Interactions on record — worth a quick check against your medications. Based on 4 of 6 ingredients. Check your meds →
Dietary supplement

VP-ZEL Tabs Ingredients & Drug Interactions

by Virtus Pharmaceuticals

VP-ZEL Tabs label
See full label image
Tablet Or Pill Category: Other Combinations
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 VP-ZEL Tabs 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

VP-ZEL Tabs is a dietary supplement by Virtus Pharmaceuticals with 6 active ingredients. Its ingredients are commonly taken for preventing neural tube birth defects, treating or preventing folate deficiency, supporting pregnancy health.Based on those ingredients, 313 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Pyridoxine, Zinc, Folic Acid. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against VP-ZEL Tabs by Virtus Pharmaceuticals

Ask about any prescription or over-the-counter medication and we check it for interactions with VP-ZEL Tabs by Virtus Pharmaceuticals — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of VP-ZEL Tabs by Virtus Pharmaceuticals

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 11, 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 6 of its 6 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

VP-ZEL Tabs contains 6 ingredients. The active ones are folic acid (a B vitamin needed for cell division and DNA), zinc (a mineral that supports immunity and wound healing), nicotinamide (a form of niacin, or vitamin B3), pyridoxine (vitamin B6, which helps your body use proteins), copper (a trace mineral involved in energy and iron metabolism), and azelaic acid (a naturally occurring compound with antimicrobial properties).

The product also contains several inactive ingredients — microcrystalline cellulose, dicalcium phosphate, croscarmellose sodium, stearic acid, magnesium stearate, silica, and a film coat — that serve as binders, fillers, and capsule material.

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: Dietary management of nutritional needs with increased folate.
  • We looked for evidence on: Anemia, Copper deficiency, Abdominal wall defects, Folate deficiency, Pregnancy support, Neural tube defect prevention.
  • The strongest evidence on file: Vitamin B6 is rated "Effective" for Sideroblastic anemia (Natural Medicines).
  • Also on file: Folic Acid is rated "Effective" for Folate deficiency.
  • Also on file: Copper is rated "Likely Effective" for Copper deficiency.

Folic acid in this product is effective for treating folate deficiency and likely effective for preventing methotrexate toxicity and neural tube birth defects; it's possibly effective for depression, phenytoin-induced gingival hyperplasia (swelling of the gums), and cognitive impairment. Zinc is effective for zinc deficiency and likely effective for Wilson disease; it's possibly effective for acne, acrodermatitis enteropathica, age-related macular degeneration, and diabetes.

Vitamin B6 is effective for sideroblastic anemia, vitamin B6 deficiency, and pyridoxine-dependent epilepsy; it's likely effective for high homocysteine levels and possibly effective for pregnancy-related nausea and vomiting. Copper is likely effective for copper deficiency and possibly ineffective for Alzheimer disease.

We hold no effectiveness data for nicotinamide or azelaic acid.

The evidence, ingredient by ingredient Folic Acid Zinc Vitamin B6 Copper

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.

Folic acid is generally well tolerated at recommended doses. At doses of 5 mg daily, some people experience abdominal cramps, diarrhea, or rash; at 15 mg daily, bitter taste, confusion, nausea, and sleep disturbances can occur.

Rarely, very high long-term doses have been linked to cancer, cardiovascular complications, liver injury, or seizures. Folic acid use late in pregnancy has been associated with a slightly increased risk of childhood asthma and lower-respiratory infections up to 18 months of age in population studies, though early pregnancy use was not.

Zinc is well tolerated below 40 mg daily; higher doses are cautioned against. Common side effects are abdominal cramps, diarrhea, nausea, vomiting, and a metallic taste — all dose-related.

Long-term high-dose zinc may deplete copper, leading to anemia or low white blood cells. Vitamin B6 is safe at normal amounts, but high doses over time can damage nerves (sensory neuropathy).

At standard doses, it may cause headache, nausea, or loss of appetite. Copper is safe in recommended amounts from food and standard supplements; excess can be toxic.

We hold no pregnancy or breastfeeding safety data for zinc, vitamin B6, copper, nicotinamide, or azelaic acid.

