/Significance Unknown.
conjugated estrogens decreases levels of pyridoxine by altering metabolism. Minor/Significance Unknown.
conjugated estrogens decreases levels of cyanocobalamin by altering metabolism. Minor/Significance Unknown. - conjugated estrogens, vaginal
conjugated estrogens, vaginal decreases levels of folic acid by altering metabolism. Minor/Significance Unknown.
conjugated estrogens, vaginal decreases levels of cyanocobalamin by altering metabolism. Minor/Significance Unknown.
conjugated estrogens, vaginal decreases levels of pyridoxine by altering metabolism. Minor/Significance Unknown. - cyclopenthiazide
cyclopenthiazide decreases levels of folic acid by increasing renal clearance. Minor/Significance Unknown.
- dapsone
dapsone will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- demeclocycline
demeclocycline will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- dexlansoprazole
dexlansoprazole decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- diflunisal
diflunisal decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
diflunisal decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - doxycycline
doxycycline will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- ertapenem
ertapenem will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- eslicarbazepine acetate
eslicarbazepine acetate decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- estradiol
estradiol decreases levels of folic acid by altering metabolism. Minor/Significance Unknown.
estradiol decreases levels of pyridoxine by altering metabolism. Minor/Significance Unknown. - esomeprazole
esomeprazole decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- estrogens conjugated synthetic
estrogens conjugated synthetic decreases levels of pyridoxine by altering metabolism. Minor/Significance Unknown.
- estradiol
estradiol decreases levels of cyanocobalamin by altering metabolism. Minor/Significance Unknown.
- estrogens conjugated synthetic
estrogens conjugated synthetic decreases levels of cyanocobalamin by altering metabolism. Minor/Significance Unknown.
estrogens conjugated synthetic decreases levels of folic acid by altering metabolism. Minor/Significance Unknown. - estrogens esterified
estrogens esterified decreases levels of pyridoxine by altering metabolism. Minor/Significance Unknown.
estrogens esterified decreases levels of cyanocobalamin by altering metabolism. Minor/Significance Unknown.
estrogens esterified decreases levels of folic acid by altering metabolism. Minor/Significance Unknown. - estropipate
estropipate decreases levels of pyridoxine by altering metabolism. Minor/Significance Unknown.
estropipate decreases levels of cyanocobalamin by altering metabolism. Minor/Significance Unknown.
estropipate decreases levels of folic acid by altering metabolism. Minor/Significance Unknown. - ethacrynic acid
ethacrynic acid decreases levels of folic acid by increasing renal clearance. Minor/Significance Unknown.
- ethotoin
pyridoxine decreases levels of ethotoin by increasing metabolism. Minor/Significance Unknown. High dose of pyridoxine (vitamin B6), >=200 mg/day.
- ethanol
ethanol decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- ethosuximide
ethosuximide decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- ethotoin
folic acid decreases levels of ethotoin by increasing metabolism. Minor/Significance Unknown. Large doses of folic acid (>10 mg/day).
- famotidine
famotidine decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- felbamate
felbamate decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- fleroxacin
fleroxacin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- fosfomycin
fosfomycin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- fosphenytoin
fosphenytoin decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
folic acid decreases levels of fosphenytoin by increasing metabolism. Minor/Significance Unknown. Large doses of folic acid (>10 mg/day).
pyridoxine decreases levels of fosphenytoin by increasing metabolism. Minor/Significance Unknown. High dose of pyridoxine (vitamin B6), >=200 mg/day. - furosemide
furosemide decreases levels of folic acid by increasing renal clearance. Minor/Significance Unknown.
- gemifloxacin
gemifloxacin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- gabapentin
gabapentin decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- gabapentin enacarbil
gabapentin enacarbil decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- gentamicin
gentamicin decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
gentamicin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown. - hydralazine
hydralazine decreases levels of pyridoxine by unspecified interaction mechanism. Minor/Significance Unknown.
- hydrochlorothiazide
hydrochlorothiazide decreases levels of folic acid by increasing renal clearance. Minor/Significance Unknown.
- ibuprofen/famotidine
ibuprofen/famotidine decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- indapamide
indapamide decreases levels of folic acid by increasing renal clearance. Minor/Significance Unknown.
- isoniazid
isoniazid decreases levels of pyridoxine by unspecified interaction mechanism. Minor/Significance Unknown. If INH dose >10 mg/kg/day, supplement 50 100mg pyridoxine/day.
- lacosamide
lacosamide decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- lamotrigine
lamotrigine decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- lansoprazole
lansoprazole decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- levetiracetam
levetiracetam decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- levofloxacin
levofloxacin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- linezolid
linezolid will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- lorazepam
lorazepam decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- meropenem
meropenem will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- meropenem/vaborbactam
meropenem/vaborbactam will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- mesalamine
mesalamine decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
mesalamine decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - mestranol
mestranol decreases levels of cyanocobalamin by altering metabolism. Minor/Significance Unknown.
mestranol decreases levels of pyridoxine by altering metabolism. Minor/Significance Unknown.
mestranol decreases levels of folic acid by altering metabolism. Minor/Significance Unknown. - metformin
metformin decreases levels of cyanocobalamin by unspecified interaction mechanism. Minor/Significance Unknown. It may take several years of metformin therapy to develop vitamin B12 deficiency.
metformin decreases levels of folic acid by unspecified interaction mechanism. Minor/Significance Unknown. - metronidazole
metronidazole will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- methotrexate
folic acid decreases effects of methotrexate by pharmacodynamic antagonism. Minor/Significance Unknown. Vitamin preparations containing folic acid or its derivatives may decrease responses to systemically administered methotrexate.
