Interactions on record — worth a quick check against your medications. Check your meds →
Dietary supplement

Direct B-12 Ingredients & Drug Interactions

by Foster Regal

Direct B-12 label
See full label image
Tablet Or Pill Category: Vitamin
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Direct B-12 against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Moderate

Direct B-12 is a dietary supplement by Foster Regal with 4 active ingredients. Its ingredients are commonly taken for morning sickness in pregnancy, premenstrual syndrome (pms), preventing or treating b6 deficiency.Based on those ingredients, 238 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Vitamin B6, Folic Acid, Vitamin B12. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Direct B-12 by Foster Regal

Ask about any prescription or over-the-counter medication and we check it for interactions with Direct B-12 by Foster Regal — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Direct B-12 by Foster Regal

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 23, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 4 of its 4 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

Direct B-12 contains four active B vitamins. Vitamin B6 (pyridoxine) helps your body use amino acids and make neurotransmitters.

Folic acid supports cell division and DNA synthesis, and is especially important in pregnancy for preventing birth defects. Biotin strengthens hair, skin, and nails and helps your body process fats and carbohydrates.

Vitamin B12 maintains your nervous system and red blood cells, and is especially important if you don't eat animal products. The remaining ingredients are inactive — mannitol, cherry flavor, vegetable stearic acid, cellulose, vitamin C, magnesium stearate, silica, and stevia — which serve as sweeteners, binders, and fillers in the tablet.

Does it work?

Strong evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Strong

Clinical evidence supports at least one of this product's ingredients for its stated purpose.

Why this rating?
  • The label markets this product for: Supports healthy nervous system and cardiovascular function.
  • We looked for evidence on: Cardiovascular disease (CVD), Anemia, Folate deficiency, Biotin deficiency, Neuropathy, Homocysteine metabolism — and 1 related terms.
  • The strongest evidence on file: Vitamin B12 is rated "Effective" for Vitamin B12 deficiency (Natural Medicines).
  • Also on file: Vitamin B6 is rated "Effective" for Sideroblastic anemia.
  • Also on file: Folic Acid is rated "Effective" for Folate deficiency.

Vitamin B6 is effective for sideroblastic anemia and B6 deficiency, and likely effective for high homocysteine levels. It's possibly effective for pregnancy-induced nausea and vomiting.

Folic acid is effective for folate deficiency and likely effective for preventing neural tube birth defects and treating methotrexate side effects; it's possibly effective for depression and cognitive impairment. Biotin is likely effective for biotin deficiency but has been rated possibly ineffective for multiple sclerosis and seborrheic dermatitis, with insufficient evidence for alopecia areata.

Vitamin B12 is effective for B12 deficiency and possibly effective for canker sores and nerve pain after shingles (postherpetic neuralgia).

The evidence, ingredient by ingredient Vitamin B6 Folic Acid Biotin Vitamin B12

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 4 of the 4 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 4 of 4.
  • General safety write-ups exist for 4 of 4.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Vitamin B6 is generally well tolerated at doses under 100 mg daily, though higher doses taken over time can damage nerves (sensory neuropathy), especially above 1,000 mg daily. Common side effects at standard doses are mild — abdominal pain, headache, nausea — but high doses can cause nerve tingling and numbness.

For pregnancy, B6 is rated likely safe, though some data suggest possible concern; use only under your doctor's guidance. Folic acid is generally safe at recommended doses and is recommended during pregnancy to prevent birth defects, though late-pregnancy use has been associated with increased childhood asthma risk in some population studies.

At high doses (15 mg daily), folic acid can cause confusion, sleep changes, and irritability. Biotin is very safe and generally well tolerated even at high doses because excess is removed in your urine; only mild diarrhea has been rarely reported.

Vitamin B12 is very safe with no established upper limit and is needed and safe in both pregnancy and breastfeeding; it's generally well tolerated, though rare allergic reactions (rash, itching) are possible.

Side effects, ingredient by ingredient Vitamin B6 Folic Acid Biotin Vitamin B12

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 3 of the 4 matched ingredients can interact with medications — Vitamin B12, Vitamin B6, Folic Acid.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: Parkinson's medications.
  • For scale: 238 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking Direct B-12, double-check with your doctor or pharmacist if you take seizure medications (phenobarbital or phenytoin) — vitamin B6 and folic acid may reduce how well they work. Also flag cancer medications (methotrexate, capecitabine, 5-fluorouracil), blood pressure drugs, amiodarone (Cordarone), levodopa without carbidopa, diabetes medications like metformin, or antiparasitic drugs like pyrimethamine (Daraprim).

