Acetaminophen, Pamabrom, Pyrilamine & Nutrient Depletion
Also searched as Midol Max Strength PMS, Pamprin, Pamprin ES. What the clinical evidence reports, what it may mean, and what to discuss with your pharmacist.
Acetaminophen, Pamabrom, Pyrilamine has been associated with depletion of POTASSIUM, VITAMIN C, MAGNESIUM and THIAMINE and 3 more. This does not mean a deficiency will occur — it means these are worth knowing about and, if you take Acetaminophen, Pamabrom, Pyrilamine long-term, worth raising with your pharmacist or healthcare provider.
Take more than one medication? Open the checker with Acetaminophen, Pamabrom, Pyrilamine pre-loaded and add the rest to see overlapping nutrient signals.
Reported nutrient depletions with Acetaminophen, Pamabrom, Pyrilamine
Each record below is shown as published in our licensed clinical database, with its evidence rating and citations. Expand a section for food sources and talking points.
No results match — clear the filter to see everything.
POTASSIUM
Major DepletionDIURETIC DRUGS
Pamabrom, the diuretic ingredient in this combination product, works by making your kidneys release more water through urine, and unfortunately potassium, a mineral your muscles and heart depend on to work properly, tends to leave the body along with that extra fluid. Because this is rated a major depletion, long-term or frequent users have a real reason to pay attention. If you take this product regularly, it is worth asking your pharmacist or doctor whether your potassium levels should be checked.
What Potassium does & food sources
Potassium keeps nerve signals, muscle contractions, and heart rhythm working normally.
Common food sources:
- Bananas and citrus fruits
- Potatoes and sweet potatoes
- Beans and lentils
- Tomatoes and leafy greens
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
Potassium is routinely checked with basic blood work. If you take a medication associated with potassium loss (like some diuretics), ask your provider how often your electrolytes should be monitored.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
Do not start potassium supplements on your own. Both low and high potassium can affect heart rhythm, and several common medications (ACE inhibitors, ARBs, potassium-sparing diuretics) raise potassium.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Caution: Potassium supplementation can be dangerous in kidney disease or alongside potassium-raising medications — this is a decision for your prescriber, guided by lab results.
Learn more about this nutrient: Potassium — uses, safety & interactions
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
VITAMIN C
Insignificant DepletionDIURETIC DRUGS
In people with chronic renal failure, a 20 mg intravenous dose of furosemide (Lasix) increases urinary losses of vitamin C, probably due to increased water excretion. Significant vitamin C depletion hasn't been reported with long-term oral use of furosemide or other diuretics.
This combination product contains pamabrom, a mild diuretic that helps reduce water retention. Because diuretics increase how much urine your body produces, there is a theoretical possibility they could carry a little extra vitamin C (which supports your immune system, skin, and wound healing) out with that extra fluid. In practice, this effect has not been shown to cause any meaningful drop in vitamin C levels with regular use of oral diuretics like pamabrom, so most people taking this product do not need to worry about it or add a supplement. If you have any concerns, a quick conversation with your pharmacist is always a good idea.
What Vitamin C does & food sources
Vitamin C is an antioxidant that supports the immune system, collagen formation, and iron absorption.
Common food sources:
- Citrus fruits
- Bell peppers
- Strawberries and kiwi
- Broccoli and Brussels sprouts
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
Frank vitamin C deficiency is uncommon with a varied diet. If your diet is limited and you take an associated medication, ask your provider whether your intake is adequate.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
Vitamin C is water-soluble and generally low-risk at food-level intakes; very high supplemental doses can cause stomach upset and may not add benefit.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Learn more about this nutrient: Vitamin C — uses, safety & interactions
References (1)
- Mydlik M, Derzsiova K, Zemberova E. Influence of water and sodium diuresis and furosemide on urinary excretion of vitamin B6, oxalic acid and vitamin C in chronic renal failure. Miner Electrolyte Metab 1999;25:352-6..
MAGNESIUM
Moderate DepletionDIURETIC DRUGS
Loop diuretics and, to a lesser extent thiazide diuretics, interfere with magnesium reabsorption in the kidneys, increasing urinary losses and reducing serum magnesium levels. Potassium-sparing diuretics, such as amiloride, triamterene, or spironolactone, are also magnesium-sparing, and can therefore counteract the magnesium losses seen with loop diuretics and thiazides. For information on foods that are rich in magnesium, see our chart.
Pamabrom, the diuretic component in this combination product, works by nudging your kidneys to release more water, and magnesium, a mineral your muscles and nerves depend on, can get swept out along with it. Because pamabrom acts similarly to thiazide diuretics, it may reduce how much magnesium your kidneys hold onto, gradually lowering your body's supply over time. The evidence here is rated moderate, so this is worth paying attention to if you use this product regularly, especially for monthly menstrual relief. It is a good idea to mention this to your pharmacist or doctor, who can help decide whether any monitoring or dietary changes make sense for you.
