Drug-induced nutrient depletion

Polymyxin B , Neomycin & Nutrient Depletion

Also searched as Neosporin G.U. Irrigant. What the clinical evidence reports, what it may mean, and what to discuss with your pharmacist.

3Nutrient associations
Insignificant DepletionHighest rating
The bottom line

Polymyxin B , Neomycin has been associated with depletion of BETA-CAROTENE, VITAMIN A and VITAMIN B12. This does not mean a deficiency will occur — it means these are worth knowing about and, if you take Polymyxin B , Neomycin long-term, worth raising with your pharmacist or healthcare provider.

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Take more than one medication? Open the checker with Polymyxin B , Neomycin pre-loaded and add the rest to see overlapping nutrient signals.

The evidence

Reported nutrient depletions with Polymyxin B , Neomycin

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.

BETA-CAROTENE

Insignificant Depletion

NEOMYCIN

Neomycin might modestly reduce levels of beta-carotene.

Oral neomycin sulfate in doses of 4-12 grams per day causes malabsorption and can reduce beta-carotene absorption. However, this is not likely to be clinically significant with short-term neomycin use.
Taking Polymyxin B , Neomycin? A supplement is not needed for most patients.
Dr. Brian Staiger, Pharm.D explains

Beta-carotene is a plant pigment your body converts into vitamin A, which supports healthy vision, skin, and immune function. The neomycin component of this combination can interfere with how your gut absorbs certain nutrients, including beta-carotene, particularly at high doses taken over time. That said, this is rated insignificant, meaning a short course at typical doses is very unlikely to cause a real problem for most people. No action is needed for the average patient, but if you have questions about your specific situation, your pharmacist is a great first stop.

What Vitamin A does & food sources

Vitamin A supports vision, immune function, and skin health.

Common food sources:

  • Liver and fish oils
  • Dairy and eggs
  • Orange and yellow vegetables (as beta-carotene)
  • Leafy greens

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

What to discuss with your clinician

Ask your provider before supplementing vitamin A — status testing is not routine, and intake from food plus multivitamins is often already adequate.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Supplement considerations

Vitamin A is fat-soluble and accumulates; excess is harmful (and dangerous in pregnancy). Prefer food sources unless a clinician advises otherwise.

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: Avoid high-dose vitamin A in pregnancy or when trying to conceive unless a clinician directs it.

Learn more about this nutrient: Beta-carotene — uses, safety & interactions

References (1)
  1. Jacobson ED, Faloon WW. Malasorptive effects of neomycin in commonly used doses. JAMA 1961;175:187-90.

VITAMIN A

Insignificant Depletion

NEOMYCIN

Neomycin might modestly reduce levels of vitamin A.

Neomycin can bind and precipitate fatty acids and bile acids in the gut, reducing fat absorption. There is limited evidence that this can affect fat-soluble vitamin absorption. Single doses of neomycin reduced absorption of large doses (300,000 units) of vitamin A given concurrently. However, there was no change in serum vitamin A levels in adults who took neomycin 1-2 grams/day for 18 weeks for treatment of hyperlipoproteinemia. It's unlikely that neomycin will cause clinically significant vitamin A depletion.
Taking Polymyxin B , Neomycin? A supplement is not needed for most patients.
Dr. Brian Staiger, Pharm.D explains

Vitamin A is a fat-soluble nutrient your body uses for healthy vision, immune function, and skin. Neomycin, one of the antibiotics in this combination, can interfere with how your gut absorbs fats by binding to bile acids in the digestive tract, and since vitamin A travels alongside fat, absorption could theoretically take a small hit. That said, studies in people taking neomycin regularly for months showed no meaningful drop in vitamin A blood levels, so this is considered an insignificant concern for most patients. No action is needed for the average person, but if you have questions about your nutritional status, your pharmacist or doctor is a great place to start.

What Vitamin A does & food sources

Vitamin A supports vision, immune function, and skin health.

Common food sources:

  • Liver and fish oils
  • Dairy and eggs
  • Orange and yellow vegetables (as beta-carotene)
  • Leafy greens

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

What to discuss with your clinician

Ask your provider before supplementing vitamin A — status testing is not routine, and intake from food plus multivitamins is often already adequate.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Supplement considerations

Vitamin A is fat-soluble and accumulates; excess is harmful (and dangerous in pregnancy). Prefer food sources unless a clinician advises otherwise.