These are the main categories where documented interactions exist.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with clinical evidence supporting its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

Direct B-12 is useful if you're deficient in any of these B vitamins or need them for pregnancy support or specific conditions like high homocysteine. However, if you take seizure medications, blood pressure drugs, cancer treatments, or diabetes medications, you need to clear this product with your doctor or pharmacist first — especially the B6 and folic acid content.

At standard doses it's generally well tolerated, but avoid high doses unless a clinician advises it, and don't self-treat suspected anemia without getting checked.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 4 of 4 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 23, 2022.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Direct B-12, straight from the product label.

Brand Foster Regal
Net contents 90 Veg Tablet(s)
Market status On market
Date entered into DSLD Feb 23, 2022
DSLD ID 260026
Product type Vitamin
Supplement form Tablet Or Pill
Dietary claims / uses Nutrient, All Other, Structure/Function
Intended target group(s) Vegetarian, Adult (18 - 50 Years), Gluten Free
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Direct B-12 by Foster Regal, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 Tablet(s)
Maximum serving Sizes:
2 Tablet(s)
Servings per container
90
IngredientAmount% DV
Vitamin B65 mg250%
Folic Acid400 mcg100%
Biotin25 mcg8.3%
Vitamin B121000 mcg16666%

Other ingredients: Mannitol, natural Cherry flavor, Vegetable Stearic Acid, Vegetable Cellulose, L-Ascorbic Acid, Vegetable Magnesium Stearate, Silica, Stevia

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Brand IP Statement(s)

Foster Regal The Best Choice.

Formulation

Gluten free

Vegetarian formula

Sublingual

Nutritionally supports healthy nervous system and cardiovascular function

Methylcobalamin is the form of B-12 active in the central nervous system. The liver may not convert cyanocobalamin, the common supplement form of vitamin B-12, into adequate amounts of methylcobalamin the body may need.

Mfg. in a Ko Kosher Certified, FDA Registered Facility using Good Manufacturing Practices (GMPs)

Conforms to USP <2091> for weight.

Made in USA

Formula

With B-6, Folic acid & Biotin

Mfg. in a Ko Kosher Certified, FDA Registered Facility using Good Manufacturing Practices (GMPs)

FDA Statement of Identity

Dietary Supplement

Precautions

Tamper evident: Do not use this product if imprinted foil seal under cap is broken or missing.

Keep out of reach of children.

Caution: If you are pregnant or nursing, consult your physician before taking this product.

Storage

Keep tightly closed. Store at room temperature: 59 degrees - 86 degrees F (15 degrees to 30 degrees C).

Suggested/Recommended/Usage/Directions

Directions: As a dietary supplement, take 1 or 2 tablets daily. Allow tablet to dissolve under tongue.

FDA Disclaimer Statement

This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Direct B-12 by Foster Regal label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

Direct B-12 label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in Direct B-12 by Foster Regal

These are the 4 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Tablet(s) Dosage formTablet Or Pill Servings per container90 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

Vitamin B6

Interacts with
210 drugs
5 mg per serving Form: Pyridoxine Hydrochloride

Vitamin B6 (pyridoxine) is an essential water-soluble vitamin that your body needs for metabolism, brain function, and making red blood cells. It is b...

Vitamin B6 monograph & interactions

Folic Acid

Interacts with
40 drugs
400 mcg per serving

Folic acid is the man-made form of vitamin B9 and is one of the most well-studied supplements, especially for preventing serious birth defects when ta...

Folic Acid monograph & interactions

Biotin

No known
interactions
25 mcg per serving

Biotin (vitamin B7) is a water-soluble vitamin your body needs to turn food into energy and to support healthy hair, skin, and nails. Most people get...

Biotin monograph & interactions

Vitamin B12

Interacts with
20 drugs
1000 mcg per serving Form: Methylcobalamin

Vitamin B12 (cobalamin) is an essential nutrient your body needs to make red blood cells, keep nerves healthy, and support DNA. Supplements are very h...

