Drugs that Deplete B Vitamins

Drugs that Deplete B Vitamins

B vitamins are your best protection against elevated levels of homocysteine, an amino acid produced in the body that in excess, can increase your risk of mood disorders, poor mental performance, and Alzheimer’s disease.

A wide range of drugs, from aspirin to estrogen to diuretics to stomach acid suppressors (such as Nexium and Prilosec) can interfere with the metabolism of one or more B vitamins, which can result in elevated levels of homocysteine.  You who are worried about preserving your brain power, take note: medical research now clearly links poor performance on mental function tests to elevated homocysteine levels.  Having too much of this amino acid floating around in your bloodstream can cost you a few IQ points!  B vitamins are also critical for mood and concentration, and a severe deficiency in B vitamins (especially vitamin B12 can result in symptoms such as severe confusion and mental fog at any age.  Elevated levels of homocysteine and/or low levels of B vitamins can also increase the risk of depression, stroke, Alzheimer’s disease, vascular dementia, heart disease, and even certain types of cancer.  If you are using a drug that depletes your body of B vitamins, you must take supplemental B vitamins daily and demand to have your homocysteine levels checked periodically by your doctor.

Pain Relievers

Generic name:  Aspirin (acetylsalicylic acid).  Brand Names:  Pure aspirin is sold under numerous brand names, including many private store labels.  Percodan and Empirin are combination aspirin and codeine products.


Generic name:  Trimethoprim: antibiotic frequently prescribed for chronic urinary tract infections.  Brand Names:  Bactrim, Septra

Antacid and Stomach Acid Suppressors

Generic name:  Cimetidine.  Brand Names:  Tagamet
Generic name:  Famotidine.  Brand Names:  Pepcid
Generic name:  Ranitidine.  Brand Names:  Zantac, Zantac 75
Generic name:  Lansoprazole.  Brand Names:  Prevacid
Generic name:  Nizatidine.  Brand Names:  Axid
Generic name:  Omeprazole.  Brand Names:  Prilosec

Antidiabetic Drugs

Generic name:  Metformin.  Brand Names:  Glucophage

Asthma Drugs

Generic name:  Beclomethasone (oral inhaler).  Brand Name:  Vanceril
Generic name:  Budesonide (oral inhaler).  Brand Name:  Pulmacort
Generic name:  Budesonide (nasal inhaler).  Brand Name:  Rhinocort
Generic name:  Flunisolide (nasal inhaler).  Brand Name:  Nasalide
Generic name:  Flunisolide (oral inhaler).  Brand Name:  Aerobid
Generic name:  Fluticasone (oral inhaler).  Brand Name:  Flovent
Generic name:  Mometasone (nasal inhaler).  Brand Name:  Nasonex
Generic name:  Triamcinolone (oral inhaler).  Brand Name:  Azmacort
Generic name:  Theophylline.  Brand Name:  Aerolate

Blood Pressure-Lowering Drugs

Generic name:  Bumetanide.  Brand Name:  Bumex
Generic name:  Hydroclorothiazide (HCTZ), used alone or in combination with other drugs.  Brand Names:  Aldactazide, Capozide, Combipres, Dyazide, HydroDIURIL, Hyzaar, Lopressor-HCT, Lotensin HCT, Maxide, Microzide, Moduretic, Prinzide, Vaseretic, Zestoretic.
Generic name:  Triamterene.  Brand Name:  Dyrenium, or in combination with other drugs in Maxide and Dyazide.
Generic name:  Furosemide.  Brand Name:  Lasix
Generic name:  Hydralazine.  Brand Name:  Apresoline
Generic name:  Torsemide.  Brand Name:  Demadex

Anticonvulsant Drugs

Generic name:  Carbamazepine.  Brand Name:  Tegretol
Generic name:  Ethosuximide.  Brand Name:  Zarontin
Generic name:  Fosphenytoin.  Brand Name:  Cerebyx
Generic name:  Mephobarbital.  Brand Name:  Mebaral
Generic name:  Phenobarbital.  Brand Name:  Phenobarbital
Generic name:  Phenytoin.  Brand Name:  Dilantin
Generic name:  Primidone.  Brand Name:  Mysoline
Generic name:  Valproic Acid.  Brand Name:  Depakote, Depakene

Cholesterol-Lowering Drugs

Generic name:  Cholestyramine.  Brand Name:  Colestid


There are dozens of different brands of estrogen products, and I have only listed the major brands here.  If you are taking estrogen in the form of birth control pills or hormone replacement therapy, even if you don’t see your particular estrogen drug on the list, assume that it works just like any other estrogen and that you need to compensate for the loss of B vitamins by taking additional B vitamins.

Generic name:  Estrogens (with or without progesterone) as contraceptives, oral or skin patch.  Brand Names:  Ortho-Novum, Ortho Tri-Cyclen, Ovral, Ovcon, Demulen, Loestrin (any estrogen-containing oral contraceptive.)
Generic name:  Estrogens (with or without progesterone) for hormone replacement therapy for menopause or hysterectomy; oral, skin patch, or cream.  Brand Names:  Premarin, Prempro, Activela, Combinpatch, Estrotest, any hormone replacement product containing estrogen.

Estrogen Substitutes for Osteoporosis

Generic name:  Raloxifene.  Brand Name:  Evista

Anti-Parkinson’s Drugs

Generic name:  Carbidopa and levodopa.  Brand Name:  Sinemet

Nonsteroidal Antiinflammatory Drugs (NSAIDS)

Generic name:  Celecoxib.  Brand Name:  Celebrex
Generic name:  Ibuprofen.  Brand Name:  Advil, Bayer Select, Motrin, Midol, etc.
Generic name:  Indomethacin.  Brand Name:  Indocin
Generic name:  Naproxen.  Brand Name:  Naprosyn, Aleve, etc.

Corticosteroids: Anti-inflammatory Drugs

Used to treat asthma, arthritis, allergy, and pain.
Generic name:  Methyl Prednisolone.  Brand Name:  Medrol
Generic name:  Prednisone.  Brand Name:  Deltasone, Orasone

Dr. Perlmutter is one of the leading lights in medicine today, illuminating the path for solving chronic illness

Mark Hyman, MD