Side effects, ingredient by ingredient Folic Acid Zinc Vitamin B6 Copper

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?
  • 4 of the 4 matched ingredients can interact with medications — Copper, Vitamin B6, Zinc, Folic Acid.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: Parkinson's medications.
  • For scale: 313 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 starting VP-ZEL Tabs, double-check if you take seizure medications (phenytoin, phenobarbital, primidone), cancer drugs (methotrexate, capecitabine, 5-fluorouracil), quinolone or tetracycline antibiotics, cephalexin, penicillamine, ritonavir, HIV integrase inhibitors, amiodarone, or oral contraceptives. These are the drug types where we have documented moderate to minor interactions with ingredients in this product.

No interactions are documented for the nicotinamide and azelaic acid we hold no data for.

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.

This product is right for someone with documented folic acid, zinc, vitamin B6, or copper deficiency who isn't taking medications that interact with these nutrients. If you're on any seizure medication, cancer treatment, antibiotic, blood-pressure drug, or HIV medication, check with your pharmacist first — the interactions are real and can affect how your drugs work.

Folic acid is recommended during pregnancy at standard prenatal doses, but talk with your doctor or pharmacist about the right formulation and amount for your situation.

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

Assessment coverage: 4 of 6 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Aug 23, 2013.

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 VP-ZEL Tabs, straight from the product label.

Brand Virtus Pharmaceuticals
Barcode (UPC) 376439221607
Net contents 60 Tablet(s)
Market status On market
Date entered into DSLD Aug 23, 2013
DSLD ID 22193
Product type Other Combinations
Supplement form Tablet Or Pill
Dietary claims / uses All Other
Intended target group(s) Adult (18 - 50 Years)
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 VP-ZEL Tabs by Virtus Pharmaceuticals, 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
60
UPC/BARCODE
376439221607
IngredientAmount% DV
Folic Acid500 mcg--
Zinc10 mg--
Nicotinamide600 mg--
Pyridoxine5 mg--
Copper1.5 mg--
Azelaic Acid5 mg--

Other ingredients: Microcrystalline Cellulose, Dicalcium Phosphate, Croscarmellose Sodium, Stearic Acid, Magnesium Stearate, Silica, film coat

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.
General Statements

Azelaic acid is an organic compound with the formula (CH2)7(CO2H)2 [or also as C9H16O4], and has CAS number 123-99-9. It is in the dicarboxylic acid (saturated) group, and is occurs naturally in wheat, rye, and barley.

Each coated, purple colored, oval-shaped tablet contains the following dietary ingredients:

Made in USA

Dispense in a tight, light-resistant container.

This is not an Orange Book product.

NDC+: 76439-221-60 +See insert for more information about National Drug Codes (NDC).

PATIENT INFORMATION: VP-ZEL Tabs is a prescription dietary supplement to be used only under licensed medical supervision.

FOLATE REGULATION: The term "folate" are B vitamins that include folic acid and any forms of active pteroylglutamates regardless of the reduction state of the molecule. Folates, or vitamin B9, are primarily hydrolyzed in the intestinal jejunum and the liver to the active circulating form of folate, l-methylfolate, with an intermediate stable form, 5,10-methylenetetrahydrofolate. Individuals with genetic polymorphorisms for the genes coding methylenetetrahydrofolate reductase (MTHFR) may not be capable of utilizing or metabolizing folic acid adequately for the vitamin B12 dependent methylation cycle. Folic acid, including reduced forms* such as folinic acid, may obscure pernicious anemia above 0.1 mg doses, and must be administered under the supervision of a licensed medical practitioner. The 1971, 1972, 1973, 1980, 1984, 2000, and 2010 Federal Register Notices addressed this concern while establishing that increased folate was proper therapy in megaloblastic anemias - specifically where homocysteine levels were elevated or risk of neural tube defects (NTDs) was at issue. The Federal Register Notice of August 2, 1973 (38 FR 20750) specifically states that: Dietary supplement preparations are available without a prescription (21 CFR 121.1134). Levels higher than dietary supplement amounts are available only with a prescription. Folic acid - including reduced forms, may be added to medical foods as defined in section 5(b) (3) of the Orphan Drug Act (21 USC 360ee(b)(3)), or to food (21 CFR 172.345).

*These products are dietary supplements that - due to increased folate levels (AUG 3 1973 FR 20750), require an Rx on the label because of increased risk associated with masking of B12 deficiency. As such this product requires licensed medical supervision, an Rx status, and a national drug code (NDC) as required by pedigree reporting requirements.

