Drug-induced nutrient depletion

Tretinoin, Benzoyl Peroxide & Nutrient Depletion

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

1Nutrient association
Moderate DepletionHighest rating
The bottom line

Tretinoin, Benzoyl Peroxide has been associated with depletion of FOLIC ACID. This does not mean a deficiency will occur — it means these are worth knowing about and, if you take Tretinoin, Benzoyl Peroxide long-term, worth raising with your pharmacist or healthcare provider.

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Take more than one medication? Open the checker with Tretinoin, Benzoyl Peroxide pre-loaded and add the rest to see overlapping nutrient signals.

The evidence

Reported nutrient depletions with Tretinoin, Benzoyl Peroxide

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.

FOLIC ACID

Moderate Depletion

RETINOIDS

Retinoids reduce serum folate levels and increase the risk of folate deficiency.

Isotretinoin (Accutane), a retinoid vitamin A derivative, reduces serum levels of folic acid in patients with acne. Advise patients taking isotretinoin to maintain the recommended dietary intake of folic acid. For information on foods that are rich in folate, see our chart.
Taking Tretinoin, Benzoyl Peroxide? Monitor for depletion; a supplement is needed for some patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Folic acid is a B vitamin your body uses to make healthy new cells, including red blood cells, and it plays a key role in DNA repair. Tretinoin belongs to the retinoid family, and research shows that retinoids can lower the amount of folate circulating in your blood, though exactly how is still being studied. With a moderate depletion rating, this is worth paying attention to, especially with longer-term use. Ask your pharmacist or doctor whether your diet is giving you enough folate, or whether a supplement makes sense for you.

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)
  1. Javanbakht AM, Pour HM, Tarrahic MJ. Effects of oral isotretinoin on serum folic acid levels. J Drugs Dermatol. 2012;11(9):e23-4.
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

Tretinoin, Benzoyl Peroxide & nutrients: FAQs

Does Tretinoin, Benzoyl Peroxide deplete FOLIC ACID?
Tretinoin, Benzoyl Peroxide has been associated with lower FOLIC ACID 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 Tretinoin, Benzoyl Peroxide long-term, ask your healthcare provider whether checking your FOLIC ACID status is appropriate.
Should I take a supplement because I take Tretinoin, Benzoyl Peroxide?
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 Tretinoin, Benzoyl Peroxide?
No — never stop a prescribed medication because of a nutrient association. Tretinoin, Benzoyl Peroxide 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 Tretinoin, Benzoyl Peroxide and your nutrition?

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Sources

Sources & How We Checked

Nutrient depletion records for Tretinoin, Benzoyl Peroxide 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.