Vitamin B12 monograph & interactions

Other (inactive) ingredients: Mannitol, Natural Cherry flavor, Vegetable Stearic Acid, Vegetable Cellulose, L-Ascorbic Acid, Vegetable Magnesium Stearate, Silica, Stevia. These complete the product’s ingredient list but are not active constituents.

Interaction report

Direct B-12 by Foster Regal Drug Interactions

Want to check YOUR meds against Direct B-12?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

 Go to the checker
238Drugs
213 Moderate 25 Minor

Ingredients driving the most interactions

Vitamin B6 210
Folic Acid 40
Vitamin B12 20

Individual Drug Interactions

The ingredients in Direct B-12 interact with 238 drugs. Click any drug to see the details.

3 of the 4 ingredients in Direct B-12 interact with drugs. Each result below shows which ingredient is responsible. Vitamin B6 Folic Acid Vitamin B12

Each ingredient & the kinds of drugs it affects

For each ingredient in Direct B-12 with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

Vitamin B65 drug types · 210 drugs

Amiodarone (Cordarone)

Theoretically, vitamin B6 might increase the photosensitivity caused by amiodarone.
Despite initial case reports suggesting that pyridoxine may have a protective effect against amiodarone-induced photosensitivity, preliminary clinical research suggests that pyridoxine may actually exacerbate this adverse effect.

Likelihood Possible Evidence B
Antihypertensive Drugs

Theoretically, vitamin B6 may have additive effects when used with antihypertensive drugs.
Research in hypertensive rats shows that vitamin B6 can decrease systolic blood pressure. Similarly, clinical research in patients with hypertension shows that taking high doses of vitamin B6 may reduce systolic and diastolic blood pressure, possibly by reducing plasma levels of epinephrine and norepinephrine.

Likelihood Possible Evidence B
Phenobarbital (Luminal)

High doses of vitamin B6 may reduce the levels and clinical effects of phenobarbital.
Preliminary clinical evidence suggests that vitamin B6 200 mg daily can reduce plasma levels of phenobarbital, possibly by increasing metabolism. It is not known whether lower doses have any effect. Advise people taking phenobarbital to avoid high doses of vitamin B6.

Likelihood Possible Evidence D
Phenytoin (Dilantin)

High doses of vitamin B6 may reduce the levels and clinical effects of phenytoin.
Preliminary clinical evidence suggests that vitamin B6 200 mg daily can reduce plasma levels of phenytoin, possibly by increasing metabolism. It is not known whether lower doses have any effect. Advise people taking phenytoin to avoid high doses of vitamin B6.

Likelihood Possible Evidence D
Levodopa

Vitamin B6 may increase the metabolism of levodopa when taken alone, but not when taken in conjunction with carbidopa.
Vitamin B6 (pyridoxine) enhances the metabolism of levodopa, reducing its clinical effects. However, this interaction does not occur when carbidopa is used concurrently with levodopa (Sinemet). Therefore, it is not likely to be a problem in most people.

Likelihood Unlikely Evidence D
Vitamin B6 full monograph & interactions

Folic Acid7 drug types · 40 drugs

5-Fluorouracil

Theoretically, high doses of folic acid might increase the toxicity of 5-fluorouracil.
Increases in gastrointestinal side effects of 5-fluorouracil, such as stomatitis and diarrhea, have been described in two clinical studies when leucovorin, a form of folic acid, was administered with 5-fluorouracil.

Likelihood Possible Evidence D
Capecitabine (Xeloda)

Use of high-dose folic acid might contribute to capecitabine toxicity.
Clinical research suggests that higher serum folate levels are associated with an increased risk for moderate or severe toxicity during capecitabine-based treatment for colorectal cancer. Additionally, in one case report, taking folic acid 15 mg daily might have contributed to increased toxicity, including severe diarrhea, vomiting, edema, hand-foot syndrome, and eventually death, in a patient prescribed capecitabine.

Likelihood Possible Evidence D
Methotrexate (Trexall, Others)

Folic acid might reduce the efficacy of methotrexate as a cancer treatment when given concurrently.
Methotrexate exerts its cytotoxic effects by preventing conversion of folic acid to the active form needed by cells. There is some evidence that folic acid supplements reduce the efficacy of methotrexate in the treatment of acute lymphoblastic leukemia, and theoretically they could reduce its efficacy in the treatment of other cancers. Advise cancer patients to consult their oncologist before using folic acid supplements. In patients treated with long-term, low-dose methotrexate for rheumatoid arthritis (RA) or psoriasis, folic acid supplements can reduce the incidence of side effects, without reducing efficacy.