HOW SUPPLIED: VP-ZEL Tabs tablets are coated, purple colored, oval-shaped tablets debossed on one side with “V221”, and are supplied in bottles of 60 tablets.

All prescriptions using this product shall be pursuant to state statutes as applicable. This is not an Orange Book product.

Formula

DESCRIPTION: VP-ZEL Tabs is an orally administered prescription dietary supplement specifically formulated for the dietary management of patients with unique nutritional needs requiring increased folate levels and nutritional supplementation.

Precautions

VP-ZEL Tabs should be administered under the supervision of a licensed medical practitioner.

If you are pregnant or nursing a baby, please ask a health professional.

KEEP THIS OUT OF REACH OF CHILDREN.

Call your licensed medical practitioner about side effects.

CONTRAINDICATIONS: This product is contraindicated in patients with a known hypersensitivity to any of the ingredients.

WARNINGS: Caution is recommended in patients with a history of bipolar illness.

DRUG INTERACTIONS: Drugs which may interact with folate include: - Antiepileptic drugs (AED): The AED class including, but not limited to, phenytoin, carbamazepine, primidone, valproic acid, fosphenytoin, valproate, phenobarbital and lamotrigine have been shown to impair folate absorption and increase the metabolism of circulating folate. - Additionally, concurrent use of folic acid has been associated with enhanced phenytoin metabolism, lowering the level of the AED in the blood and allowing breakthrough seizures to occur. Caution should be used when prescribing this product among patients who are receiving treatment with phenytoin and other anticonvulsants. - Capecitabine: Folinic acid (5-formyltetrahydrofolate) may increase the toxicity of Capecitabine. - Cholestyramine: Reduces folic acid absorption and reduces serum folate levels. - Colestipol: Reduces folic acid absorption and reduces serum folate levels. - Cycloserine: Reduces folic acid absorption and reduces serum folate levels. - Dihydrofolate Reductase Inhibitors (DHFRI): DHFRIs block the conversion of folic acid to its active forms, and lower plasma and red blood cell folate levels. DHFRIs include aminopterin, methotrexate, pyrimethamine, triamterene, and trimethoprim. - Fluoxetine: Fluoxetine exerts a noncompetitive inhibition of the 5-methyltetrahydrofolate active transport in the intestine. - Isotretinoin: Reduced folate levels have occurred in some patients taking isotretinoin. - L-dopa, triamterene, colchicine, and trimethoprim may decrease plasma folate levels. - Nonsteroidal Anti-inflammatory Drugs (NSAIDs): NSAIDs have been shown to inhibit some folate dependent enzymes in laboratory experiments. - NSAIDs include ibuprofen, naproxen, indomethacin and sulindac. - Oral Contraceptives: Serum folate levels may be depressed by oral contraceptive therapy. - Methylprednisolone: Reduced serum folate levels have been noted after treatment with methylprednisolone. - Pancreatic Enzymes: Reduced folate levels have occurred in some patients taking pancreatic extracts, such as pancreatin and pancrelipase. - Pentamidine: Reduced folate levels have been seen with prolonged intravenous pentamidine. - Pyrimethamine: High levels of folic acid may result in decreased serum levels of pyrimethamine. - Smoking and Alcohol: Reduced serum folate levels have been noted. - Sulfasalazine: Inhibits the absorption and metabolism of folic acid. - Metformin treatment in patients with type 2 diabetes decreases serum folate. - Warfarin can produce significant impairment in folate status after a 6-month therapy. Drugs which may interact with nicotinamide: - The clearance of primidone and carbamazepine may be reduced with the concomitant use of nicotinamide. Drugs which may interact with zinc oxide: - The absorption of quinolones or tetracycline may be decreased with the concomitant use of zinc. Drugs which may interact with cupric oxide: - Concomitant use of penicillamine and copper can cause decreased absorption of both substances. PREGNANCY and NURSING MOTHERS: VP-ZEL Tabs is not intended for use as a prenatal/ postnatal multivitamin for lactating and nonlactating mothers. Talk with your medical practitioner before using if pregnant or lactating.

PRECAUTIONS: General: Folate, when administered as a single agent in doses about 0.1 mg daily, may obscure the detection of vitamin B12 deficiency (specifically, the administration of folic acid may reverse the hematological manifestations of B12 deficiency, including pernicious anemia, while not addressing the neurological manifestations). Folate therapy alone is inadequate for treatment of a vitamin B12 deficiency.