- methsuximide
methsuximide decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- methyclothiazide
methyclothiazide decreases levels of folic acid by increasing renal clearance. Minor/Significance Unknown.
- metolazone
metolazone decreases levels of folic acid by increasing renal clearance. Minor/Significance Unknown.
- minocycline
minocycline will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- moxifloxacin
moxifloxacin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- neomycin PO
neomycin PO will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
neomycin PO decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - nitrofurantoin
nitrofurantoin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- nizatidine
nizatidine decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- octreotide
octreotide decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- octreotide (Antidote)
octreotide (Antidote) decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- ofloxacin
ofloxacin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- omeprazole
omeprazole decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- oxcarbazepine
oxcarbazepine decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- oxytetracycline
oxytetracycline will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- pantoprazole
pantoprazole decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- paromomycin
paromomycin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
paromomycin decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - penicillamine
penicillamine decreases levels of pyridoxine by unspecified interaction mechanism. Minor/Significance Unknown.
- pentamidine
pentamidine decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- phenobarbital
folic acid decreases levels of phenobarbital by increasing metabolism. Minor/Significance Unknown.
phenobarbital decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
pyridoxine decreases levels of phenobarbital by increasing metabolism. Minor/Significance Unknown.
phenobarbital decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - phenytoin
folic acid decreases levels of phenytoin by increasing metabolism. Minor/Significance Unknown. Large doses of folic acid (>10 mg/day).
phenytoin decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
pyridoxine decreases levels of phenytoin by increasing metabolism. Minor/Significance Unknown. High dose of pyridoxine (vitamin B6), >=200 mg/day. - pivmecillinam
pivmecillinam will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- primidone
primidone decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
folic acid decreases levels of primidone by increasing metabolism. Minor/Significance Unknown.
primidone decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - quinupristin/dalfopristin
quinupristin/dalfopristin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- rabeprazole
rabeprazole decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- salicylates (non-asa)
salicylates (non-asa) decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- rose hips
rose hips decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- rufinamide
rufinamide decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- salicylates (non-asa)
salicylates (non-asa) decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- salsalate
salsalate decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
salsalate decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - streptomycin
streptomycin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
streptomycin decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - sulfadiazine
sulfadiazine will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- sulfamethoxazole
sulfamethoxazole decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- sulfamethoxazole
sulfamethoxazole will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- sulfasalazine
sulfasalazine decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
sulfasalazine decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. - sulfisoxazole
sulfisoxazole will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- teicoplanin
teicoplanin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- temocillin
temocillin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- tetracycline
tetracycline will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- theophylline
theophylline decreases levels of pyridoxine by altering metabolism. Minor/Significance Unknown.
- tiagabine
tiagabine decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- ticarcillin
ticarcillin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- tigecycline
tigecycline will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- tobramycin
tobramycin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- torsemide
torsemide decreases levels of folic acid by increasing renal clearance. Minor/Significance Unknown.
- tobramycin
tobramycin decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- topiramate
topiramate decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- triamterene
triamterene decreases levels of folic acid by increasing renal clearance. Minor/Significance Unknown.
- trimethoprim
trimethoprim will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- valproic acid
valproic acid decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- vancomycin
vancomycin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- willow bark
willow bark decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
willow bark decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
Adverse Effects
Frequency Not Defined
Allergic reactions
Bronchospasm
Flushing
Malaise
Erythema
Rash
Paresthesias
Somnolence
Unsteady gait
Diarrhea
Nausea
Pruritus
Urticaria
Altered sleep patterns
Irritability
Peripheral vascular thrombosis
Polycythemia
Warnings
Contraindications
Hypersensitivity to any component
Cautions
Caution in patients with history of bipolar illness; mood elevation possible in this population
Caution in patients taking anticonvulsant medications; folate may interfere with anticonvulsant medication, and may lower seizure threshold; it has been reported that anticonvulsant medications interfere with folate metabolism; exact action is unclear; caution recommended with patients in this therapeutic group
Folinic acid may enhance toxicity of fluorouracil; deaths from severe enterocolitis, diarrhea, and dehydration reported in elderly patients receiving weekly formyl-THF and fluorouracil; concomitant granulocytopenia and fever reported present in some but not all of the patients
Concomitant use of formyl-THF with trimethoprim-sulfamethoxazole for acute treatment of Pneumocystis carinii pneumonia in patients with HIV infection associated with increased rates of treatment failure and mortality in a placebo-controlled study
Patients undergoing cancer treatment should consult their licensed medical practitioner for advice
Folate alone is improper therapy in treatment of pernicious anemia and other megaloblastic anemias where vitamin B12 is deficient; folate in doses above 0.1 mg daily may obscure pernicious anemia in that hematologic remission may occur while neurological manifestations progress
Pregnancy & Lactation
Pregnancy
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Lactation
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Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Nutrition
See individual monographs
Pharmacology
Mechanism of Action
Folic acid: Plays a role in the formation of coenzymes involved in purine and pyrimidine synthesis as well as other metabolic systems; required for nucleoprotein synthesis and maintenance of erythropoiesis; enhances metabolism of formic acid, the toxic metabolite of methanol, to nontoxic metabolites
Cyanocobalamin: Plays a role in cell replication and hematopoiesis; coenzyme in protein synthesis as well as fat and carbohydrate metabolism
Pyridoxine: Plays a role in carbohydrate, protein, and fat metabolism; aids in the release of liver and muscle stored glycogen and the synthesis of GABA
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Formulary
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