Likelihood Probable Evidence B
Phenobarbital (Luminal)

Folic acid might have antagonistic effects on phenobarbital and increase the risk for seizures.
Folic acid can have direct convulsant activity in some people, reversing the effects of phenobarbital and worsening seizure control. Monitor closely for increased seizure activity.

Likelihood Probable Evidence B
Phenytoin (Dilantin)

Folic acid might reduce serum levels of phenytoin in some patients.
Folic acid may be a cofactor in phenytoin metabolism. Folic acid, in doses of 1 mg daily or more, can reduce serum levels of phenytoin in some patients. Increases in seizure frequency have been reported. If folic acid supplements are added to established phenytoin therapy, monitor serum phenytoin levels closely. If phenytoin and folic acid are started at the same time and continued together, adverse changes in phenytoin pharmacokinetics are avoided. Note that phenytoin also reduces serum folate levels.

Likelihood Probable Evidence B
Primidone (Mysoline)

Folic acid might have antagonistic effects on primidone and increase the risk for seizures.
Folic acid can have direct convulsant activity in some people, reversing the effects of primidone and worsening seizure control. Monitor closely for increased seizure activity. Note that primidone also reduces serum folate levels.

Likelihood Probable Evidence B
Pyrimethamine (Daraprim)

Folic acid might antagonize the effects of pyrimethamine.
Folic acid can antagonize the antiparasitic effects of pyrimethamine against toxoplasmosis and Pneumocystis carinii pneumonia. Folic acid doesn't antagonize the effects of pyrimethamine in the treatment of malaria, because malarial parasites cannot use exogenous folic acid. Use folinic acid as an alternative to folic acid when indicated.

Likelihood Probable Evidence D
Folic Acid full monograph & interactions

Vitamin B121 drug type · 20 drugs

Metformin (Glucophage)

Metformin, a common medication used to manage type 2 diabetes, has been associated with lower vitamin B12 levels in some individuals. Prolonged use of metformin can interfere with the absorption of B12 in the digestive system, potentially leading to a deficiency in this essential vitamin.

Likelihood Possible Evidence A
Vitamin B12 full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Direct B-12, from the product label.

Foster Regal

See all Foster Regal products
Name
Foster Regal Laboratories
Street Address
115 S.C.T. Ct.
City
White House
State
TN
ZipCode
37188
Pharmacist Counseling Corner

Direct B-12 by Foster Regal: Common Questions

Does Direct B-12 by Foster Regal interact with any medications?
Yes. Based on its ingredients, Direct B-12 has a known interaction with 238 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Direct B-12 contains 4 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Can I take this while pregnant?
Vitamin B6 is rated likely safe but possibly unsafe in pregnancy — use only under your doctor's guidance, especially for morning sickness. Folic acid and B12 are both rated likely safe and are actually recommended during pregnancy; in fact, folic acid is standard in prenatal vitamins to prevent birth defects. Biotin is also likely safe in pregnancy. Talk with your doctor or midwife about the right doses for you.
Is this safe while breastfeeding?
Yes — vitamin B6, folic acid, and B12 are all rated likely safe during breastfeeding at normal recommended amounts. Biotin is also likely safe. Follow your doctor's or lactation specialist's guidance on dosing.
Will this really help my energy or fatigue?
If your fatigue is due to a deficiency in one of these B vitamins — which a blood test can confirm — then yes, supplementing can help. If you're not deficient, the evidence for energy boost is not established in our data. Talk with your doctor about whether you actually need B-vitamin supplementation.
What are the most common side effects?
At standard doses, vitamin B6 can cause mild abdominal pain, headache, or nausea. Folic acid at recommended amounts is usually well tolerated; at very high doses (15 mg daily) it can cause sleep changes or confusion. Biotin and B12 are rarely associated with side effects at normal doses. High-dose B6 over time is the main concern — it can cause nerve tingling and numbness.
Why shouldn't I take this if I have a B12 deficiency from anemia?
You can take B12 for a B12 deficiency — that's actually what it's for. The caution is not to self-treat suspected anemia without a blood test first. Taking folic acid alone to treat an undiagnosed B12 deficiency can mask the symptoms and allow nerve damage to develop silently, so get properly diagnosed before supplementing.
Is there any limit to how much of this I can take?
Folic acid and B12 have no strict upper limit at normal recommended doses. Vitamin B6 and biotin should generally not exceed 100 mg and 300 mg daily respectively, unless a doctor advises otherwise — higher doses of B6 carry a risk of nerve damage. Check the label for the dose per tablet and talk with your pharmacist or doctor about what's right for you.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Direct B-12 label
Go deeper