PREGNANCY and NURSING MOTHERS: VP-ZEL Tabs is not intended for use as a prenatal/postnatal multivitamin for lactating and nonlactating mothers. Talk with your medical practitioner before using if pregnant or lactating.

ADVERSE REACTIONS: Allergic sensitization has been reported following both oral and parental administration of folic acid, and may possibly occur with other forms of folate.

Suggested/Recommended/Usage/Directions

DOSAGE AND ADMINISTRATION: Usual adult dose is one or two tablets taken once or twice a day with or without food or as prescribed by a licensed medical practitioner.

INDICATIONS AND USAGE: VP-ZEL Tabs is indicated for the distinct nutritional requirements of patients in need of dietary supplementation as determined by a licensed medical practitioner. VP-ZEL Tabs should be administered under the supervision of a licensed medical practitioner.

FDA Statement of Identity

Prescription Dietary Supplement

Rx

Storage

STORAGE: Store at Controlled Room Temperature 15(0)-30(0)C (59(0)-86(0)F). [See USP]. Protect from light and moisture.

General

Rev. 09/12

Seals/Symbols

V Virtus PHARMACEUTICALS

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

See for yourself

VP-ZEL Tabs by Virtus Pharmaceuticals label

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

VP-ZEL Tabs 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 VP-ZEL Tabs by Virtus Pharmaceuticals

These are the 6 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Tablet(s) Dosage formTablet Or Pill Servings per container60 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.

Folic Acid

Interacts with
40 drugs
500 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

Zinc

Interacts with
67 drugs
10 mg per serving Form: Zinc Oxide

Zinc is an essential mineral that your body needs for immune function, wound healing, taste, and smell. Most people get enough from food, but suppleme...

Zinc monograph & interactions

Nicotinamide

600 mg per serving Form: Vitamin B3

Pyridoxine

Interacts with
210 drugs
5 mg per serving

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...

Pyridoxine monograph & interactions

Copper

Interacts with
31 drugs
1.5 mg per serving Form: Cupric Oxide

Copper is an essential trace mineral your body needs in small amounts for making red blood cells, supporting nerves and bones, and helping enzymes wor...

Copper monograph & interactions

Azelaic Acid

5 mg per serving

Other (inactive) ingredients: Microcrystalline Cellulose, Dicalcium Phosphate, Croscarmellose Sodium, Stearic Acid, Magnesium Stearate, Silica, Film coat. These complete the product’s ingredient list but are not active constituents.

Interaction report

VP-ZEL Tabs by Virtus Pharmaceuticals Drug Interactions

Want to check YOUR meds against VP-ZEL Tabs?

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
313Drugs
276 Moderate 37 Minor

Ingredients driving the most interactions

Pyridoxine 210
Zinc 67
Folic Acid 40
Copper 31

Individual Drug Interactions

The ingredients in VP-ZEL Tabs interact with 313 drugs. Click any drug to see the details.

4 of the 6 ingredients in VP-ZEL Tabs interact with drugs. Each result below shows which ingredient is responsible. Pyridoxine Zinc Folic Acid Copper

Each ingredient & the kinds of drugs it affects

For each ingredient in VP-ZEL Tabs 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.

Pyridoxine5 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
Pyridoxine full monograph & interactions

Zinc10 drug types · 67 drugs

Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)

Theoretically, zinc might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide should be taken at least 2 hours before or 6 hours after zinc containing products.

Likelihood Probable Evidence D
Cephalexin (Keflex)

Zinc might decrease cephalexin levels by chelating with cephalexin in the gut and preventing its absorption.
A pharmacokinetic study shows that zinc sulfate 250 mg taken concomitantly with cephalexin 500 mg decreases peak levels of cephalexin by 31% and reduces the exposure to cephalexin by 27%. Also, taking zinc sulfate 3 hours before cephalexin decreases peak levels of cephalexin by 11% and reduces the exposure to cephalexin by 18%. By decreasing cephalexin levels, zinc might increase the risk of treatment failure. This effect does not occur when zinc is taken 3 hours after the cephalexin dose. To avoid an interaction, advise patients take zinc sulfate 3 hours after taking cephalexin.