What Magnesium does & food sources
Magnesium is involved in muscle and nerve function, heart rhythm, blood sugar control, and bone health.
Common food sources:
- Nuts and seeds (almonds, pumpkin seeds)
- Whole grains
- Leafy green vegetables
- Beans and legumes
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
Ask whether a magnesium level is worth checking if you take an associated medication long-term — particularly with symptoms like muscle cramps, twitching, or palpitations. Blood levels do not always reflect total body stores, which is worth discussing too.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
Magnesium supplements come in many forms and can cause loose stools at higher doses. They can also bind some medications in the gut (certain antibiotics, thyroid medication), so timing matters — check with your pharmacist.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Caution: Magnesium supplementation can be risky in kidney disease, where magnesium can accumulate — always check with a clinician first if your kidney function is reduced.
Learn more about this nutrient: Magnesium — uses, safety & interactions
References (4)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Ryan MP. Diuretics and potassium/magnesium depletion. Directions for treatment. Am J Med 1987;82:38-47.. PubMed
- Hollifield JW. Magnesium depletion, diuretics, and arrhythmias. Am J Med 1987;82:30-7.. PubMed
- Heidenreich O. Mode of action of conventional and potassium-sparing diuretics--aspects with relevance to Mg-sparing effects. Magnesium 1984;3:248-56..
THIAMINE
Moderate DepletionDIURETIC DRUGS
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Pamabrom, the mild diuretic in this combination product, works by nudging your kidneys to shed extra water, and that process can carry some thiamine (a B vitamin your nerves and heart muscle depend on) out with it. The risk is considered moderate, and it tends to matter most for older adults who take diuretics long-term or whose diets are already low in B vitamins. If you use this product only occasionally for menstrual bloating, this likely is not a concern, but regular or heavy use is worth a conversation with your pharmacist or doctor.
What Vitamin B1 (thiamine) does & food sources
Thiamine helps convert food into energy and is essential for nerve and heart function.
Common food sources:
- Whole grains and fortified cereals
- Pork
- Beans and lentils
- Nuts and seeds
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
Ask about thiamine if you take an associated medication (for example, a long-term loop diuretic in heart failure) and have symptoms like fatigue or worsening heart failure control — this is an area your care team can weigh.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
Thiamine is water-soluble and generally low-risk, but supplementing to treat a suspected problem should still be clinician-guided so the real cause is not missed.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Learn more about this nutrient: Thiamine — uses, safety & interactions
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
FOLIC ACID
Insufficient EvidenceDIURETIC DRUGS
Limited data suggests diuretics may increase excretion of folic acid. Reduced red blood cell folate levels, possibly contributing to increased homocysteine levels, were found in one group of people taking diuretics for six months or longer. The need for folic acid supplementation during diuretic therapy hasn't been adequately studied. Advise patients to maintain a good dietary intake of folic acid. For information on foods that are rich in folate, see our chart.
Folic acid is a B vitamin your body uses to build healthy red blood cells and keep certain proteins in check. This combination product contains pamabrom, a mild diuretic, and some early research suggests diuretics may cause the kidneys to flush out a bit more folate than usual. That said, the evidence here is quite thin, so this is listed as insufficient to draw firm conclusions. Keeping folate-rich foods in your diet is a sensible step, and if you have concerns, a quick chat with your pharmacist or doctor can help.
What Folic acid (folate) does & food sources
Folate is needed for cell division, red blood cell formation, and healthy fetal development.
Common food sources:
- Leafy green vegetables
- Beans, lentils, and peas
- Fortified grains and cereals
- Citrus fruits
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
Ask your provider whether folate monitoring or supplementation is appropriate for you — this matters most before and during pregnancy, and with long-term use of certain seizure or arthritis medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
Folate needs are individual. With some medications (for example, methotrexate), folic acid is often prescribed deliberately on a specific schedule — follow your prescriber's instructions rather than adding your own.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Caution: High-dose folic acid can mask vitamin B12 deficiency, so the two are often evaluated together.
Learn more about this nutrient: Folic Acid — uses, safety & interactions
References (1)
- Morrow LE, Grimsley EW. Long-term diuretic therapy in hypertensive patients: effects on serum homocysteine, vitamin B6, vitamin B12, and red blood cell folate concentrations. South Med J 1999;92:866-70. PubMed
GLUTATHIONE
Insufficient EvidenceACETAMINOPHEN
Chronic or excessive acetaminophen has been associated with low levels of glutathione. Usually a cysteine containing supplement is used to replenish glutathione. Cysteine is converted to glutathione in the body.