The Full Monographs Behind Direct B-12’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

Vitamin B6

Interacts with 210 drugs

Vitamin B6 (pyridoxine) is an essential water-soluble vitamin that your body needs for metabolism, brain function, and making red blood cells. It is best known for helping with pregnancy-rel...

Read the full Vitamin B6 monograph → Herb & supplement monograph

Folic Acid

Interacts with 40 drugs

Folic acid is the man-made form of vitamin B9 and is one of the most well-studied supplements, especially for preventing serious birth defects when taken before and during early pregnancy. I...

Read the full Folic Acid monograph → Herb & supplement monograph

Biotin

Biotin (vitamin B7) is a water-soluble vitamin your body needs to turn food into energy and to support healthy hair, skin, and nails. Most people get plenty from a normal diet, and true defi...

Read the full Biotin monograph → Herb & supplement monograph

Vitamin B12

Interacts with 20 drugs

Vitamin B12 (cobalamin) is an essential nutrient your body needs to make red blood cells, keep nerves healthy, and support DNA. Supplements are very helpful for people who are deficient — su...

Read the full Vitamin B12 monograph →
Sources

Sources & How We Checked

Direct B-12's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

The 122 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Vitamin B6 32 references
  1. Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
  2. Yates AA, Schlicker SA, Suitor CW. Dietary reference intakes: The new basis for recommendations for calcium and related nutrients, B vitamins, and choline. J Am Diet Assoc 1998;98:699-706. PubMed
  3. Geerling BJ, Dagnelie PC, Badart-Smook A, et al. Diet as a risk factor for the development of ulcerative colitis. Am J Gastroenterol 2000;95:1008-13. PubMed
  4. South M. Neonatal seizures after pyridoxine use -- reply. Lancet 1999;354:2083. PubMed
  5. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (2000). Washington, DC: National Academy Press, 2000. Available at: http://b
  6. Baxter P, Aicardi J. Neonatal seizures after pyridoxine use. Lancet 1999;354:2082-3. PubMed
  7. Bendich A, Cohen M. Vitamin B6 safety issues. Ann N Y Acad Sci 1990;585:321-30.
  8. Schaumburg H, Kaplan J, Windebank A. Sensory neuropathy from pyridoxine abuse. A new megavitamin syndrome. N Engl J Med 1983;309:445-8. PubMed
  9. Gordon N. Pyridoxine dependency: an update. Dev Med Child Neurol 1997;39:63-5. PubMed
  10. Lewis PJ. Pain in the hand and wrist. Pyridoxine supplements may help patients with carpal tunnel syndrome. BMJ 1995;310:1534. PubMed
  11. Kaufman G. Pyridoxine against amiodarone-induced photosensitivity (letter). Lancet 1984;1:51-2. PubMed
  12. Mulrow JP, Mulrow CD, McKenna WJ. Pyridoxine and amiodarone-induced photosensitivity. Ann Intern Med 1985;103:68-9. PubMed
  13. Kawada A, Kashima A, Shiraishi H, et al. Pyridoxine-induced photosensitivity and hypophosphatasia. Dermatology 2000;201:356-60.. PubMed
  14. Vasile A, Goldberg R, Kornberg B. Pyridoxine toxicity: report of a case. J Am Osteopath Assoc 1984;83:790-1. DOI
  15. Hansson O, Sillanpaa M. Pyridoxine and serum concentration of phenytoin and phenobarbitone. Lancet 1976;1:256. DOI
  16. Jansen T, Romiti R, Kreuter A, Altmeyer P. Rosacea fulminans triggered by high-dose vitamins B6 and B12. J Eur Acad Dermatol Venereol 2001;15:484-5..
  17. Chittumma P, Kaewkiattikun K, Wiriyasiriwach B. Comparison of the effectiveness of ginger and vitamin B6 for treatment of nausea and vomiting in early pregnancy: a randomized double-blind controlled trial. J Med Assoc Thai 2007;90:15-20.
  18. Hatzitolios, A., Iliadis, F., Katsiki, N., and Baltatzi, M. Is the anti-hypertensive effect of dietary supplements via aldehydes reduction evidence based? A systematic review. Clin Exp.Hypertens. 2008;30(7):628-639. PubMed