Likelihood Probable Evidence B
Cisplatin (Platinol-Aq)

Theoretically, zinc might interfere with the therapeutic effects of cisplatin.
Animal research suggests that zinc stimulates tumor cell production of the protein metallothionein, which binds and inactivates cisplatin. It is not known whether zinc supplements or high dietary zinc intake can cause clinically significant interference with cisplatin therapy. Cisplatin might also increase zinc excretion.

Likelihood Possible Evidence D
Integrase Inhibitors

Theoretically, taking zinc along with integrase inhibitors might decrease the levels and clinical effects of these drugs.
Zinc is a divalent cation. Pharmacokinetic studies have shown that other divalent cations such as calcium and iron can decrease blood levels of the integrase inhibitor dolutegravir through chelation.

Likelihood Possible Evidence D
Penicillamine (Cuprimine, Depen)

Zinc might reduce the levels and clinical effects of penicillamine.
By forming an insoluble complex with penicillamine, zinc interferes with penicillamine absorption and activity. Zinc supplements reduce the efficacy of low-dose penicillamine (0.5-1 gram/day), but do not seem to affect higher doses (1-2.75 gram/day), provided dosing times are separated. Advise patients to take zinc and penicillamine at least 2 hours apart.

Likelihood Probable Evidence B
Quinolone Antibiotics

Zinc can decrease the levels and clinical effects of quinolones antibiotics.
Quinolones form complexes with zinc in the gastrointestinal tract, reducing absorption of both the quinolone and zinc if taken at the same time. Advise patients to take these drugs at least 2 hours before, or 4-6 hours after, zinc supplements.

Likelihood Probable Evidence B
Ritonavir (Norvir)

Zinc modestly reduces levels of ritonavir.
Clinical research shows that zinc might reduce serum ritonavir levels by chelating with ritonavir in the gut and preventing its absorption. In patients with HIV, ritonavir is taken with atazanavir to prevent the metabolism and increase the effects of atazanavir. A pharmacokinetic study shows that, in patients being treated with atazanavir/ritonavir, co-administration of zinc sulfate (Solvazinc tablets) 125 mg as a single dose or as multiple daily doses for 2 weeks reduces plasma levels of ritonavir by about 16%. However, atazanavir levels still remains high enough to prevent HIV virus replication. Therefore, the decrease in ritonavir levels is not likely to be clinically significant.

Likelihood Probable Evidence B
Tetracycline Antibiotics

Zinc might reduce levels of tetracycline antibiotics.
Tetracyclines form complexes with zinc in the gastrointestinal tract, which can reduce absorption of both the tetracycline and zinc when taken at the same time. Taking zinc sulfate 200 mg with tetracycline reduces absorption of the antibiotic by 30% to 40%. Demeclocycline and minocycline cause a similar interaction. However, doxycycline does not seem to interact significantly with zinc. Advise patients to take tetracyclines at least 2 hours before, or 4-6 hours after, zinc supplements to avoid any interactions.

Likelihood Probable Evidence B
Amiloride (Midamor)

Amiloride can modestly reduce zinc excretion and increase zinc levels.
Clinical research shows that amiloride can reduce urinary zinc excretion, especially at doses of 10 mg per day or more. This zinc-sparing effect can help to counteract zinc losses caused by thiazide diuretics, but it is unlikely to cause zinc toxicity at usual amiloride doses. The other potassium-sparing diuretics, spironolactone (Aldactone) and triamterene (Dyrenium), do not seem to have a zinc-sparing effect.

Likelihood Probable Evidence B
Atazanavir (Reyataz)

Zinc modestly reduces levels of atazanavir, although this effect does not seem to be clinically significant.
Clinical research shows that zinc might decrease serum atazanavir levels by chelating with atazanavir in the gut and preventing its absorption. Although a single dose of zinc sulfate (Solvazinc tablets) 125 mg orally does not affect atazanavir concentrations in patients being treated with atazanavir/ritonavir, co-administration of zinc sulfate 125 mg daily for 2 weeks reduces plasma levels of atazanavir by about 22% in these patients. However, despite this decrease, atazanavir levels still remain at high enough concentrations for the prevention of HIV virus replication.

Likelihood Probable Evidence B
Zinc 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

Copper2 drug types · 31 drugs

Penicillamine (Cuprimine, Depen)

Theoretically, taking copper with penicillamine might decrease the absorption of penicillamine; separate dosing by at least 2 hours.
Copper chelates penicillamine, which decreases its absorption and may reduce its clinical effects.