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: Avoid high-dose vitamin A in pregnancy or when trying to conceive unless a clinician directs it.

Learn more about this nutrient: Vitamin A — uses, safety & interactions

References (2)
  1. Barrowman JA, Broomhall J, Cannon AM, et al. Impairment of vitamin A absorption by neomycin. Clin Sci 1972;42:17P. PubMed
  2. Schade RWB, van't Laar A, Majoor CLH, Jansen AP. A comparative study of the effects of cholestyramine and neomycin in the treatment of type II hyperlipoproteinemia. Acta Med Scand 1976;199:175-80..

VITAMIN B12

Insignificant Depletion

NEOMYCIN

Neomycin, when taken in typical doses and for a typical duration, is unlikely to reduce levels of vitamin B12.

Absorption of vitamin B12 can be reduced by neomycin, but prolonged use of large doses is needed to induce pernicious anemia. Supplements aren't needed with normal doses. For information on foods that are rich in vitamin B12, see our chart.
Taking Polymyxin B , Neomycin? A supplement is not needed for most patients.
Dr. Brian Staiger, Pharm.D explains

Vitamin B12 is something your nerves and red blood cells genuinely depend on, so it is worth knowing how neomycin relates to it. Neomycin can interfere with how your gut absorbs vitamin B12, but research shows this only becomes a real concern with very large doses taken over a long period of time. At the normal doses used in most treatments, this is rated an insignificant depletion, meaning the vast majority of people have nothing to worry about. No routine supplement is needed, but if you ever have questions about your specific situation, your pharmacist is a great first stop.

What Vitamin B12 does & food sources

Vitamin B12 supports red blood cell formation, nerve function, and DNA synthesis.

Common food sources:

  • Meat, poultry, and fish
  • Eggs and dairy products
  • Fortified cereals and nutritional yeast

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

What to discuss with your clinician

If you take an associated medication long-term, ask your healthcare provider whether checking a vitamin B12 level (sometimes with methylmalonic acid) is appropriate — especially if you notice fatigue, numbness, tingling, or memory changes.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Supplement considerations

B12 status is easy to check and low levels are usually straightforward to address, so testing before supplementing is often the sensible order. High-dose folic acid can mask a B12 deficiency, which is one reason B12 and folate questions are best sorted out together with your provider.

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: B12 deficiency can look like other conditions — do not self-diagnose from symptoms alone.

Learn more about this nutrient: Vitamin B12 — uses, safety & interactions

References (2)
  1. Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
  2. Jacobson ED, Faloon WW. Malabsorptive effects of neomycin in commonly used doses. JAMA 1961;175:187-90. DOI
Important

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.
Understand the basics

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.

Common questions

Polymyxin B , Neomycin & nutrients: FAQs

Does Polymyxin B , Neomycin deplete BETA-CAROTENE?
Polymyxin B , Neomycin has been associated with lower BETA-CAROTENE levels in the clinical literature — see the evidence rating and details above. An association is not a guarantee: dose, duration, diet, and your own health all matter. If you take Polymyxin B , Neomycin long-term, ask your healthcare provider whether checking your BETA-CAROTENE status is appropriate.
Should I take a supplement because I take Polymyxin B , Neomycin?
Not automatically. The right first step is usually a conversation with your pharmacist or provider — they can weigh your dose and duration, decide whether testing makes sense, and recommend food-first strategies or a supplement if genuinely needed. Some supplements can interact with medications, so do not add one without checking.
Should I stop taking Polymyxin B , Neomycin?
No — never stop a prescribed medication because of a nutrient association. Polymyxin B , Neomycin is prescribed for good reasons, and nutrient considerations are usually manageable with monitoring or diet. Any change to your medication belongs in a conversation with your prescriber.
Where does this information come from?
The depletion records come from the Natural Medicines (Therapeutic Research Center) database — an evidence-graded clinical reference — and are displayed as published, with their citations. The plain-English context is written and reviewed by licensed HelloPharmacist pharmacists.

Questions about Polymyxin B , Neomycin and your nutrition?

Ask a licensed pharmacist — free, no appointment needed.

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Sources

Sources & How We Checked

Nutrient depletion records for Polymyxin B , Neomycin are evidence-graded and sourced from the Natural Medicines database, and are displayed as published with their citations.

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