Glutathione is a natural antioxidant your body makes to protect cells from damage, and the acetaminophen in this product can actually use up a fair amount of it as the liver works to break the drug down. That said, the research here is still thin, and this concern is mainly tied to high or long-term acetaminophen use rather than typical doses taken as directed. Because the evidence is currently insufficient, most people using this product occasionally have little reason to worry. If you take acetaminophen regularly or in large amounts, it is worth bringing up with your pharmacist or doctor.
Learn more about this nutrient: Glutathione — uses, safety & interactions
References (1)
- Herzenberg LA, De Rosa SC, Dubs JG, et al. Glutathione deficiency is associated with impaired survival in HIV disease. Proc Natl Acad Sci USA 1997;94:1967-72. PubMed
SODIUM
Insufficient EvidenceDIURETIC DRUGS
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Pamabrom, the mild diuretic ingredient in this combination product, works by nudging your kidneys to release more fluid, and there is a theoretical concern that this process could also carry some sodium out of the body. Sodium is the mineral that keeps your fluid balance, nerve signals, and muscle function on track. That said, pamabrom is a very gentle diuretic, and right now there simply is not enough evidence to know whether this combination meaningfully affects sodium levels in real patients. Most people using this occasional product do not need to worry, but if you have any questions about your sodium levels, it is worth a quick chat with your pharmacist or doctor.
What Sodium does & food sources
Sodium maintains fluid balance, blood pressure, and nerve/muscle function.
Common food sources:
- Table salt and most processed foods — dietary shortage is rare; medication-related loss is about balance, not intake
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
Sodium is part of routine blood work. If you take an associated medication (like certain diuretics or antidepressants), ask how often your electrolytes should be checked — especially if you feel confused, weak, or unusually tired.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
Low sodium from a medication is managed by your care team (often by adjusting the medication or fluids) — not by eating more salt on your own.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Caution: Significant symptoms of low sodium (confusion, severe weakness) warrant prompt medical attention.
Learn more about this nutrient: Sodium — uses, safety & interactions
References (2)
- Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
- Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.
This tool is educational and is not a substitute for professional medical advice. An association is not a diagnosis and does not mean a deficiency will occur. Always talk to your pharmacist or healthcare provider before starting, stopping, or changing any medication or supplement.
Disclaimer: This checker finds which nutrients might be depleted by prescription or over-the-counter medications. Each nutrient depletion issue is rated based on clinical significance. Use your own professional judgment prior to making clinical decisions.© 2026 Therapeutic Research Center Licensed records refresh weekly · last updated July 3, 2026.
More about Acetaminophen, Pamabrom, Pyrilamine
What drug-induced nutrient depletion means
Some medications can, over time, lower the levels of certain vitamins, minerals, or other nutrients — through reduced absorption, increased loss, or changes in how the body uses them.
Association is not deficiency
An entry here means a depletion has been reported or studied — not that it happens to everyone, or that you are deficient. Dose, duration, diet, and your own health all matter.
Evidence varies by pair
Some drug–nutrient links (like metformin and vitamin B12) are well studied; others rest on limited or preliminary research. Each entry shows the evidence rating from our licensed clinical database.
When to ask about labs
If you take an associated medication long-term, ask your healthcare provider whether monitoring is appropriate for you. Not everyone needs testing — your provider can weigh your dose, duration, and symptoms.
Don't self-supplement blindly
Supplements are not risk-free: some can interact with medications, and some (like potassium or magnesium) can be risky with kidney disease. Talk to your pharmacist before adding anything.
Never stop a medication over this
These medications are prescribed for good reasons, and the benefit usually far outweighs a manageable nutrient consideration. Any change belongs in a conversation with your prescriber.
Food first, usually
For many nutrients, a varied diet covers the gap. Each entry lists common food sources; a supplement is a decision to make with your pharmacist or provider, not a default.
Acetaminophen, Pamabrom, Pyrilamine & nutrients: FAQs
Does Acetaminophen, Pamabrom, Pyrilamine deplete POTASSIUM?
Should I take a supplement because I take Acetaminophen, Pamabrom, Pyrilamine?
Should I stop taking Acetaminophen, Pamabrom, Pyrilamine?
Where does this information come from?
Questions about Acetaminophen, Pamabrom, Pyrilamine and your nutrition?
Ask a licensed pharmacist — free, no appointment needed.
Sources & How We Checked
Nutrient depletion records for Acetaminophen, Pamabrom, Pyrilamine are evidence-graded and sourced from the Natural Medicines database, and are displayed as published with their citations.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for drug-induced nutrient depletions, supplements, and interactions — the basis for this page.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for medication overviews across the site.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.