Likelihood Probable Evidence D
Contraceptive Drugs

Theoretically, taking copper with contraceptive drugs might increase the levels and toxic effects of copper.
A meta-analysis of clinical studies suggests that chronic use of oral contraceptives increases serum copper levels by a mean of 57 mcg/dL. In most people, this resulted in levels above the normal reference range for copper.

Likelihood Possible Evidence D
Copper full monograph & interactions
The maker

Brand information

Manufacturer and brand details for VP-ZEL Tabs, from the product label.

Virtus Pharmaceuticals

See all Virtus Pharmaceuticals products
Name
Virtus Pharmaceuticals, LLC
City
Tampa
State
FL
ZipCode
33619
Pharmacist Counseling Corner

VP-ZEL Tabs by Virtus Pharmaceuticals: Common Questions

Does VP-ZEL Tabs by Virtus Pharmaceuticals interact with any medications?
Yes. Based on its ingredients, VP-ZEL Tabs has a known interaction with 313 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
VP-ZEL Tabs contains 6 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.
Is this safe to take if I'm pregnant?
Folic acid — the main ingredient here — is recommended during pregnancy at standard prenatal doses to help prevent birth defects. However, we don't have pregnancy safety data on file for the other ingredients (zinc, vitamin B6, copper, nicotinamide, and azelaic acid). Talk with your doctor or pharmacist about whether this specific product is right for you during pregnancy.
Does folic acid really prevent birth defects?
Yes — folic acid is likely effective at preventing neural tube birth defects. It's also recommended during pregnancy at standard prenatal doses. That said, always follow your doctor's recommendation on prenatal vitamins.
Can I take this while breastfeeding?
Folic acid is considered safe at normal recommended doses while breastfeeding. We don't have breastfeeding safety data for zinc, vitamin B6, copper, nicotinamide, or azelaic acid — talk with your pharmacist about your specific situation.
What does zinc do in this product?
Zinc supports your immune system and helps with wound healing. It's effective for treating zinc deficiency and likely effective for Wilson disease. It's also possibly effective for acne and age-related macular degeneration.
At what dose does vitamin B6 become risky?
Vitamin B6 is well tolerated at doses below 100 mg daily. High doses over a long time can damage nerves (a condition called sensory neuropathy), especially doses above 1,000 mg daily or total doses of 1,000 grams or more, but nerve damage can occur even at lower doses. Stick to recommended amounts.
Can high-dose zinc hurt me?
Yes. Zinc above 40 mg daily (the upper safe limit for adults) can be harmful over time. High-dose long-term zinc may deplete copper, potentially leading to anemia or low white blood cells. Common side effects at any dose include nausea, diarrhea, and a metallic taste.

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.

VP-ZEL Tabs label
Go deeper

The Full Monographs Behind VP-ZEL Tabs’s Ingredients

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

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

Zinc

Interacts with 67 drugs

Zinc is an essential mineral that your body needs for immune function, wound healing, taste, and smell. Most people get enough from food, but supplements can help correct or prevent a defici...

Read the full Zinc monograph → 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

Copper

Interacts with 31 drugs

Copper is an essential trace mineral your body needs in small amounts for making red blood cells, supporting nerves and bones, and helping enzymes work. Most people get enough copper from fo...

Read the full Copper monograph →
Sources

Sources & How We Checked

VP-ZEL Tabs'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 187 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.

Folic Acid 56 references
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See these in context on the Folic Acid monograph →

Zinc 88 references
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  55. Sharquie, K. E., Najim, R. A., Farjou, I. B., and Al Timimi, D. J. Oral zinc sulphate in the treatment of acute cutaneous leishmaniasis. Clin.Exp.Dermatol. 2001;26(1):21-26. PubMed
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  58. Jafek, B. W., Linschoten, M. R., and Murrow, B. W. Anosmia after intranasal zinc gluconate use. Am J Rhinol. 2004;18(3):137-141. DOI
  59. Simonart, T. and de, Maertelaer, V. Systemic treatments for cutaneous warts: a systematic review. J Dermatolog.Treat. 2012;23(1):72-77. PubMed
  60. Cochran, R. J., Tucker, S. B., and Flannigan, S. A. Topical zinc therapy for acne vulgaris. Int.J Dermatol. 1985;24(3):188-190. DOI
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Vitamin B6 32 references
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Copper 11 references
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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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