  19. Vasdev, S., Ford, C. A., Parai, S., Longerich, L., and Gadag, V. Dietary vitamin B6 supplementation attenuates hypertension in spontaneously hypertensive rats. Mol.Cell Biochem. 1999;200(1-2):155-162.
  20. de, Vogel S., Dindore, V., van, Engeland M., Goldbohm, R. A., van den Brandt, P. A., and Weijenberg, M. P. Dietary folate, methionine, riboflavin, and vitamin B-6 and risk of sporadic colorectal cancer. J Nutr 2008;138(12):2372-2378. PubMed
  21. Hagen, I., Nesheim, B. I., and Tuntland, T. No effect of vitamin B-6 against premenstrual tension. A controlled clinical study. Acta Obstet.Gynecol.Scand. 1985;64(8):667-670. PubMed
  22. Aybak, M., Sermet, A., Ayyildiz, M. O., and Karakilcik, A. Z. Effect of oral pyridoxine hydrochloride supplementation on arterial blood pressure in patients with essential hypertension. Arzneimittelforschung. 1995;45(12):1271-1273.
  23. Lal, K. J., Dakshinamurti, K., and Thliveris, J. The effect of vitamin B6 on the systolic blood pressure of rats in various animal models of hypertension. J Hypertens. 1996;14(3):355-363. PubMed
  24. Lauritzen CH, Reuter HD, Repges R, Bohnert K, and Schmidt U. Treatment of premenstrual tension syndrome with Vitex agnus castus. Controlled, double-blind study versus pyridoxine. Phytomed 1997;4(3):183-189. PubMed
  25. Fonseca VA, Lavery LA, Thethi TK, et al. Metanx in type 2 diabetes with peripheral neuropathy: A randomized trial. Am J Med 2013;126(2):141-9. PubMed
  26. Hankey GJ, Eikelboom JW, Yi Q, et al. Treatment with B vitamins and incidence of cancer in patients with previous stroke or transient ischemic attack: Results of a randomized placebo-controlled trial. Stroke 2012;43(6):1572-7. PubMed
  27. Hoyer-Kuhn H, Kohbrok S, Volland R, Franklin J, Hero B, Beck BB, Hoppe B. Vitamin B6 in primary hyperoxaluria I: first prospective trial after 40 years of practice. Clin J Am Soc Nephrol. 2014 Mar;9(3):468-77. PubMed
  28. Mahmoud A, Tabassum S, Al Enazi S, et al. Amelioration of levetiracetam-induced behavioral side effects by pyridoxine. A randomized double blind controlled study. Pediatr Neurol 2021;119:15-21. PubMed
  29. Gupta M, Gallante B, Bamberger JN, et al. Prospective randomized evaluation of idiopathic hyperoxaluria treatments. J Endourol 2021;35(12):1844-1851. PubMed
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Biotin 4 references
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See these in context on the Biotin monograph →

Vitamin B12 30 references
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  3. Jansen T, Romiti R, Kreuter A, Altmeyer P. Rosacea fulminans triggered by high-dose vitamins B6 and B12. J Eur Acad Dermatol Venereol 2001;15:484-5..
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  6. Geissbuhler, P., Mermillod, B., and Rapin, C. H. Elevated serum vitamin B12 levels associated with CRP as a predictive factor of mortality in palliative care cancer patients: a prospective study over five years. J.Pain Symptom.Manage. 2000;20(2):93-103. PubMed
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  8. Looker, H. C., Fagot-Campagna, A., Gunter, E. W., Pfeiffer, C. M., Sievers, M. L., Bennett, P. H., Nelson, R. G., Hanson, R. L., and Knowler, W. C. Homocysteine and vitamin B(12) concentrations and mortality rates in type 2 diabetes. Diabetes Metab Res R
  9. Uhl, W., Nolting, A., Golor, G., Rost, K. L., and Kovar, A. Safety of hydroxocobalamin in healthy volunteers in a randomized, placebo-controlled study. Clin Toxicol (Phila) 2006;44 Suppl 1:17-28. PubMed
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See these in context on the Vitamin B12 monograph →

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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

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